EMT

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Frequently Asked Questions

What is POLST?
POLST is the Providers Orders for Life-Sustaining Treatment (POLST) program in Montana.  It is designed to improve the quality of care people receive at the end of life.  This is accomplished by the development of an effective communication process to assure patient wishes are communicated to the medical providers.  The process utilizes a POLST form, which is official documentation of medical orders on a standardized form coupled with a promise by health care professionals to honor those wishes.

What is the POLST form?
The Provider Orders for Life-Sustaining Treatment (POLST) form represents a way of summarizing wishes of an individual regarding life-sustaining treatment. The form is intended for any individual with an advanced life-limiting illness. The form accomplishes two major purposes: it is portable from one care setting to another and it translates wishes of an individual into actual medical orders. The attending physician, nurse practitioner (APRN) or physician assistant (PA) should complete the document with the patient. The attending physician, APRN or PA must sign the form and assume full responsibility for its accuracy. The POLST form facilitates the process of translating end-of-life discussions with patients into actual treatment decisions, and provides security for the individual and physician that the expressed wishes will be carried out. There is no other form that streamlines the process in this way.

How is the form used?
In a health care facility, the form should be the first document in the clinical record. It should be recognized as a set of medical orders, to be implemented as any medical orders would. In a non-institutionalized setting (such as a home), the form should be located in a prominent location. It will be recognized by emergency personnel as orders to be followed.
 
How is the form transferred from one setting to another?
The form must be transferred with the individual to be valid. The institution may wish to keep a duplicate copy in the permanent medical record upon discharge.

Does the POLST form need to be signed?
Yes. A provider (physician, nurse practitioner, or physician assistant) must sign the form in order for it to be a medical order that is understood and followed by other health care professionals.

If I have a POLST form do I need an advanced directive too?
If you have a signed POLST form, The Department of Public Health & Human Services and Board of Medical Examiners recommends you also have an advanced directive, though it is not required. You may obtain more information about advanced directives from your provider.

What if my loved one can no longer communicate his/her wishes for care?
If you are the designated health care representative, you can speak on behalf of your loved one. A provider can complete the POLST form based on your understanding of your loved one’s wishes.

In what setting is the POLST form used?
The completed POLST form is a provider order form that will remain with you if you are transported by an ambulance, transported between care settings, regardless of whether you are in the hospital, at home or in a long-term care facility.

Where is the POLST form kept?
If you live at home you should keep the original POLST form in a prominent location (e.g., on the front of the refrigerator, on the back of the bedroom door, on a bedside table, or in your medicine cabinet). If you reside in a long-term facility, your POLST form may be kept in your medical chart along with other medical orders.

I have “Comfort One”, do I need to get a POLST?
No, Comfort One is still honored by EMT personnel and your wishes will still be followed by the EMT personnel.  You may wish to discuss POLST with your provider if you want your wishes expanded beyond withholding life sustaining treatment at home or wish the medical facilities and other medical providers to honor your wishes.

How do I obtain a copy of the POLST form?
From your physician or other health care provider or you can download a copy from the website, polst.mt.gov.
If your physician or other health care provider is not yet aware of, or needs more information about POLST you can direct them to the official POLST website for Montana at: polst.mt.gov.

Education and Training

PowerPoint Training Programs - (download to local machine to use)
Provider

The provided Power Point presentation is a generic presentation developed for instructors.  It is not intended to be used as an independent study program and requires an instructor.

The instructors should modify the presentation to meet their student’s needs.  Instructor notes are attached to each slide to identify the purpose of the slide; blank slides have been included for the instructor’s convenience. 

 

End-of-Life Registry

Montana's End-of-Life Registry stores advance health care directives in a secure computer database and makes these documents available to health care providers. Section 50-9-501 of the Montana Code Annotated authorizes Montana's Attorney General to create and maintain an End-of-Life Registry that:
securely stores directives relating to life-sustaining treatment
is accessible online
provides immediate access to authorized health care providers Montana law defines a health care provider as a person who is licensed, certified or otherwise authorized by the laws of Montana to administer health care in the ordinary course of business or practice of a profession. This includes but is not limited to hospitals, doctors, skilled nursing facilities, nursing facilities, home health agencies, home health care providers, ambulatory surgery facilities and hospices.

www.endofliferegistry.mt.gov

Administrative Rules

PUBLIC HEALTH AND HUMAN SERVICES
EMERGENCY HEALTH SERVICES
The Montana Rights of the Terminally Ill Act
Do Not Resuscitate statute
37.10.1: Living Wills

POLST / DNR Protocol


Contacts

Kathryn Borgenicht MD
kborgenicht@bdh-boz.com
406-414-2400

Linda Bierbach RN BS CHPN
Linda.bierbach@providence.org
406-327-1831