How POLST first started
In 1991 leading medical ethicists in Oregon discovered that patient preferences for end-of-life care were not consistently honored. Recognizing that advance directives were inadequate for the patients with serious illness or frailty — who frequently require emergency medical care — a group of stakeholders developed a new tool for honoring patients’ wishes for end-of-life treatment. After several years of evaluation, the program became known as Physician Orders for Life-Sustaining Treatment (POLST).
Development of National POLST
Led by Advisory Panel and then Task Force
In September 2004 the National POLST Advisory Panel, later known as the National POLST Paradigm Task Force, convened to establish quality standards for POLST forms and programs and to assist states in developing POLST as a model process (or “paradigm”). At that time only six states had POLST programs: New York, Oregon, Pennsylvania, Washington, West Virginia and Wisconsin. Leaders from those states, some of whom had been developing their POLST programs in their respective states for almost 10 years, served as original members along with several consultants who advised on topics critical to the development of the POLST Paradigm.
New governance structure formed 2017
The National POLST Paradigm Task Force was replaced with a new governance structure in 2017. The new governance structure is designed to encourage more participation, from all 50 states, in decision making at the national level. POLST is defined as a “portable medical order” (we no longer use POLST as an acronym). Learn more about the evolution of the name and logo of National POLST.
The National POLST Office
The National POLST Office supports the activities of National POLST and serves as a resource to all POLST programs. Originally housed at the Oregon Health & Science University (OHSU) Center for Ethics in Health Care, the National Office left OHSU in January 2017. National POLST is a project of Tides and is based in Washington DC.