"POLST" is a national movement, implemented at the state level, that supports patient autonomy regarding treatment preferences during a medical emergency. As a health care provider, you have a critical role in identifying appropriate patients for the POLST model, implementing the POLST conversation process and completing the POLST portable medical order.
POLST stands for “Practitioner Orders for Life
Sustaining Treatment”. A POLST form is a
signed medical order that travels with the patient to assure that a patient’s treatment
preferences are honored across settings of care.
The POLST form is designed to ensure that
seriously ill or frail patients can choose the treatments they want or do not want and that
their wishes are documented and honored.
The POLST decision-making process and resulting medical orders are intended for people of any age who are at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. The POLST form should not be used to limit treatment for patients with chronic, stable
medical or functionally disabling problems who have many years of life expectancy.
POLST is designed to:
Help health care professionals know and honor the life - sustaining treatment wishes of their patients.
Promote patient autonomy by creating medical orders that reflect the patient’s treatment preferences.
Facilitate appropriate treatment by emergency medicine and EMS personnel.
The POLST form is intended to be completed after patients and their health care
professionals/providers discuss together: the patient’s current medical condition(s) and
prognosis; possible causes of deterioration and indicated medical responses/treatments;
the risks, burdens and benefits of those treatments;
and the patient’s own values and goals
for treatment. The discussions are of primary importance to the POLST process as the form
serves as a potential guide for these discussions. Completed forms are a product of the
discussions and are signed by the patient or legal representative, an attending physician,
and a witness. The completed form is an actionable medical order.
Health care professionals and providers are required by law to honor treatment choices shown on a POLST form and are protected from liability if they do so in good faith.
Use of the POLST form is voluntary. This form contains orders that can be revoked or changed at any time by patients or their legal representative.
When a patient’s condition changes significantly, prior decisions about treatment should be revisited and consideration should be given to completing a new, updated POLST form.
Education & Training Tools
TRAINING PRE/POST TEST
The POLST Training Test can be used to confirm that attendees at an educational event have captured information accurately.
demonstration of the POLST conversation
between a practitioner and patient to learn how
physicians elicit detailed answers from patients about their end-of-life treatment choices
for recording on the POLST form. This conversation is the key to making the POLST program work for patients and their
Developed by Coalition for Compassionate Care
The POLST form is
available in English and Spanish. To ensure emergency personnel can understand and follow the orders, it is
recommended that the POLST form be presented in English.
The Spanish version of the form is helpful for educational