POLST in Oregon

Oregon is unaffiliated at this time, due to a difference of opinion about National POLST’s Conflict of Interest Policy that allowed—in highly vetted circumstances—the ability to accept industry funding. National POLST’s policy is a commitment to transparency and inclusion for considering partnerships with those supporting its mission, vision and essential values and who are interested in helping people have access to quality POLST programs. National agrees with Oregon POLST that the purpose of POLST is to elicit, document and honor patient treatment wishes and that reducing costs is not a purpose of the form, and that patient participation in POLST must be voluntary.

POLST Registry 

Currently, four states provide a centralized POLST registry and about 16 states are actively working on the development of one. Pennsylvania is now among those who are doing so. 

The Pennsylvania Patient and Provider Network or P3N, under the auspices of the Pennsylvania Department of Human Services, facilitates the secure sharing of patient information across a larger geographic area. While in the early stage, going forward, P3N can provide the capability for an Advance Care Directive and POLST registry where information will be uploaded and accessed securely through a Health Information Exchange.  

Updates will be provided as progress occurs.  

POLST Training Program 

The POLST training program has been presented in numerous areas of the state since 2014. We recognize the POLST Task Force for NEPA for having presented the course, under the direction of Dr. Rob Yanoshak, for the 13^th time this month.

The course was recently presented in Pittsburgh by the Jewish Healthcare Foundation. In the below picture, Libby Moore, LSW DHCE, is leading a discussion on “How to Have a POLST Discussion”. 

POLST Best Practice 

Verbal Orders

A health care practitioner's verbal order for a POLST is effective from the date given without countersignature until the expiration of the period of countersignature if all of the following requirements are met:

1. The order is entered for a patient receiving care from a health care facility.
2. The order is documented on the POLST form and countersigned by the health care practitioner in accordance with any applicable laws and regulations governing the health care facility, including but not limited to a timeframe in which the order must be countersigned.
3. No law or regulation governing the health care facility establishes a time limit in which the order must be countersigned, and the order is countersigned by the health care practitioner within seven days.

Verbal Consent

A surrogate decision maker's verbal consent for a POLST is effective on the date all the following requirements are satisfied:

1. Obtaining the signature of the surrogate decision maker is not feasible in a timely manner.
2. The consent is documented on the POLST form by the health care facility in accordance with its policies and procedures.
3. The signature of the surrogate decision maker is obtained as soon as feasible.

POLST Form

 There has been a minor modification to the 2nd page of the POLST form. The 2010 form, approved by the PA Department of Health, did not list the two websites where both the English and Spanish versions of POLST forms can be downloaded, www.PAPOLST.org and www.upmc.com/services/aginginstitute/partnerships-and-collaborations/polst.

Users should download and print the form on Pulsar Pink stock (#65). While the form now has a 2018 date at the bottom on both sides, 2010 forms continue to be valid.  

POLST Website and New Video

Remember to go to our POLST website for information on POLST and to view the new video, “The Second Conversation: How to talk with a Patient who has a POLST “, www.PAPOLST.org and www.upmc.com/services/aginginstitute/partnerships-and-collaborations/polst.

Thank you for your continuing support of POLST.

Judith Black, MD, MHA

National POLST Paradigm Leadership Council

Jewish Healthcare Foundation Medical Advisor

blackjs352@gmail.com

Marian Kemp

POLST Coordinator

Coalition for Quality at the End of Life (CQEL)

PAPOLST@verizon.net

Coalition for Quality at the End of Life (CQEL)

Jewish Healthcare Foundation

Centre City Tower, Suite 2400

650 Smithfield Street

Pittsburgh, PA 15222

412-594-2550

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