What is TPOPP/POLST?
The TPOPP/POLST initiative is designed to improve quality of care for those living with serious illness and/or frailty by translating patient goals and preferences into medical orders. This applies to patients with advanced or serious illness in Kansas and Missouri regardless of whether the patient is in a hospital setting, skilled nursing facility or living independently in their own community. TPOPP/POLST establishes communication between the patient or recognized decision maker (e.g., the healthcare Agent, proxy, or other designated decision-maker) and their healthcare team and translates patient preferences into a medical order.
In sum, TPOPP/POLST:
- Is grounded in the belief that individuals have the right to make their own healthcare decisions and to shared decision making.
- Details patient preferences beyond an advance directive (aka living will or the DPOA) and transforms those wishes into medical orders that are carried out by the healthcare team.
- Enhances the transfer of patient records between healthcare professionals and health care settings while respecting patient privacy and confidentiality.
- Clarifies treatment intentions and minimizes confusion regarding a person’s treatment preferences.
- Reduces repetitive activities in compliance with the federal Patient Self-Determination Act.
- Promotes and facilitates appropriate treatments by emergency medicine and EMS personnel.
POLST is a process and a form. POLST has different names in different states. At the national level, it is simply called POLST: Portable Medical Orders, or POLST for short. Portable means that the order is valid outside the clinic or doctor’s office, similar to a drug prescription.
POLST is many things, including:
- A process. Part of advance care planning, which helps you live the best life possible.
- Conversation. A good talk with your provider about your medical condition, treatment options, and what you want.
- A medical order form that travels with you (called a POLST form).
National POLST is a non-profit organization that organizes the efforts to standardize the POLST process, POLST form and education throughout the U.S., since POLST varies from state to state. Learn more about the history of POLST and National POLST.
TPOPP/POLST for Clinicians
TPOPP/POLST is modeled from national POLST. TPOPP/POLST is one of more than 45 state-wide efforts currently underway to address these important issues.
TPOPP/POLST is a medical order to honor treatment preferences for those living with advanced or serious illness. The TPOPP/POLST model:
- Promotes ongoing conversations about goals of care and treatment preferences between healthcare providers and those living with advanced or serious illness.
- Translates those current goals and treatment preferences into a set of actionable medical orders.
- Shares the current treatment preferences across health settings
- Allows for a single medical order set in an effort to comply with state laws and the federal Patient Self Determination Act.
Community Task Forces and Coalitions
Research has shown that successful implementation of TPOPP/POLST is supported by interdisciplinary community-level organizations across the continuum of care. More than two dozen regional and community-based initiatives are involved in implementing TPOPP/POLST.
The TPOPP/POLST Guidebook for Clinicians is an essential element for implementing the TPOPP/POLST process and completing the TPOPP/POLST medical order.
The most recent edition of the Clinical Guidebook (2021/2022) includes updated resources and references for advance care planning training and evidence based practices.
2022 NEW TPOPP/POLST Form and Clinical Guidebook
A. Overview of Initiative – Leadership Team (coming soon)
B. Kansas-Missouri TPOPP/POLST Coalition Structure (historical reference)
C. Early Endorsements and Integrations 2017 (historical references)
D. Comparison of TPOPP/POLST to Kansas Pre-hospital DNR Directive Law
E. Comparison of TPOPP/POLST to Missouri OHDNR Law (purple form)
VI. COMMUNITY INSTITUTION PROFILE
If you are interested in working in your community to implement TPOPP/POLST, please email TPOPP@PracticalBioethics.org or call 816-979-1366.
VII. CARING CONVERSATIONS CONTINUED
TPOPP/POLST Caring Conversations Continued is a small booklet that educates the public about TPOPP/POLST (includes the Durable Power of Attorney for Healthcare Decision forms and a TPOPP/POLST form (education version).
A. View TPOPP/POLST Caring Conversations Continued
B. Order TPOPP/POLST Caring Conversations Continued