The treatment options are listed more consistently in each section of the form (from most aggressive to least aggressive), so patients can better understand what these choices involve. Earlier this year, the Institute of Medicine released a report focusing on the need for improved end-oflife care. The report, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, found that “improving the quality and availability of medical and social services for patients and their families could not only enhance quality of life through the end of life, but may also contribute to a more sustainable care system.” The report also highlighted the need for all states to develop POLST programs likes the ones that already exist in California and 16 other states. I know from personal experience that patients want end-of-life planning. When I’ve brought up the subject with patients, most have been eager to discuss it. And it doesn’t take a great deal of time. Though advance care planning is a process rather than a single event, I’ve found that patients often already have a good sense of the kind of end-of-life care they want and can begin to effectively express their wishes almost immediately. POLST hasn’t just become an important part of my practice; it has become a standard tool at HealthCare Partners for patients with serious illness and has gained broad acceptance throughout the state. By the beginning of 2012, nearly 95 percent of California hospitals had admitted a patient with a POLST, 65 percent had a formal POLST policy, 87 percent had blank forms available, and 84 percent had educated staff about POLST. Among California nursing home facilities, in 2012 66 percent had a formal POLST policy and 87 percent had educated their staffs about POLST. I’ve seen the benefits of POLST in both my personal life and professional life, and I encourage all medical staff to take the time to have end-oflife conversations with their seriously ill patients. Information on the new POLST form is available at capolst.org/2014polst, including translations in 12
languages and Braille. Physicians should only use the new version of the POLST form, but previous versions will continue to be honored. Healthcare professionals who would like to learn more about POLST can contact the Coalition for Compassionate Care of California (coalitionccc. org) with questions or to arrange training for their colleagues. The Coalition website also lists upcoming education opportunities and local POLST coalitions (coalitionccc.org/who-we-are/localcoalitions). o Please contact Dr. Thomas at JRThomas@ heathcarepartners.com with any questions. HealthCare Partners is a member of CAPG.
Published on Nov 5, 2014
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