Using the Perspectives of Advanced Practice Providers to Design Strategies to Increase Engagement of Surgical Patients in Advance Care Planning
Objective:. Advanced practice providers (APPs) are essential members of surgical teams. We sought to understand the barriers and facilitators they perceive when participating in advanced care planning (ACP) discussions with patients and use this knowledge to design strategies to promote interprofess...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2025-03-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000506 |
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| author | Christopher L. Johnson, MA Katherine E. Barnes, BS Alexis Colley, MD, MS Jeanette Broering, PhD, MPH, RN Alisa Yee, MSN Tasce Bongiovanni, MD, MPP Sanziana Roman, MD Elizabeth C. Wick, MD |
| author_facet | Christopher L. Johnson, MA Katherine E. Barnes, BS Alexis Colley, MD, MS Jeanette Broering, PhD, MPH, RN Alisa Yee, MSN Tasce Bongiovanni, MD, MPP Sanziana Roman, MD Elizabeth C. Wick, MD |
| author_sort | Christopher L. Johnson, MA |
| collection | DOAJ |
| description | Objective:. Advanced practice providers (APPs) are essential members of surgical teams. We sought to understand the barriers and facilitators they perceive when participating in advanced care planning (ACP) discussions with patients and use this knowledge to design strategies to promote interprofessional ACP uptake for surgical services and potentially extend ACP discussions and documentation to more patients.
Background:. ACP has been challenging to integrate into surgical practice despite being endorsed by national societies and payors as an essential aspect of caring for older adults.
Methods:. Using qualitative and quantitative methods, we surveyed and interviewed APPs at a single tertiary academic medical center. A previously validated Likert scale survey of clinician knowledge, attitudes, and experiences with ACP was adapted to include demographic information and details about practice experience.
Results:. Of the 88 APPs who were sent our surveys, 46 (52%) responded. Eighty-eight percent of respondents believed APPs play an important role in ACP discussions, 80% believed that ACP information was helpful in guiding clinical care discussions, 71% expressed comfort with discussing ACP with patients, and 59% endorsed comfort with communicating a prognosis to patients. Twelve interviews yielded 3 main themes: (1) clinical and professional benefits of ACP; (2) barriers to APP involvement in ACP; (3) proposed interventions to integrate APPs into ACP.
Conclusions:. To increase surgical ACP uptake by APPs, data on proposed ACP interventions must focus on establishing a multi-disciplinary team-based workflow, addressing competing clinical demands, opportunities for additional education, and clarifying the scope of work. |
| format | Article |
| id | doaj-art-4cffc6d11e2f41e2905a76566a448528 |
| institution | DOAJ |
| issn | 2691-3593 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-4cffc6d11e2f41e2905a76566a4485282025-08-20T02:42:08ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932025-03-0161e50610.1097/AS9.0000000000000506202503000-00001Using the Perspectives of Advanced Practice Providers to Design Strategies to Increase Engagement of Surgical Patients in Advance Care PlanningChristopher L. Johnson, MA0Katherine E. Barnes, BS1Alexis Colley, MD, MS2Jeanette Broering, PhD, MPH, RN3Alisa Yee, MSN4Tasce Bongiovanni, MD, MPP5Sanziana Roman, MD6Elizabeth C. Wick, MD7* UCSF School of Medicine, San Francisco, CA* UCSF School of Medicine, San Francisco, CA* UCSF School of Medicine, San Francisco, CA* UCSF School of Medicine, San Francisco, CA† UCSF Health, San Francisco CA* UCSF School of Medicine, San Francisco, CA* UCSF School of Medicine, San Francisco, CA* UCSF School of Medicine, San Francisco, CAObjective:. Advanced practice providers (APPs) are essential members of surgical teams. We sought to understand the barriers and facilitators they perceive when participating in advanced care planning (ACP) discussions with patients and use this knowledge to design strategies to promote interprofessional ACP uptake for surgical services and potentially extend ACP discussions and documentation to more patients. Background:. ACP has been challenging to integrate into surgical practice despite being endorsed by national societies and payors as an essential aspect of caring for older adults. Methods:. Using qualitative and quantitative methods, we surveyed and interviewed APPs at a single tertiary academic medical center. A previously validated Likert scale survey of clinician knowledge, attitudes, and experiences with ACP was adapted to include demographic information and details about practice experience. Results:. Of the 88 APPs who were sent our surveys, 46 (52%) responded. Eighty-eight percent of respondents believed APPs play an important role in ACP discussions, 80% believed that ACP information was helpful in guiding clinical care discussions, 71% expressed comfort with discussing ACP with patients, and 59% endorsed comfort with communicating a prognosis to patients. Twelve interviews yielded 3 main themes: (1) clinical and professional benefits of ACP; (2) barriers to APP involvement in ACP; (3) proposed interventions to integrate APPs into ACP. Conclusions:. To increase surgical ACP uptake by APPs, data on proposed ACP interventions must focus on establishing a multi-disciplinary team-based workflow, addressing competing clinical demands, opportunities for additional education, and clarifying the scope of work.http://journals.lww.com/10.1097/AS9.0000000000000506 |
| spellingShingle | Christopher L. Johnson, MA Katherine E. Barnes, BS Alexis Colley, MD, MS Jeanette Broering, PhD, MPH, RN Alisa Yee, MSN Tasce Bongiovanni, MD, MPP Sanziana Roman, MD Elizabeth C. Wick, MD Using the Perspectives of Advanced Practice Providers to Design Strategies to Increase Engagement of Surgical Patients in Advance Care Planning Annals of Surgery Open |
| title | Using the Perspectives of Advanced Practice Providers to Design Strategies to Increase Engagement of Surgical Patients in Advance Care Planning |
| title_full | Using the Perspectives of Advanced Practice Providers to Design Strategies to Increase Engagement of Surgical Patients in Advance Care Planning |
| title_fullStr | Using the Perspectives of Advanced Practice Providers to Design Strategies to Increase Engagement of Surgical Patients in Advance Care Planning |
| title_full_unstemmed | Using the Perspectives of Advanced Practice Providers to Design Strategies to Increase Engagement of Surgical Patients in Advance Care Planning |
| title_short | Using the Perspectives of Advanced Practice Providers to Design Strategies to Increase Engagement of Surgical Patients in Advance Care Planning |
| title_sort | using the perspectives of advanced practice providers to design strategies to increase engagement of surgical patients in advance care planning |
| url | http://journals.lww.com/10.1097/AS9.0000000000000506 |
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