Increasing Advance Care Planning Using a Surgical Optimization Program for Older Adults

Objectives To describe an innovative model of care, the Surgery Wellness Program (SWP), that uses a multidisciplinary team to develop and implement preoperative care plans for older adults, and its effect on engagement in advance care planning (ACP). Design Retrospective analysis of clinical demonstration project. Setting Preoperative optimization program for older adults undergoing surgery at a 796‐bed academic tertiary hospital. Participants Older adults (N=131) who participated in the SWP from February 2015 to August 2017. Intervention All SWP participants met with a geriatrician who engaged them in a semistructured ACP discussion. Trained medical and nurse practitioner students were used as health coaches who contacted participants regularly to address and document ACP. Measurements Self‐report of ACP engagement before and after participation in the SWP was determined using SWP geriatrician and health coach progress notes. Medical records were examined for scanned documentation. Feasibility data on number of health coach calls were collected. Results After completion of the program, the proportion of participants with a designated surrogate increased from 67% to 78% (p