Focusing on Quality Improvement
The Oregon POLST Quality Improvement Committee, chaired by Pam Hiransomboon-Vogel, DNP, APRN, FNP-BC, ACHPN, will focus in 2018 on facilitating the progress of two initiatives:
1. Reduce the use of POLST in those who are "too healthy" to have a POLST form
The Coalition recommends integrating a standard code status section on hospital transfer forms instead of using POLST orders routinely for all patients transferred to facilities. This is primarily an issue for patients going for short term rehabilitation. These transfer forms would with orders for Full Code would replace the POLST forms for patients who are not POLST appropriate, and/or have not had a thoughtful Goals of Care conversation. The short and long versions of the recommendation are available in the Professional Resource Library.
2. Improve hospice submission rates to the Oregon POLST Registry
Effective October 13, 2017, POLST forms with verbal orders were allowed to be directly submitted to the Registry. This allows hospice and long term care to be able to submit forms more rapidly for those patients who have a pressing need. The amended rule eliminates the need to obtain a written signature prior to submitting to the Registry; it does not change standard practices regarding procedures for verbal orders. Click here to view the POLST changes impacting hospice and to learn why timely POLST form submission to the Registry benefits patients.
Recent Quality Article
"POLST: Avoid the Seven Deadly Sins" is a recent article published in Bifocal, the American Bar Association Commission's bi-monthly journal. The author, Charlie Sabatino, J.D., writes "The growth of POLST programs has benefited countless individuals and families facing advanced illness. But it has also brought many challenges in education, quality assurance, and monitoring." Click here to view the article which starts on page 60.