Oregon Does Not Endorse the National POLST Form

The currently recommended form from the National POLST office incorporates almost all of the elements of the 2018 Oregon POLST form and adds additional search function features of the Oregon POLST form (2019 version) and includes the use of the word "portable." We are honored that so many of the form elements that were developed and refined in Oregon are included in the recommended new form being promoted by the National POLST office. However, we do not endorse the current version of the national form, because lessons learned from the Oregon form revision process have not been incorporated.

— Oregon POLST Program & Coalition

9/12/2019

1. The tube feeding section was removed, as explained in the Journal of the American Geriatrics Society (JAGS) article, "It is Time to Remove Feeding Tubes from POLST Forms." Further details of Oregon’s first six months of experience were provided in a subsequent JAGS letter.

2. Oregon reaffirms the value of not requiring the signature of the supervising physician for physician assistant (PA) signers. Since 2007, PAs in Oregon have been able to sign POLST forms without the signature of their supervising physician. Annually, about 5% of all POLST forms submitted to the Oregon POLST Registry are signed by PAs (approximately 2,000 forms).

3. Retain the patient’s address in the demographic information, as this element is a valuable asset in the Oregon POLST Registry’s matching and quality assurance protocols.

4. In describing Who Was Present for Discussion, it is important to retain the category "Relative or friend (without written appointment)," as family members without a formal appointment may feel undervalued when referred to as "Other."

5. Oregon removed the section for the last four digits of the social security number, as the use of a social security number as an identifier is now actively discouraged to protect personal privacy.

6. Encouraging the signature of a capable patient can be instructive for the family when the patient loses decision making capacity; however, the signature of surrogates should not be required. For some surrogates, signing may be an added emotional burden and the distance of the surrogate from the patient may make the physical act of signing prohibitive.

Approved: September 16, 2019