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POLST Form

The form below is a Physician Order for Life Sustaining Treatment. It is based upon the form used in Oregon. It has been field tested in Cambridge Minnesota. We are seeking feedback from interested parties. Feedback received by January 15, 2009 will be used to update this form. It will then be reviewed and (hopefully) endorsed by organizations such as the Minnesota Emergency Medical Services Board, the Minnesota Medical Association, Hospice Minnesota, the Minnesota Medical Directors Association and the Minnesota Leadership Council on Aging.

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To comment: click on Comments (below). Unless requested, all comments will be posted for public viewing.

For more information about POLST, see www.polst.org

This site was created by Edward Ratner, MD, Associate Professor, University of Minnesota ratne001@umn.edu

Comments

It is easy to post. Looking forward to your input.

The explanatory statement that a comfort patient should not be transported to a Level 1 trauma facility makes sense in a rural community, but for statewide use I suggest "For comfort care: Transport to preferred local or nearest hospital, rather than distant tertiary care facility"

I am pretty familiar with Polst but have not used it in our practice. We write our own advance care plans as individualized physician orders after some training in how to do it effectively. My only constructive ideas are; 1. Fracture management could be addressed more actively rather than passively. There are a significant number of late stage patients whom choose non-operative management of fractures including hip fractures and I favor giving that option in a more active fashion. If comfort is not able to be acheived via non-operative efforts, then clearly a new course will be charted. These orders strike me as being most useful at the time of the acute event and may not be very effective for chronic care decisions. Likewise, nobody has a feeding tube urgently placed in their home, nursing home, ALF, or even in the ER. Feeding tubes are chronic care decisions so the section on artificial nutrition and hydration should be limited to real life rescue therapies like IV hydration and blood products. Over all though, it is a step in the right direction. Thanks Ed. Nick Schneeman MD

Hospice Minnesota Board of Directors strongly support the use of the POLST form in Minnesota and will assist in achieving that goal.

Minnesota's Area Agencies on Agign look forward to receiving information about POLST as related to our work with older persons and family caregivers via the Senior LinkAge Line.