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The National POLST Paradigm helps ensure an informed medical plan, shaped by the values and goals of the seriously ill or frail individual, is developed for anticipated medical emergencies based on their current medical condition. The POLST Paradigm emphasizes eliciting, discussing, documenting, and honoring a person’s wishes for the treatment they receive during medical crisis. Today, all 50 states and Washington DC have a POLST program (although they vary in level of implementation).
POLST forms are not the same as advance directives. An advance directive is a mechanism for naming a health care agent, surrogate, or durable power of attorney, along with outlining general treatment wishes. However, even if a patient has completed an advance directive, in the event of a medical emergency, emergency personnel are legally required to attempt everything possible to save the person’s life, including performing CPR and ventilating.
People who are seriously ill or frail may not want that level of treatment.
In contrast to an advance directive, a POLST form is an actionable, portable medical order designed to let the patient communicate what treatments he/she wanted to receive during a medical emergency to health care providers. After a conversation regarding diagnosis, prognosis, treatment options, goals of care, based on shared decision-making with the patient, the provider completes a POLST form. This form serves as an immediately available and recognizable order set in a standardized format to aid emergency personnel and help ensure unwanted treatment is never provided.
It is important to note that the National POLST Paradigm is not for everyone, but rather for those with either serious illness or frailty whose health care professionals wouldn’t be surprised if they died within a year. For healthier patients, advance directives remain the appropriate tool for making end-of-life wishes known.
For more information about the National POLST Paradigm, click here.