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| December 8, 2011 | Volume 3, Number 4 |
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National POLST News
California Hosts National POLST Conference in San Diego
Register now for the national POLST conference , Partners in POLST: Honoring Patient Wishes across Care Settings, on February 16, 2012 at the Catamaran Resort & Spa in San Diego. Join end-of-life and palliative care leaders from across the country to learn the latest on advancing the POLST Paradigm.
CCCC's 4th Annual Conference & Membership Meeting precedes the National POLST Conference on February 15, 2012. Hear Myra Christopher, national expert in aging and end-of-life care, talk about healthcare reform. Find out the latest on Californians' end-of-life experiences and attitudes from Dr. Steve Pantilat, winner of the 2011 James Irvine Leadership Award. Click here for more information.
Don't miss the early-bird deadline and save money on your registration - January 9, 2012!
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Evaluating POLST Quality and Utilization
Improving POLST Quality
CCCC is providing consultation to POLST coalitions to develop a quality improvement strategy that is tailored to each community. To facilitate consistency in data collection, a POLST Audit Toolbox is being developed for POLST coalitions that includes a chart audit tool, interview guide and detailed instructions on conducting nursing home audits and reporting results.
In addition to audits, a plan and tools to assess the quality of the POLST Conversation are being developed for 2012.
A quantitative survey is currently being conducted to determine POLST utilization in acute care hospitals. In 2012, similar surveys will be conducted with assisted living facilities and EMS providers, and skilled nursing facilities will be re-surveyed to measure changes in POLST utilization since an initial survey conducted in 2010.
Results of all of these evaluations will be highlighted in future issues of this POLST Update.
California POLST Registry
CCCC recently published an article highlighting the current state of electronic POLST registries. Challenges such as respecting patient privacy rules, ensuring that the most current and valid form is accessed, educating large numbers of health professionals in their use, achieving critical mass of participants, and covering the expense of operating the electronic registries are some of the issues to consider.
CCCC is looking into the feasibility of developing an electronic POLST registry in California.
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POLST Education
Pediatric POLST Curriculum
In collaboration with the Children's Hospice and Palliative Care Coalition, a POLST curriculum for pediatric care teams has been developed and was piloted in October. Three one-day Pediatric POLST workshops will be offered in 2012 - in Larkspur in March, in Southern California in September, and in the Central Valley (date TBD).
2012 POLST Trainings
Two POLST train-the-trainer programs will be offered in 2012 - March 22-23 in Larkspur and September 20-21 in Loma Linda. The intensive training provides opportunities to develop skills for facilitating meaningful conversations with patients and families about POLST and goals of care, as well as ideas for implementing POLST in communities and training other health care providers.
Information and registration about the Pediatric POLST workshops and POLST Train-the-Trainer programs will be posted soon on the California POLST website.
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POLST Coalitions
New POLST Coalitions Formed
A new POLST Coalition has recently been formed in Marin County to bring together health care providers to work on POLST implementation locally.
In addition, the Chinese American Coalition for Compassionate Care is actively outreaching to Chinese Americans throughout California about the importance of advance care planning and providing education about POLST.
A full listing of the 26 active California POLST coalitions can be accessed on the CCCC website. If you are interested in forming a coalition in your area, please contact Erin Henke, POLST Program Manager.
Funding Available to POLST Coalitions
With funding from the CHCF, CCCC administers a POLST Expense Reimbursement Fund. The two-year fund was established in 2011 to offset any out-of-pocket expenses that POLST coalitions incur as a result of their local POLST implementation efforts. Nine coalitions accessed the fund in 2011.
Additional POLST coalitions may apply to access the fund and receive reimbursement of up to $5,000 in 2012. For more information, contact Erin Henke, POLST Program Manager.
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POLST Public Policy
POLST Lawsuit
A lawsuit has been filed in California with the claim that POLST orders were not followed. This is the first lawsuit directly related to following or not following POLST orders.
POLST is a simple concept, but its implementation can be complicated. Without knowing the details of the case, we cannot determine the merits of the legal case. However, we encourage physicians, patients, and their families to talk about what is important to them, and to use and respect POLST as a tool that allows patients to express their wishes. We will be following the case closely.
Policy Group Formed to Address Surrogate Issues
A POLST Public Policy Committee has been meeting to discuss surrogate issues, specifically when a surrogate completes a POLST form that conflicts with a previously executed advance healthcare directive.
The Committee is developing a POLST Policy Statement to clarify that POLST does not create a legal authority for third party patient surrogates to override the previously expressed preferences of a patient who has lost capacity to make health care decisions, and to ensure third party surrogates make decisions that are consistent with the patient's wishes.
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POLST In the News
Most Days I Clamor for POLST
Pallimed, October 28, 2011
Some Days I Hate POLST
GeriPal, October 27, 2011
The Consistency Between Treatments Provided to Nursing Facility Residents and Orders on the Physician Orders for Life-Sustaining Treatment Form
Journal of the American Geriatrics Society, October 22, 2011
Covering your Medical What-Ifs
Press Democrat, August 5, 2011
How to start the toughest conversation of all: Santa Cruz doctor creates living will app for iPad
Santa Cruz Sentinel, July 18, 2011
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Newsletters are available at www.caPOLST.org in PDF format for anyone who is having trouble reading this email version.
The Coalition for Compassionate Care of California (CCCC) is a statewide collaboration of organizations - representing healthcare providers, consumers and regulatory agencies - working together to improve end-of-life and palliative care for all Californians. CCCC provides leadership and oversight for the implementaion of POLST in California, with support from the California HealthCare Foundation.
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