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  • Writer's pictureKaren McPhail, RN, MSN

What is the National POLST Paradigm Program?

The POLST Paradigm was developed to improve patient care and enhance quality by creating a system that identifies the wishes of patients regarding desired medical treatment. The program then communicates these wishes in a concrete written form by creating portable medical orders.

The POLST Paradigm still supports the completion of advance directives, however, clinical experience and research show that these advance directives should perhaps not stand alone and may not be enough to assure that those suffering from serious illnesses will have their preferences for treatment honored unless a POLST Paradigm Form is completed.

A key aspect of this system is mindful, concrete, and supportive advance care planning conversations between health care professionals, patients and those individuals close to them to determine what treatments they want and do not want. The plan is base don their preferences, personal beliefs, health conditions, and more. Planning and open expression is vital during this process. Throughout the planning stage, patients are informed of their treatment options and when and if ready the process moves forward. With their approval, their health care professional will then complete a POLST Paradigm Form based on their discussions, wishes and treatment preferences.

The POLST Paradigm is strictly intended for patients with serious illnesses or medical issues that their health care professionals feel will limit their life span to a year or less.

For these patients, their current health status indicates the need for standing medical orders for emergent medical care.

So for someone who is is a healthy individual the POLST program is not appropriate. In this case, an advanced directive is still the best and most appropriate mechanism for making future end-of-life care wishes known to health professionals and loved one's.

visit to obtain more information and to learn if your state participates in this program.

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