RESOURCES FOR HEALTHCARE PROVIDERS
In Illinois, "POLST" is a national movement, implemented at the state level, that supports patient autonomy regarding treatment preferences during a medical emergency. As a healthcare 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.
Guidance Document for HealthCare Professionals
OVERVIEW
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. A patient may choose NOT to complete a POLST form, and they will receive full treatment including CPR and mechanical ventilation by default.
POLST is designed to:
- Help healthcare 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 first responders and EMS personnel.
The POLST form is intended to be completed after patients and their healthcare 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, and an attending physician. The completed form is an actionable medical order.
- Healthcare 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.
