Document ensures directions are followed
The Physician Orders for Life-Sustaining Treatment (POLST) form has been in use in Oregon since 1995, four years after the initiative was begun in the state. Since 1995, some form of the POLST program has been adopted in more than 30 states.
"Each state differs in the level of implementation, but it is encouraging to see a document that is actionable and ensures the respect of the patient's wishes reaching so many people," says Deborah Jaques, executive director of the Oregon Hospice Association in Portland. Although POLST has been in use for a long time in Oregon, changes have been made to improve upon the program, she says.
"Our POLST is a bright pink form that is easily found in any medical chart," Jaques points out.
Patients who are in their homes when an emergency medical technician (EMT) is called or who enter the emergency department unexpectedly, also have ways to alert health care providers to their wishes, even if they are not able to communicate, Jaques says. "The refrigerator is the most common place to post the POLST, so EMTs know to look there for a POLST," she says. "We also distribute wallet cards for patients to keep with them."
Beginning January 2010, all Oregon residents with a POLST will have the option of including their document on a statewide database that can be accessed by any first responder, says Jaques. "This will make it possible for an emergency room physician or an EMT to look up the information even if the form is not available," she adds.
In La Crosse, WI, the POLST also is a key component of the communitywide program to promote advance health care planning, says Bernard "Bud" Hammes, PhD, ethics consultant, director of medical humanities, and director of Respecting Choices, Gundersen Lutheran Medical Foundation, La Crosse. First responders in the city also have access to all POLST documents because the two health systems in the area have sophisticated electronic medical records systems that enabled the development of a database that provides access to health care providers, no matter which health system with which they are affiliated. "If we are trying to respect a patient's wishes, we have to make sure that all health care providers will know what those wishes are," he says.
Need More Information?
For more information about incorporating Physician Orders for Life-Sustaining Treatment (POLST) into advance care planning in your community or agency, go to www.polst.org. The web site has information on how to set up a program, educational materials, and resources for legal, regulatory, and clinical issues. Educational materials and resources such as POLST forms and wallet cards used by different states are available for purchase as well.
The Physician Orders for Life-Sustaining Treatment (POLST) form has been in use in Oregon since 1995, four years after the initiative was begun in the state. Since 1995, some form of the POLST program has been adopted in more than 30 states.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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