What is POLST: History of the POLST paradigm:
POLST or Physician Orders for Life Sustaining Treatment was developed in the late 1970's in Oregon in an effort to improve advanced care planning by engaging patients with serious illness and/or frailty in shared decision making. The National POLST Paradigm began in 2004 to help as many states began adopting this approach. The name of the approach and form have varied from state to state because it must work in conjunction with the advance care planning laws of the individual state. For example in New York it is called MOLST standing for Medical Orders for Life Sustaining Treatment, in Iowa it is called I-POST which stands for Iowa Physician Orders for Scope of Treatment. In Texas, Medical Orders for Scope of Treatment or MOST was chosen as it seemed to mesh well with our advance directive rules and regulations. The main tenants of this approach are:
(i) advance care planning conversations between patients, health care professionals and loved ones;
(ii) shared decision-making between a patient and his/her health care professional about the treatment the patient would and would not like to receive at the end of his/her life; and
(iii) ensuring patient wishes are honored.
As a result of these conversations, patient treatment wishes may be documented on a POLST Form, which translates the shared decisions into actionable medical orders. The POLST Form assures patients that health care professionals will provide only the treatments that patients themselves wish to receive, and not the treatments they wish to avoid. The goal is for this order set to follow the patient to any setting they may be in and to be honored.
MOST: A POLST type form consistent with Texas state laws
Medical Orders for Scope of Treatment (MOST):
Medical Order for Scope of Treatment (click here for form) is a way to capture the wishes of a patient as they face serious advancing illnesses and allow those wishes to determine the care the patient wants.
The conversation supporting completion of a MOST form is only for patients who are terminal with advanced illnesses or for whom their physician would not be surprised if they died in the next 12 months. The conversation is an effort to focus on what level of treatment the patient wants based on their current conditions and to engage the patient in shared decision making with their physician.
This document puts the advance directive into action by translating the patient’s treatment wishes into a medical order, centralizing information, facilitating record keeping, and ensuring transfer of appropriate information among healthcare professionals and across care settings.
POLST or Physician Orders for Life Sustaining Treatment was developed in the late 1970's in Oregon in an effort to improve advanced care planning by engaging patients with serious illness and/or frailty in shared decision making. The National POLST Paradigm began in 2004 to help as many states began adopting this approach. The name of the approach and form have varied from state to state because it must work in conjunction with the advance care planning laws of the individual state. For example in New York it is called MOLST standing for Medical Orders for Life Sustaining Treatment, in Iowa it is called I-POST which stands for Iowa Physician Orders for Scope of Treatment. In Texas, Medical Orders for Scope of Treatment or MOST was chosen as it seemed to mesh well with our advance directive rules and regulations. The main tenants of this approach are:
(i) advance care planning conversations between patients, health care professionals and loved ones;
(ii) shared decision-making between a patient and his/her health care professional about the treatment the patient would and would not like to receive at the end of his/her life; and
(iii) ensuring patient wishes are honored.
As a result of these conversations, patient treatment wishes may be documented on a POLST Form, which translates the shared decisions into actionable medical orders. The POLST Form assures patients that health care professionals will provide only the treatments that patients themselves wish to receive, and not the treatments they wish to avoid. The goal is for this order set to follow the patient to any setting they may be in and to be honored.
MOST: A POLST type form consistent with Texas state laws
Medical Orders for Scope of Treatment (MOST):
Medical Order for Scope of Treatment (click here for form) is a way to capture the wishes of a patient as they face serious advancing illnesses and allow those wishes to determine the care the patient wants.
The conversation supporting completion of a MOST form is only for patients who are terminal with advanced illnesses or for whom their physician would not be surprised if they died in the next 12 months. The conversation is an effort to focus on what level of treatment the patient wants based on their current conditions and to engage the patient in shared decision making with their physician.
This document puts the advance directive into action by translating the patient’s treatment wishes into a medical order, centralizing information, facilitating record keeping, and ensuring transfer of appropriate information among healthcare professionals and across care settings.
