Featured News and Resources
Multiple publications focus on POLST in various settings
|“POLST: Promise and Pitfalls in Skilled Nursing Centers.” Karl Steinberg, MD, who serves on the National POLST Leadership Council, wrote this article published in the July 2019 issue of Provider magazine, the monthly print publication of the American Health Care Association and the National Center for Assisted Living. It not only explains why POLST is particularly valuable for nursing home residents, but some pitfalls to avoid and processes one can take to best ensure a patient’s wishes are honored. An added bonus: some updates about National POLST are also provided! Read online.
Article on POLST quality by Brazilian authors previewed in American Academy PC-FACS (Palliative Care-Fast Article Critical Summary) in the July 2nd issue. Their “bottom line” is: “Medical orders that result from structured ACP conversations have high interrater reliability; however, multiple cases of disagreement seen in this study leave open concerns regarding changing preferences or the inherent subjectivity of ACP.” View issue of PC-FACS or view original article in JAMA Open Network.
POLST article, “Planning for the End of Life,” published in SAEM Pulse. Written by Ray Fowler, MD, and Amy Vandenbroucke, JD, this article published by the Society for Academic Medicine presents an overview of POLST. Go to page 22 to view the article online.
|A retrospective study by Dana Zive et al published in Prehospital Emergency Care looked at older adults in the Oregon POLST Registry who suffered and were transported by EMS in response to a traumatic injury. Their POLST orders were reviewed before, after, and at the time of the trauma event. The presence of a POLST form before the injury was correlated with a higher tendencies to (1) have other risk factors for morbidity (2) be more frail and (3) die from the injury. View online.
Another study by Justin Kim et al, published in Journal of Pain and Symptom Management, included adults of all ages with underlying chronic illness. The study found that younger patients were least likely to have completed any advance care planning, especially if they did not have multiple chronic illnesses or had a history of fewer hospitalizations. Thus the authors concluded that this population of younger chronically ill may especially benefit from more ACP education. View online (limited access).
A third study by Jessica Ballou et al published in Journal of Trauma and Acute Care Surgery found that older patients who already had a POLST at the time of injury were more likely to spend fewer days in the ICU, without an increase in likelihood of dying in-hospital. View online (limited access).
National POLST Paradigm News in Brief