Dr. Susan Tolle explains the POLST Program
In this video from 2011, Dr. Susan Tolle, Director of the Center for Ethics in Health Care at Oregon Health & Science University, provides an overview of the Oregon POLST Program and discusses who can benefit from it.
Years Ago POLST was Envisioned in Oregon
POLST Orders have been Entered into Oregon's Registry
Of Oregonians Die with a POLST Form on File in the Registry
Calls Received by the POLST Registry Hotline since 2009
About the Oregon POLST® Program
In 1991, Oregon leaders in clinical ethics, emergency medical services and long-term care recognized that preferences to have or to limit life-sustaining treatments of patients with advanced illness or frailty were frequently not found nor transferable and therefore were not honored. The Center for Ethics in Health Care at Oregon Health & Science University convened representatives from stakeholder health care organizations to develop portable medical orders based on a patient’s values for treatment.
After initial evaluation, the “Physician Orders for Life-Sustaining Treatment” (POLST) form was released for statewide use throughout Oregon in 1995. Using a “train-the-trainer” model, members of the Oregon POLST Coalition educated health care professionals about use of the form. Ongoing education, research and a continuous statewide experience-based quality improvement process has helped the Coalition to improve the content of the POLST form and the process of implementation.
Learn more by reviewing our Timeline.
My father died before the advent of the POLST Program. It was a traumatic experience as emergency workers tried to resuscitate him after his death in front of the family. With my mother’s death, a few years later, it was a profoundly moving experience thanks to the POLST form. She died in a much more peaceful setting.
Mission, Vision & Values Statement
The Mission of the Oregon POLST® Coalition is to improve the quality of life for Oregonians nearing the end of life by providing an evidence-based, patient-centered, voluntary process that elicits, records and honors the treatment goals of those with advanced illness and frailty in a compassionate manner that is respectful of the inherent dignity of the individual.
Our Vision & Values
In order to deliver evidence-based, high quality care we will assure the following components are part of the POLST completion process:
- The right patient: the patient will feel empowered by the discussion of the POLST form with their health care professional;
- The right decision-maker: as part of the quality process, and with the patient’s permission, the patient’s correct legal decision-maker will participate in the conversation to assure they know and feel comfortable honoring the patient’s wishes;
- The right time: the healthcare professional would offer the opportunity for a POLST discussion to a patient with advanced illness or frailty;
- The right conversation: the health care professional is trained and experienced in having a sensitive and meaningful “Goals of Treatment Conversation” with the patient and their legal decision-maker; and
- The right documentation: the POLST form will be carefully and correctly completed, submitted to the Oregon POLST Registry, and easily available to those who will need to locate and honor the POLST orders across the continuum of care.
Oregon POLST® Coalition’s Statement Against Discrimination in End-of-Life Care
The Oregon POLST® Coalition endorses the efforts of our member organizations to stand against systemic racism and injustice. The Oregon POLST Program is committed to fight against discrimination in end-of-life care for all people, regardless of their race, religion, national origin, citizenship status, gender, gender identity, sexual orientation, physical or intellectual disability, age, or socioeconomic status.
We honor diversity and support inclusion in the care of the patients we serve who are nearing the end of their lives. Inequality and bias can both impair access to necessary medical treatments and lead to reduced access to high-quality end-of-life care. In response to the values expressed in this statement, the POLST Coalition has published guidelines related to the use of POLST for persons with significant disabilities that we hope are useful to those who support and provide care to people with disabilities. (See Guidelines on POLST Use for Persons with Significant Disabilities who are Now Near the End of Life.)
Oregon POLST® Program Leaders
Susan Tolle, MD
Chair, Oregon POLST Coalition
Susan Tolle is the Director of the OHSU Center for Ethics in Health Care. She is also a professor of medicine, OHSU School of Medicine, and the Cornelia Hayes Stevens Endowed Chair in Health Care Ethics. She previously practiced as an Internal Medicine Physician at OHSU. Susan is a founding member of the Oregon POLST Coalition, known originally as the Oregon POLST Task Force.
Christine Mullowney, MD
Co-Chair, Oregon POLST Coalition
Christine Mullowney is an assistant professor of medicine at OHSU, where she has served as a primary care physician in General Internal Medicine since 2010. She divides her time between her clinical practice and primary care quality improvement projects, including making systems improvements related to POLST. She serves as the OHSU representative on the Oregon POLST Coalition.
Executive Director, Oregon POLST Program
As Executive Director, Anthony directs and facilitates the development and implementation of the Oregon POLST Program. He is the first point of contact and primary educational resource statewide for patients, families, and health care professionals. Anthony has served in the field of Health and Human Services for over 30 years.
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