• Jared Chiarchiaro, Natalie C Ernecoff, Praewpannarai Buddadhumaruk, Kimberly J Rak, Robert M Arnold, and Douglas B White.
• Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh PA; Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, University of Pittsburgh, Pittsburgh, PA. Electronic address: chiarchiaroj@upmc.edu.
• J Crit Care. 2015 Dec 1; 30 (6): 1418.e7-1418.e12.

PurposeThere is a paucity of scalable advance care planning strategies that achieve the diverse goals of patients, families, and clinicians. We convened key stakeholders to gain their perspectives on developing a Web-based advance care planning tool for lung disease.Materials And MethodsWe conducted semistructured interviews with 50 stakeholders: 21 patients with lung disease, 18 surrogates, and 11 clinicians. Interviews explored stakeholders' desired content and design features of a Web-based advance care planning tool. Participants also rated the tool's acceptability and potential usefulness. We analyzed the interviews with modified grounded theory and validated themes through member checking.ResultsStakeholders highly rated the acceptability (median, 5; interquartile range, 5-5) and potential usefulness (median, 5; interquartile range, 4-5) of a Web-based tool. Interviewees offered several suggestions: (1) use videos of medical scenarios and patient narratives rather than text, (2) include interactive content, and (3) allow the user control over how much they complete in 1 sitting. Participants identified challenges and potential solutions, such as how to manage the emotional difficulty of thinking about death and accommodate low computer literacy users.ConclusionsThere is strong stakeholder support for the development of a Web-based advance care planning tool for lung disease.Copyright © 2015 Elsevier Inc. All rights reserved.

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