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End of Life Care Manual

 

 

 

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Intro | A 

Section 6 - The POLST Program: A Simple Approach to Communicating Your Patient's Medical Care Decisions

When it comes time to determine what type of care an individual wants ordered by her or his physician in preparation for possible life-threatening medical events, there is often a tremendous amount of effort and emotion. The Physician Orders for Life-Sustaining Treatment (POLST) form is a tool for streamlining this process and ensuring a patient's end of life care decisions are made known to health care providers, family members and emergency personnel.

Washington state agencies and associations support the POLST form and it has been used successfully in Oregon state for over five years. Both the Washington State Department of Health (DOH) and the Washington State Department of Social and Health Services (DSHS) support the POLST form. The Washington State Medical Association's Patient Awareness and Community Education Program provided a grant backing the program during its introduction in our state. The POLST form is endorse by the Washington State Medical Association, Washington State Hospital Association and the Association of Washington Public Hospital Districts endorse the POLST form.

Initially, the POLST form was introduced in Washington state as a DOH sponsored pilot project in Spokane and Whitman counties. Participating hospitals and nursing homes adopted the POLST form and reported that it was used successfully and was met with positive feedback from health care providers. Policies and procedures for using the POLST form were in-serviced to EMS personnel, hospitals, nursing homes, and home nursing staff during the pilot project.

At this stage, DOH will authorize the POLST form's use in any Washington county that would like to use it. DSHS supports the POLST form in nursing homes. For an example of a DSHS approved POLST implementation policy, please see the policy from St. Joseph Care Center included in these materials.

The POLST form is a simple and straightforward two-sided form that asks relatively brief questions regarding the type of care a patient wants in the event of an emergency or during the final stages of life.

The POLST form is not an advance directive. It is actually a physician order form that requires the signature of both the physician and the patient or the patient's legal surrogate. The POLST form may complement an advance directive.

The form is appropriate for any patient, but especially for anyone who is a "No Code," "DNR," or has orders limiting medical interventions. Also, doctors who foresee a possibility their patient may not live through the year based on the patients medical condition should recommend a POLST form be filled out. The form should accompany the patient during a transfer - for example, to a hospice, home, or nursing home.

The pilot project demonstrated that EMS personnel could easily recognize and follow the physician orders outlined on the POLST form. One obstacle both health care providers and emergency personnel encountered during the pilot project was POLST forms that lacked either a doctor or patient (or the patient's legal surrogate) signature. This problem was handled by allowing a faxed signature to act as a substitute by stapling it to the form as an addendum.

Following this introduction are materials intended to assist your facility with implementing the POLST form. Included in this section are the following:

  • Introductory sheets on the POLST form;
  • The DSHS approved policy and procedures guidelines for implementing the POLST forming in nursing homes (developed by St. Joseph Care Center);
  • Guidelines for nurses (developed by Sacred Heart Medical Center); and
  • The POLST form.

The POLST form included in this section may be photocopied and used as is. We encourage you to use the same lime green color, as it will satisfy both DOH and emergency personnel. The bright color also increases the form's visibility, facilitating its use and transfer with the patient. Cardstock may be used, but it will hamper faxing.

You may obtain more information by contacting Dr. Jim Shaw at the Providence Center for Faith and Healing, (509) 474-3008.



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