What is "POLST"?
"POLST" is a national movement, implemented at the state level, that supports patient autonomy regarding treatment preferences during a medical emergency. The "P" used to mean "Physician" but it means so much more than that:
"P" for Process. The POLST Paradigm is not a form: it is a process. The POLST form is the most visible part, but the process behind its completion is the most important part. The conversation between the patient and his/her health care professional should include the patient’s goals of care considering current diagnosis, prognosis, and treatment options (including risks and benefits of each). The result of the conversation may be the completion of a POLST form—or it may be a first step in the care planning process.
"P" is for Patient. The POLST decision-making process and resulting medical orders are intended for patients who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. Read more about for whom POLST is appropriate.
"P" is for Patient Autonomy. Patients have a right to participate in medical decision-making regarding their treatment plan. Participation in having a POLST form is always voluntary. Read more about the Appropriate Use of POLST.
"P" is for Portable. The POLST form is an immediately available, standardized, recognizable, portable, out-of-hospital medical order set that assists emergency personnel in providing treatments aligned with patient preferences during an emergency.
"P" is for Professional (as in Inter-Professional). The name of the form varies among states. The POLST process can include many professionals. The National POLST Paradigm recommends physicians, advanced practice registered nurses, and physician assistants be permitted to participate in the POLST process and sign POLST forms (read more and see which can sign in each state). Other health care professionals, like social workers and chaplains, may have roles in the process too!
"P" is for Palliative. Palliative care focuses on helping patients improve their quality of life, helping alleviate symptoms, and understand their choices for medical treatment. The POLST process can be part of palliative care.
"P" is for Planning (as in Advance Care Planning). A POLST form is an advance care plan and can support patients towards the end of life. Find out how POLST differs from other advance care plans, like advance directives, here.
"P" is for Program. The National POLST Paradigm is the national entity that provides guidance and support to state POLST programs. From its start, the POLST movement has been a voluntary, collaborative group process. Our policies, guidance and program recognition standards have all been created through group consensus and each state POLST program chooses if they want to participate. We are grateful the vast majority of states believe that, collectively, we can have a greater impact in eliciting, documenting and honoring patient treatment wishes by building the National POLST Paradigm together. Thank you to the states participating in the national governance of the POLST Paradigm!
"P" is for Paradigm. The purpose of this organization has been to shift the focus from health care professionals automatically providing the standard of care to encouraging them to elicit, document and honor what treatments the patient wants to receive.