POLST CaliforniaBy the POLST Physician Leadership Council
The POLST Physician Leadership Council is a group of California physicians representing multiple specialties who collaborate on POLST education and tools for healthcare professionals, patients, their families and others.


The new POLST form goes into effect on Wednesday, October 1, 2014.

Here is everything a healthcare provider needs to know about implementing the new form.

EFFECTIVE DATE

  • California’s revised Physician Orders for Life-Sustaining Treatment (POLST) form goes into effect on October 1, 2014.
  • Previous versions of POLST will still be honored after the 2014 form goes into effect.

INSTRUCTIONS

  • Begin using the revised POLST form on October 1, 2014, and discard old blank forms.
  • It is ideal to complete a 2014 version of POLST—and void older versions of the form—when a patient’s POLST is updated with changes to its contents.

KEY CHANGES TO THE FORM

  • In order to be consistent with Section A, treatment choices for Sections B and C have been switched in their order, and each section begins with the most aggressive and invasive treatment choices.
  • In Section B, the choice of “Limited Additional Interventions” has been renamed to “Selective Treatment,” and the choice of “Comfort Measures Only” has been renamed to “Comfort-Focused Treatment.”
  • Goal statements have been added for each treatment choice in Section B. These descriptions help patients understand the goals of care within each option, and aim to promote quality conversations with a patient and/or legally recognized decisionmaker.
  • The goal statements are as follows:
    • Full Treatment – primary goal of prolonging life by all medically effective means.
    • Selective Treatment – goal of treating medical conditions while avoiding burdensome measures.
    • Comfort-Focused Treatment – primary goal of maximizing comfort.
  • In Section B, the Full Treatment option features a box which can be marked to indicate: “Trial Period of Full Treatment.” This option is beneficial for patients who want to try short-term ventilatory support but do not want prolonged life support.
  • “Address” was clarified and now reads as “Mailing Address.”
  • The new “Office Use Only” box is in place for internal use only.

REMINDERS

  • POLST is a voluntary form.
  • Previously completed POLST forms remain valid.
  • It is recommended that POLST be copied on pink paper to help ensure that the document stands out and is followed. However, POLST on any color paper is valid.
  • Copies and faxes of POLST are valid.
  • Whenever possible, ensure the Advance Directive and POLST form are consistent with each other.

For more detail on the changes to the California POLST in 2014, watch the POLST Changes webinar presentation on GoToWebinar (length: approximately 1 hour).

Have a question about the implementation of the new POLST form? Contact us.

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