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Improving Preoperative Completion of Advanced Care Planning Documents in Patients With Expected Postoperative Intensive Care Unit Stay

Urman, Richard D. MD, MBA*; Gross, Caroline S. MD; Sadovnikoff, Nicholas MD, FCCM; Bader, Angela M. MD, MPH*

doi: 10.1213/XAA.0000000000000993

Directed discussion about advanced care planning in the preoperative setting is often lacking. We implemented an educational intervention pilot to increase the number of high-risk patients who have health care proxy and advanced directives documents completed. We developed a novel short video describing the advanced care planning process and the intensive care setting, encouraging patients to have conversations about advanced care planning. Survey results showed that majority of patients felt the intervention increased their knowledge about advanced care planning (65%–70%) and that the video raised some topics worth discussing with family and health care providers. This intervention is scalable and could improve documentation and quality of care.

From the *Department of Anesthesiology, Perioperative Medicine and Pain Medicine, Brigham Health, Boston, Massachusetts

Division of Critical Care Medicine, Department of Anesthesiology, Perioperative Medicine and Pain Medicine, Brigham Health, Boston, Massachusetts.

Accepted for publication January 29, 2019.

Funding: Supported by Brigham Care Redesign Incubator and Startup Program (BCRISP) grant, Brigham and Women’s Hospital, Boston, Massachusetts.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal’s website.

IRB: Approved by Partners Institutional Review Board.

Address correspondence to Richard D. Urman, MD, MBA, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. Address e-mail to

Copyright © 2019 International Anesthesia Research Society
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