POLST - Physician Orders for Life-Sustaining Treatment

 The Physician Orders for Life-Sustaining Treatment (POLST) is a program designed to improve the quality of care people receive at the end of life by translating patient/resident goals and preferences into medical orders.  POLST is based on communication between the patient/resident, Health Care Agent or other designated decision-maker and health care professionals that ensures informed medical decision-making.

 POLST in the Inland empire today

• As a major goal for the Coalition for 2006, the IEPCC launched the Physicians Orders for Life Sustaining Treatment POLST Initiative; the first in the State.  Its goal was to have the POLST form to gain universal acceptance in the healthcare community.  The POLST form itself is a sustaining treatment.  Our initiative is a collaborative effort that builds on best practices and knowledge in and outside of California.
• In 2007, the Compassionate Care Coalition awarded the IEPCC a $20,000 grant to implement the POLST form in Riverside and San Bernardino Counties.  The IEPCC was one of six counties to receive a grant for the implementation of the POLST form.  With this funding, our efforts will focus on expanding the use of the POLST form throughout Riverside and San Bernardino Counties.
• Currently, the POLST form is in use at Parkview Community Hospital and Riverside Community Hospital, six area nursing home facilities, and all emergency medical services

 Healthcare Professionals

If you are a healthcare professional or facility and are interested in participating in the POLST initiative, contact us at (951) 686-3342, ext. 306 or iepcc@rcmanet.org

 What is a POLST Form

• The POLST form is a bright pink medical order form signed by a California State Licensed physician that indicates why types of life-sustaining treatment the patient does or does not want if they become seriously ill.  Additionally, a health care professional must sign this form in order for it to be followed by other health care professionals.  Other health professionals who work with the patient’s health care professional may complete the form.  The form includes medical orders and patient preferences regarding;
  • CPR (cardiopulmonary resuscitation)
  • Intubation and mechanical ventilation
  • Artificial hydration and nutrition
  • Future hospitalization and transfer
  • Antibiotics

Obtain a POLST Form - click here to view and print a POLST Form

What advantage does a POLST form offer vs. an Advance Directive?

An advance directive is recommended for ALL adults.  POLST is recommended for people who are in the last year of life.

Advance directives are most useful for designating the person you want to speak for yourself.  They have not been very useful with respect to specific treatment decisions.  Imagining many years in advance whether you’ll want life support under unknown circumstances for an unknown period time has not proven to be helpful.

Because POLST is used with people on a downward disease trajectory that is expected to result in death, POLST translates the person’s broader/more general wishes (as reflected on the advance directive) and operationalizes those wishes given the person’s actual medical condition.

Also, advance directives come in too many shapes and sizes to be useful to emergency responders.  Emergency responders need to make a decision in split second whether to start life support & don’t have time to read through a multi-page document.  Because POLST is standardized and uses clear, consistent language, it is honored / followed by emergency responders.