OHSU studies program that converts patient wishes into medical orders

October 10, 2005

PORTLAND, Ore. - Oregon Health & Science University's School of Nursing has received a $1.3 million dollar grant to study the use and effectiveness of a unique end-of-life program developed in Oregon called the Physician Orders for Life-Sustaining Treatment Program, or POLST. The funding for this research project comes from the National Institute of Nursing Research, a component of the National Institutes of Health.

The POLST Program was created by a coalition of Oregon health professionals in the early 1990's to ensure patient treatment preferences are known and honored. The centerpiece of the program is the brightly colored POLST medical order form. The program allows seriously ill persons to direct their end-of-life care by developing a detailed care plan with their health care provider and recording these preferences on the POLST form. The form is then signed by their physician or nurse practitioner, turning preferences into medical orders. POLST forms provide specific instructions about treatments that are wanted and those that are not. These treatments may include cardiopulmonary resuscitation, hospitalization, antibiotics, and feeding tubes.

Because the POLST form travels with a person from nursing home, to hospital to other health care settings, they are particularly useful in cases where input about health care options is immediately needed. For instance, if a seriously ill person is incapacitated when paramedics arrive, the form provides the emergency medical technicians with orders for treatments that are consistent with patient preferences.

"More than a dozen states are currently using the POLST either statewide or regionally," explained Susan Hickman, Ph.D., an assistant professor of nursing in the OHSU School of Nursing and the principal investigator for the study. "Several studies have been conducted on the POLST Program in Oregon. However, as use of the program grows, it is important for us to measure it's usefulness and impact in different communities around the country."

Hickman and the OHSU School of Nursing will collaborate with Susan Tolle, MD, director of the OHSU Center for Ethics in Health Care to conduct the research. The ethics center led the coalition that originally created of the POLST form and continues to oversee the program in Oregon. Alvin Moss, M.D., of West Virginia University, and Bernard Hammes, Ph.D., of Gundersen Lutheran Medical Foundation and Health System in Wisconsin, also serve as co-investigators on this study.

The research will specifically focus on residents of nursing homes in three states: Oregon, where POLST was launched more than a decade ago; Wisconsin, which initiated the program 8 years ago in some regions of the state; and West Virginia, which launched a statewide program similar to POLST 3 years ago.

The researchers will work closely with nursing homes and long-term care advocacy groups in each state to assess: To gather the data for this study, researchers will conduct phone surveys to determine which nursing homes are currently using the form and which are not. Permission will be sought from a subset of facilities to conduct reviews of medical charts to assess the effect of on resident's health care.

"This research will gather plenty of useful data for states currently using POLST as well as for states that are considering implementation," said Susan Tolle, M.D., director for the OHSU Center for Ethics in Health Care. "Overall, we hope some of the lessons we learn through this research will aid all states in improving their end-of-life programs."
-end-


Oregon Health & Science University

Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.