In the last issue, we shared about the two POLST bills that were introduced in the Pennsylvania House and Senate this term. SB631 is currently in the Senate Health and Human Services Committee awaiting action. This bill is critical to ensure the POLST form is used appropriately in Pennsylvania by specifying the appropriate patients for whom is should be offered, by defining clearly inappropriate uses of the POLST form, and by creating a POLST advisory committee that could periodically review the form and its use in view of evolving research and experience in its use.
We encourage you to contact Health and Human Services Committee Chair Michele Brooks to share your expertise on why changes to POLST are so important.
You can check the status of the legislation and sign up for updates here.
Updates from National POLST
During the National POLST Collaborative (NPC) Member States Meeting on March 25, the Executive Committee shared that Epic has incorporated the National POLST form into its foundation platform without permission. They noted that while it’s exciting to see interest in POLST use in EHRs, the model form should not be used verbatim by any state, and Epic has given little guidance to states on compliance with their POLST laws and regulations. This can result in invalid POLST forms being created in Epic, leading to patients and their families not having their POLST orders honored, and liability to healthcare systems, NPC, and Epic. NPC is recommending that Epic users hold off on implementing this feature and is working with Epic to develop a set of guidelines and examples for each state. Read the official letter here.
National POLST recently offered two webinars of interest:
Investigating EMS as an Untapped Resource for Rural POLST Education: Webinar recording
Changing Public Perceptions of Serious Illness Care: Webinar recording
Systematic Review Highlights Findings, Limitations of POLST Research
In the April 2024 issue of JAMDA: The Journal of Post-Acute and Long-Term Care Medicine, Elizabeth Umberfield et al. published the results of a systematic review of POLST research. The authors reviewed 94 articles on POLST published between 1996 and 2022. The vast majority of studies (n = 92) were level 3 or 4 evidence and only 15 studies involved a comparison group. In these, the authors found that POLST use was significantly associated with positive outcomes in care quality and actions taken based on patient preferences. However, the lack of randomization in the studies poses limitations. Given the ongoing debate around the evidence supporting the utility of advance care planning and POLST, it is clear that more high-quality research is needed.
Help Spread the Word about Free On-Demand POLST Education
Introduced in August 2022, the POLST Learning Center offers 10 self-paced online continuing education modules, providing a total of 11 CME/CNE credits at no cost! To date, a total of 690 modules have been completed through the PA POLST website, with additional over 3,000 EMS providers completing POLST training via the PA TRAIN website. Module 1, Introduction to POLST, has the highest number of completions. This likely is the result of the module being incorporated as a required prerequisite to in-person POLST trainings.
Overall, satisfaction with the training is high. Participants reported high levels of satisfaction with the program's quality, with the majority falling into the "High" and "Very High" categories. Additionally, participants found the content of the program highly relevant to their practice, with a significant number indicating "High" and "Very High" levels of relevance.
We encourage you to share information about the modules to ensure that your staff are trained in proper POLST practices. Download a promotional flyer and a PowerPoint slide you can incorporate into your next POLST presentation!
Help your staff improve their skills in administering POLST.
