POLST was passed by our Illinois General Assembly in 2012 to improve the Illinois DNR Advanced Directive form. POLST is a process that includes shared decision making by health care professionals and their patients. POLST is a binding provider order. POLST is about patient self-determination to advocate for themselves regarding their most personal wishes regarding their end of life experience and is an act of autonomy, control and dignity which is driven by their own personal decisions.
In 2014, the Illinois State Medical Society introduced SB3076 which was enacted into law in August, 2014. Briefly, this law:
- Expands the types of health care professionals, in addition to physicians, who may execute the POLST form to include advanced practice nurses, physician assistants, and medical residents after their initial year of experience. The legislation clarifies that the health care professional who “is selected by or assigned to the patient; and has primary responsibility treatment and care of the patient” may be the practitioner who completes the POLST order. Appropriately, the measure changes the changes the “P” in POLST from “Physician” to “Practitioner, so the acronym stands for “Practitioner Orders for Life-Sustaining Treatment.”
- Addressed undue confusion and a significant patient care issue created by how the IDPH drafted the initial POLST form. By placing a border on the initial form that boldly repeats the phrase UNIFORM DNR ADVANCE DIRECTIVE, individuals who check that they wish to have CPR or other life-sustaining care may have had that choice overlooked. This law calls for the IDPH to redraft the form and specifies that the revised form “may be referred to as the Department of Public Health Uniform DNR/POLST form.”
More recent legislation passed in 2015, PA 099-0319, has further revised the form. In January, 2016 the form will be called “Illinois Department of Public Health Uniform Practitioner Orders for Life Sustaining Treatment (POLST) Form”. The DNR is being removed from the title and the border to reduce confusion.
POLST Illinois will continue to work closely with IDPH in revising the form, “to be in compliance with national standards to be considered a practitioner order for life sustaining treatment (POLST) form.”