Physician Orders for Life-Sustaining Treatment (POLST) is a physician order that outlines a plan of care reflecting a patient’s wishes concerning care at life’s end. The POLST form is voluntary and is intended to:
- Help you and your patient discuss and develop plans to reflect his or her wishes
- Assist physicians, nurses, healthcare facilities, and emergency personnel in honoring a person’s wishes for life-sustaining treatment
Having a conversation with a seriously-ill patient about end-of-life issues is an important and necessary part of good medical care. POLST can provide structure for those important discussions between you and your seriously-ill patients.POLST is making a difference. Studies have shown that among patients with POLST forms treatment preferences were respected 98% of the time, and no one received unwanted CPR, intubations, intensive care or feeding tubes.
At the Coalition for Compassionate Care of California (CCCC), we are here to help guide you through the use of POLST. We offer multiple trainings and resources, all designed to help you learn more about POLST, and to develop and enhance your skills for facilitating meaningful conversations with patients and families about goals of care and POLST.
About the POLST Physician Leadership Council
The POLST Physician Leadership Council — an advisory group to the Coalition for Compassionate Care of California — is a group of California physicians representing multiple specialties who collaborate on POLST education and tools for healthcare professionals, patients, their families and others. Their goal is to assure that the health care wishes of Californians facing serious illness are elicited and honored. This group regards meaningful conversations among patients, families, and the healthcare team as the fundamental basis for advance care planning and the proper creation of the POLST form.
The POLST Physician Leadership Council promotes best practices for the use of POLST by:
- Educating professionals and community members about documenting goals of care conversations on the POLST form,
- Advising on POLST form development and quality improvement, and
- Supporting innovation in POLST education and outreach.
If you are interested in contacting a physician from this group for education or guidance about the POLST form, have specific questions about POLST, or questions regarding a particular case, please Contact Us.
Get training on the California POLST from the California POLST experts.
24/7 Online Training
Working with POLST for Professionals: Education through the CSU Institute for Palliative Care
This 3-hour, online, self-paced course is designed to help healthcare professionals understand the role and value of POLST, and how to employ it in documenting and honoring patient wishes.
An optional 3 Continuing Education units (CEs) are available for purchase for an additional $25.00. See website for more course details.
FAQ for Providers PDF
Frequently Asked Clinical Questions for Providers PDF
POLST Facts for Nonclinical Staff PDF
Helpful Phrases for Having the POLST Conversation / Frases útiles para usar en las conversaciones sobre POLST PDF
This guide walks healthcare providers through the most commonly used phrases in walking a patient and family through conversations about the POLST form. The guide includes phrases and questions in English and Spanish.
Quick Reference: Relationship Between POLST Sections A & B PDF
Quick Reference: POLST in Nursing Homes PDF
POLST in California Assisted Living Communities PDF
The Guides are recommended for use by healthcare professionals who treat seriously-ill patients in hospitals, palliative care units, skilled nursing facilities, hospices and medical groups. The Guides are intended to supplement conversations between patients and healthcare providers.
TOPICS INCLUDE: artificial hydration, cardiopulmonary resuscitation (CPR), mechanical ventilation, and tube feeding.
LANGUAGES: English, Chinese, Spanish and Vietnamese
COMING SOON: A series of Decision Guides for the pediatric audience is nearing completion.
POLST QAPI Toolkit
Designed to provide skilled nursing facilities with useful, QAPI-based tools which can be used to improve POLST utilization in California’s nursing homes and assure that residents’ end-of-life treatment wishes are understood, documented and followed.
Download the QAPI Toolkit as a PDF
What is QAPI?
QAPI stands for Quality Assurance and Performance Improvement.
QAPI is a data-driven, proactive approach to improving the quality of life, care, and services in nursing homes. The activities of QAPI involve members at all levels of the organization to: identify opportunities for improvement; address gaps in systems or processes; develop and implement an improvement or corrective plan; and continuously monitor effectiveness of interventions.
Effective QAPI programs are critical to improving the quality of life, and quality of care and services delivered in nursing homes.
- AB 3000 (2008) – Implementing POLST
- AB 637 (2015) – Authorizing NP/PA Signature on POLST
- SB 19 (2015) – Authorizing POLST eRegistry Pilot
POLST SNF and RCFE Regulation (PDFs)
- AFL 14-20 / 9-9-2014 –MDS 3.0 “Section S” Coding Updates
- AFL 11-26 / 3-28-2011 – MDS 3.0 “Section S” Submission and Coding Updates
- AFL 10-42 / 11-16-2010 – MDS 3.0 “Section S” Submission and Coding Issues
- AFL 10-25/ 10-01-2010 – MDS 3.0 “Section S” and POLST
- AFL 9-27/ 12/03/2009 –POLST Implementation
- AFL 8-29/ 10-08-2009 – POLST Implementation
- Transmittal 09APX-03/02-2009 – RCFE Summary and Implementation Plan for POLST (Appendix A)