Elizabeth Wick

August 12, 2024: I CAN DO Surgical ACP Seeks to Open the Door to Team-Based Surgical Care

Posted on by Damon Seils

Few of the 20 million older adults who undergo elective surgical procedures in the United States each year engage in advance care planning. I CAN DO Surgical ACP, an NIH Collaboratory Trial, aims to address this missed opportunity to align older patients’ preferences with their surgical decisions and improve patient-clinician communications.

We spoke with co–principal investigator Elizabeth Wick about the I CAN DO Surgical ACP trial at the NIH Collaboratory’s 2024 Annual Steering Committee Meeting.

“We’re really hoping that our trial will open the door to more team-based care in surgery,” Wick said.

Wick is a professor of surgery and the vice chair of quality and safety in the Department of Surgery at the University of California, San Francisco, and cochair of the department’s research committee.

The I CAN DO Surgical ACP trial will will test a system-based approach to help older adults undergoing elective surgery engage in advance care planning. Another goal of the study is to understand digital engagement, language, and social drivers of health that drive engagement in the intervention. The study is supported by the National Institute on Aging.

Learn more about I CAN DO Surgical ACP.

August 30, 2023: NIH Pragmatic Trials Collaboratory Welcomes New NIH Collaboratory Trial: I CAN DO Surgical ACP

Posted on by Lauren Stewart

Headshots of Drs. Elizabeth Wick, Genevieve Melton-Meaux, and Rebecca SudoreWe are excited to welcome I CAN DO Surgical ACP (Improving Completion, Accuracy, and Dissemination of Surgical Advanced Care Planning) to our portfolio of innovative NIH Collaboratory Trials. This project is supported within the NIH Pragmatic Trials Collaboratory by a grant from the National Institute on Aging (NIA).

Despite advance care planning (ACP) being incorporated into national quality metrics and society guidelines for surgical care for older adults, effective integration of ACP into the presurgical phase remains uncommon. Efforts to date have mostly focused on improving surgeons' use of ACP, but barriers remain significant, including lack of ACP familiarity, lack of appropriate patient-facing ACP tools, and lack of time dedicated to conversations around ACP during the presurgical period.

The I CAN DO Surgical ACP team has designed and tested a theory-based, interactive ACP patient-facing technology solution (PREPARE) based on the new ACP paradigm of preparing people for communication and medical decision-making. By including PREPARE in the electronic health record presurgery workflow for older adults and including automated reminders, the team expects that they can empower patients and surgical teams to engage in ACP discussions. The results of this study are the first step in ensuring optimal and patient-aligned medical decisions and communications for older adults undergoing surgery.

Dr. Elizabeth Wick, Dr. Genevieve Melton-Meaux, and Dr. Rebecca Sudore will serve as the co–principal investigators for I CAN DO Surgical ACP. Dr. Wick is a colorectal surgeon at the University of California, San Francisco Medical Center. Dr. Melton-Meaux is a professor of surgery, the senior associate dean of health informatics and data science, and the director of the Center for Learning Health System Sciences in the Institute for Health Informatics at the University of Minnesota. Dr. Sudore is a professor of medicine, the director of the Innovation and Implementation Center in Aging and Palliative Care, and a geriatrician at the University of California, San Francisco.

This new NIH Collaboratory Trial is the third trial in the NIH Collaboratory portfolio to study an intervention designed to improve ACP, following PROVEN and ACP PEACE.