PCMS_Philadelphia_Medicine_Spring2018 - 21

p h i l a m e d s o c  .o rg

Sunrise Allscripts screen, April 2017.

Activation of the POLST form requires documentation that the
patient is deemed unable to make decisions and documentation of
a terminal diagnosis, meaning either an end stage disease, or the
presence of permanent unconsciousness.
The original POLST belongs to and is kept by the patient making
it available for future reuse. A copy of the POLST is placed in the
medical chart. The POLST remains valid unless voided by the
patient; the original POLST and each copy needs "VOID" written
across the form.
How does a POLST form differ from an Advance Directive?

POLST choises in Sunrise EHR.

POLST orders on the form differ from advance directives in
that POLST directives make clear an individual's wishes regarding
treatment measures via a legal medical order that is applicable across
all health care settings: the ER, in-patient care, nursing homes, home
care and hospice. Advance directives are ideal for identifying a
surrogate health care decision-maker but often lack specificity
regarding a patient's end-of-life treatment preferences.
Although POLST forms are currently available in Pennsylvania,
these forms presently are not recognized by Pennsylvania law. House
Bill 1196 will codify these orders and require that physicians, nurses,
emergency medical technicians, and other medical professionals
deliver care consistent with a patient's end-of-life preferences.
Continued on page 22

Spring 2018 : Philadelphia Medicine 21


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