POLST Legislation and Education Are Key to Successful Implementation

By: Lisa George, MPH, CHES – Jewish Healthcare Foundation

The POLST (Pennsylvania Orders for Life-Sustaining Treatment) form has been used in Pennsylvania since 2010 (and the Oregon POLST form in use from 2000 to 2010)—providing a standardized way to translate patients’ wishes for care into actionable medical orders. Given this long history of use, it may be surprising to many that the Commonwealth does not have legislation on the books related to POLST. That, however, may soon change.

Pennsylvania State Senator Gene Yaw (R – District 23) announced that he will be reintroducing POLST legislation, previously SB 572 of the 2021–22 session, in the Pennsylvania Senate this session. The legislation will update and revise Pennsylvania law (Title 20) to include the codification of “Pennsylvania Orders for Life Sustaining Treatment (POLST)” to be used by medical professionals across all healthcare settings for patients who voluntarily wish to execute a POLST order. It also would result in discontinuation of the Out of Hospital Do-Not-Resuscitate orders. POLST legislation is critical to ensure appropriate use of POLST across the Commonwealth, in the appropriate populations, as part of a conversation about wishes for end-of-life medical care. More information on Senator Yaw’s plans for reintroduction is available here.

A crucial part of effective POLST implementation, whether POLST is codified into legislation or not, is standardized education for healthcare providers on appropriate use of POLST. The PA POLST Learning Center is a new continuing education resource that provides access to a library of on-demand trainings on POLST—all of which offer free continuing medical education and continuing nursing education credits. Developed by a multidisciplinary, statewide curriculum committee, the training equips healthcare providers with tools to hold conversations with seriously ill patients and their loved ones about treatment options near the end of life and to document the patient’s wishes via a POLST form—translating their wishes into portable medical orders. Previously, the only option for POLST education was via in-person trainings. The new on-demand virtual curriculum enables providers to gain valuable skills in having POLST conversations when and where it is most convenient for them. Topics include an introduction to POLST and advance directives, POLST conversations, POLST tools, POLST implementation, Medicare reimbursement for advance care planning conversations, case-based conversation scenarios, POLST and EMS, pediatric considerations, and cultural humility. This project was supported by a grant from the McElhatten Foundation to enhance access to POLST education and resources for healthcare providers and personnel throughout Pennsylvania.

To stay up to date on POLST legislation, education, and resources subscribe to the POLST Notes newsletter. Visit www.papolst.org to sign up. For more information on the POLST educational offerings or answers to your questions about POLST, contact [email protected].

Lisa George, MPH, CHES is the PA POLST Coordinator and Senior Communications and Program Specialist at the Jewish Healthcare Foundation.