Using the POLST Paradigm to Honor Patient Wishes Across the Care Continuum: Presenting a Comprehensive Toolkit Designed to Help Health Care Professionals and Facilities Implement the POLST Paradigm (FR431)

Abstract

•Review advance care planning and define the differences between advance directives and the POLST Paradigm.•Identify challenges to POLST Paradigm implementation in nursing home, hospice, primary care offices and hospitals.•Illustrate appropriate clinician training, public education, policies and procedures in nursing homes, hospice and primary care offices to ensure patient POLST Paradigm orders are elicited, known and honored. A key recommendation from the Institute of Medicine’s (IOM) Report Dying in America is to “encourage states to develop and implement a Physician Orders for Life-Sustaining Treatment (POLST) paradigm program in accordance with nationally standardized core requirements.” The National POLST Paradigm sets those core requirements and works to ensure that individuals with serious advanced illness or frailty not only have access to POLST Paradigm forms but to professionals who understand the value of POLST and are trained to have meaningful goals of care conversations to elicit and document patient treatment wishes properly on a POLST Paradigm form, as well as professionals who will honor them. Since its inception in 1994, the POLST Paradigm has grown exponentially and now exists, at some level, in 49 states, creating an intense need for education and resources to help facilities and professionals appropriately use POLST Paradigm Forms. Used appropriately, these actionable medical order forms potentially avoid unwanted hospitalizations and emergency department visits and achieves the triple aim. Patients have peace of mind that their wishes are known and will be honored during a medical emergency. In this concurrent session, a toolkit created in partnership with the Pew Charitable Trusts will be presented. Using POLST to Honor Patient Wishes Across the Care Continuum will help facilities implement the Paradigm by addressing the needs of specific patient populations and professionals in primary care offices, hospitals, nursing homes and hospice facilities. In addition to educating about the benefits and value of the POLST Paradigm (including how it differs and complements advance directives as well as how it fits within advance care planning), the toolkit provides setting-specific resources for POLST Paradigm implementation to address the specific needs of implementing POLST in different types of care facilities.