We 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.