POLST Facilitation in Complex Care Management: A Feasibility Study.

The American Journal of Hospice & Palliative Care
Alexia M TorkeDawn Butler

Abstract

The Physician Orders for Life-Sustaining Treatment (POLST) form is an advance care planning tool designed for seriously ill patients. The discussions needed for high-quality POLST decision-making are time intensive and often do not occur in the outpatient setting. We conducted a single-arm feasibility study of POLST facilitation by nonphysicians using Respecting Choices Last Steps, a standardized, structured approach to facilitation of POLST conversations. Community-dwelling adults aged 65 and older enrolled in a complex care management program in a Midwestern urban hospital. We assessed the feasibility and acceptability by determining the proportion of eligible patients who enrolled and completed the study, by adherence to the Respecting Choices protocol, and by responses to qualitative and quantitative survey items about the intervention. We enrolled 18 (58.1%) of 31 eligible patients, with a mean age of 77.8 years (standard deviation: 6.95); 12 were African American. The POLST facilitation was delivered to all 18; 10 (55.6%) completed POLST forms. Direct observation of intervention delivery using a checklist found 85% of the required elements were performed by facilitators. We completed 6- to 8-week follow-up interviews in 1...Continue Reading

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Software Mentioned

Research Electronic Data Capture
Epic
POLST Orders for
GRACE CCM
POLST
GRACE
SAS
POLST Resources for GRACE

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