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POLST California

Jennifer Hopping-Winn, Juliette Mullin, Laurel March, Michelle Caughey, Melissa Stern, Jill Jarvie
Since 2013, Kaiser Permanente Northern California has engaged in a systematic effort to elicit, document, and honor the care preferences of patients as they near the end of life. This is done through its Advanced Steps program, in which selected patients discuss their preferences for future medical care with their healthcare agent during a structured conversation with a trained advance care planning facilitator. The facilitator then translates the patient's wishes into an actionable medical order set using a Physician's Order for Life-Sustaining Treatment (POLST) form...
April 2018: Journal of Palliative Medicine
Lee A Jennings, David Zingmond, Rachel Louie, Chi-Hong Tseng, Judy Thomas, Kate O'Malley, Neil S Wenger
BACKGROUND: Physician Orders for Life-Sustaining Treatment (POLST) is a tool that facilitates the elicitation and continuity of life-sustaining care preferences. POLST was implemented in California in 2009, but how well it disseminated across a large, racially diverse population is not known and has implications for end-of-life care. OBJECTIVE: To evaluate the use of POLST among California nursing home residents, including variation by resident characteristics and by nursing home facility...
October 2016: Journal of General Internal Medicine
Anna N Rahman, Matthew Bressette, Zachary D Gassoumis, Susan Enguidanos
PURPOSE OF THE STUDY: Previous studies examining preferences documented in Physician Orders for Life Sustaining Treatment (POLST) have found that most sampled POLSTs show a preference to limit care. These studies were conducted in states that are relatively ethnically homogeneous. This study investigated the POLST preferences of nursing home residents in an ethnically diverse state-California-that requires nursing homes to document whether residents execute POLST. DESIGN AND METHODS: Data were collected from POLST forms executed by 941 residents in a convenience sample of 13 nursing homes in Southern California...
August 2016: Gerontologist
Takehiro Sugiyama, David Zingmond, Karl A Lorenz, Allison Diamant, Kate O'Malley, Judy Citko, Victor Gonzalez, Neil S Wenger
Physician Orders for Life-Sustaining Treatment (POLST) is a tool to document and ensure continuity of end-of-life treatment decisions across healthcare settings that became a legal document in California in January 2009. Hospitals were surveyed to evaluate factors associated with uptake of this intervention and whether a grassroots community coalition intervention facilitated dissemination. A mail and telephone survey of all acute care hospitals in California was conducted between August 2011 and January 2012, and community coalition reports of interaction with hospitals and hospital characteristics from the California Office of Statewide Planning and Development and Census ZIP Code Tabulation Areas were analyzed...
August 2013: Journal of the American Geriatrics Society
Caroline J Wilson, Jeffrey Newman, Sharon Tapper, Steve Lai, Peter H Cheng, Frances M Wu, Ming Tai-Seale
BACKGROUND: The ambulatory care setting is a new frontier for advance care planning (ACP). While electronic health records (EHR) have been expected to make ACP documentation more retrievable, the literature is silent on the locations of ACP documentation in EHRs and how readily they can be found. OBJECTIVE: The study's objective is to identify the locations of ACP documentation in EpicCare EHR and to determine which patient and primary care provider (PCP) characteristics are associated with having a scanned ACP document...
September 2013: Journal of Palliative Medicine
Neil S Wenger, Judy Citko, Kate O'Malley, Allison Diamant, Karl Lorenz, Victor Gonzalez, Derjung M Tarn
BACKGROUND: Implementing Physician Orders for Life Sustaining Treatment (POLST) forms aims to improve communication of life-sustaining treatment preferences across care venues. California enabled this clinical tool in 2009, and a novel intervention of community coalitions was undertaken to advance POLST in localities around the state. Coalitions engaged facilities, including nursing homes (NHs), to foster POLST adoption. Eighteen months after introduction of POLST, we studied POLST implementation in California NHs...
January 2013: Journal of General Internal Medicine
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