Chronically ill patients across the nation are getting some help to make sure they receive consistent care in managing pain and other symptoms. To provide clarity about the individual’s wishes, there’s a medical form known as Provider Orders for Life-Sustaining Treatment, or POLST. In Arizona, the form and new protocols are termed AzMOST, or Arizona Medical Orders for Scope of Treatment.
“POLST and AzMOST provide continuity of care across settings of care with a goal of increasing patient quality of life and improving patient satisfaction,” said Dawn Rivas, M.S., R.N., a doctoral student and an assistant clinical professor at Northern Arizona University’s School of Nursing.
Rivas and Emmalee Kennedy, M.D., the medical director of Northern Arizona Healthcare’s (NAH) Palliative Care Program, are currently members of the AzMOST task force and are working in conjunction with other state leaders to develop and implement a POLST/AzMOST program in Arizona. At present, Flagstaff Medical Center has a POLST pilot program, which is the only such program in the state. Meanwhile, other communities are looking into starting POLST pilot projects of their own.
“As physicians and health care providers, our goal is to cure sometimes, to relieve often and to comfort always,” said Dr. Kennedy. “When a cure is not possible, Palliative Care is there to provide support and care for the patient and their loved ones.”
With POLST/AzMOST, the patient’s medical orders are known and carried out without requiring a new set of orders every time the patient needs medical care. The medical order form tells providers and caregivers the patient’s desires for life-sustaining treatment, based on the patient’s current medical condition and values.
It also includes information about the patient’s diagnosis, prognosis and desires regarding medical and life-sustaining treatments and interventions, as well as general orders about what level of invasive treatments (such as a feeding tube) a patient would consider if the condition worsened. The form may also include orders for do not resuscitate, do not intubate and other life-sustaining treatments.
Some of the more common chronic diseases include cancer, stroke, diabetes, heart disease, Alzheimer’s Disease and Parkinson’s disease.
To learn more, Northern Arizona Heathcare and NAU are hosting a one-day Palliative Care Conference on Saturday, Sept. 16, at the High Country Conference Center in Flagstaff for health care providers, caregivers and the public. Topics will include when and how to refer a patient to palliative care; how to request palliative care for a loved one; pain management protocols; and information about the new POLST/AzMOST forms and protocols. The cost is $50 per person and includes curriculum, materials and two meals. For information, contact the NAH Education Department at 928-773-2491 or NAHEducation@NAHealth.com. FBN
By Starla S. Collins, FBN
NAU’s Dawn Rivas, M.S., R.N., shows the new Arizona Medical Orders for Scope of Treatment form (printed on bright pink paper), which is part of a pilot project aimed at ensuring the medical wishes of those with chronic illnesses are documented and followed.
Photo by Starla S. Collins