POLST: An improvement over traditional advance directives

Area of Science:

• Medical Ethics
• Palliative Care
• Healthcare Policy

Background:

• Traditional advance directives have limitations in capturing patient end-of-life wishes.
• Effective communication of patient goals is crucial for life-sustaining treatment decisions.
• A need exists for a process that translates patient preferences into portable medical orders.

Purpose of the Study:

• To introduce the Physician Orders for Life-Sustaining Treatment (POLST) process.
• To explain how POLST facilitates the communication of patient end-of-life care wishes.
• To highlight POLST's role in overcoming limitations of existing advance directives.

Main Methods:

• POLST involves a conversation between healthcare professionals and patients or their surrogates.
• It assesses and documents patient wishes regarding life-sustaining treatments.
• The resulting orders accompany the patient across different care settings.

Main Results:

• POLST provides a mechanism to translate patient goals into medical orders.
• It ensures patient preferences are respected in end-of-life care decisions.
• The process is applicable to patients with serious life-limiting illnesses and individuals of advanced age.

Conclusions:

• POLST is an effective process for documenting and communicating end-of-life care preferences.
• It enhances the ability of healthcare providers to honor patient autonomy.
• POLST improves the continuity of care by ensuring orders follow patients.