An environmental scan of advance care planning decision AIDS for patients undergoing major surgery: a study protocol.
BACKGROUND
Patients who undergo major surgery are at risk for perioperative morbidity and mortality. It would be appropriate to initiate advance care planning with patients prior to surgery, but surgeons may experience difficulty initiating such conversations. Rather than focus on changing clinician behavior, advance care planning decision aids can be an innovative vehicle to motivate advance care planning among surgical patients and their families.


OBJECTIVE
The purpose of this paper is to describe a study protocol for conducting an environmental scan concerning advance care planning decision aids that may be relevant to patients undergoing high-risk surgery.


METHODS
This study will gather information from written or verbal data sources that incorporate professional and lay perspectives: a systematic review, a grey literature review, key informant interviews, and patient and family engagement. It is envisioned that this study will generate three outcomes: a synthesis of current evidence, a summary of gaps in knowledge, and a taxonomy of existing advance care planning decision aids.


CONCLUSIONS
This environmental scan will demonstrate principles of patient-centered outcomes research, and it will exemplify a pioneering approach for reviewing complex interventions. Anticipated limitations are that information will be gathered from a small sample of patients and families, and that potentially relevant information could also be missing from the environmental scan due to the inclusion/exclusion criteria. Outcomes from the environmental scan will inform future patient-centered research to develop and evaluate a new decision aid.
Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, 600 North Wolfe Street, Meyer 297A, Baltimore, MD, 21287-7295, USA, raslaks1@jhmi.edu.
Rebecca A
RA
Aslakson
Anne L R
AL
Schuster
Judith
J
Miller
Matthew
M
Weiss
Angelo E
AE
Volandes
John F P
JF
Bridges
D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology* / Q000601:surgery*; D032722:Advance Care Planning / Q000458:organization & administration*; D003657:Decision Making; D004777:Environment; D006302:Health Services Research; D006801:Humans; D010358:Patient Participation; D018802:Patient-Centered Care / Q000458:organization & administration; D013514:Surgical Procedures, Operative / Q000523:psychology*