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Physician Orders for Life-Sustaining Treatment (POLST)

Physician Orders for Life-Sustaining Treatment (POLST) is a document to help ensure that a patient’s wishes are known and honored toward the end of life. It uses a standardized medical order used to indicate which types of life-sustaining treatment a seriously ill patient wants or doesn’t want if his or her condition worsens.

POLST assists health care providers and patients or their surrogate to develop a transferable care plan of desired interventions when dealing with serious, life-limiting illness. Through focused conversations about preferences for nature and intensity of care, people are able to establish a customized standard of care across care settings. The bright pink card stock form travels with the patient and is legally binding in California when properly dated and signed.

POLST brings clarity around the difficult decisions for end of life care. When used with an advance directive that names a surrogate decision-maker, it helps limit unwanted or medically ineffective care, reduces patient and family suffering, and helps assure that care is delivered in accord with patient preferences.

Use of the POLST form has now expanded to more than 27 states from its origins in Oregon in the early 1990s. In California, the Coalition for Compassionate Care of California is helping to implement POLST through a statewide coalition of stakeholders (hospitals, physician organizations, nursing homes, emergency services, consumers, etc.)and 18 community coalitions including the Sonoma County Coalition for Compassionate Care, a program of the Community Network Journey.

More information about POLST and state-of-the-art information concerning end of life care may be found at the website for Coalition for Compassionate Care of California. You can also watch videos about POLST, preview and download numerous helpful resources including the an Advance Health Care Directive and POLST form, CCCC POLST professional and consumer brochures, and POLST Frequently Asked Questions. View the new video released in March 2011 titled: Facilitating Meaningful Conversations About Goals of Care to see experienced practiced health care providers having conversations on every aspect of POLST with key teaching points reviewed at the end of each of the 8 chapters, a true gem!

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