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Physician Orders for Life-Sustaining Treatment: Recommendations for Implementation in Pennsylvania

The Physician Orders for Life-Sustaining Treatment (POLST) form was designed to help individuals in the last stages of life express their wishes regarding life-sustaining treatment. End-of-life care is often provided in a multitude of health care settings including hospitals, skilled nursing facilities, hospice centers, and in patients homes. Communication failure between these facilities and patients or their families often leads to care that is in opposition to the patients desires. In addition, living wills and advance directives that are currently in use do not provide health care workers with the information needed to properly carry out the patients last wishes specific to life-sustaining treatment. POLST seeks to overcome these barriers by creating a simple, understandable form that is easily transferred between care settings. The POLST form was created in Oregon in 1991 and has since been used throughout the state. Numerous studies conducted in the state have found that the use of POLST ensures that patients receive the desired level of care during the end stages of life. The Commonwealth of Pennsylvania has been using the POLST form in a limited number of settings since 2000; however, widespread use of the form has yet to occur. As Pennsylvania has an aging population, quality care for those in the end stages of life is of particular public health importance. This paper examines the literature surrounding the development and implementation of POLST in Oregon, its spread throughout the United States, and its current status in Pennsylvania in order to answer the following questions: 1) Should Pennsylvania adopt widespread use of the POLST? And (2) if yes, how should the Commonwealth go about overcoming the barriers to implementation?

Identiferoai:union.ndltd.org:PITT/oai:PITTETD:etd-04082009-231045
Date29 June 2009
CreatorsRobertson, Jamie Michelle
ContributorsSteven Albert, PhD, Wesley Rohrer, PhD, Beth Nolan, PhD
PublisherUniversity of Pittsburgh
Source SetsUniversity of Pittsburgh
LanguageEnglish
Detected LanguageEnglish
Typetext
Formatapplication/pdf
Sourcehttp://etd.library.pitt.edu/ETD/available/etd-04082009-231045/
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