Transportable Physician Orders for Patient Preferences (TPOPP/POLST)

Transportable Physician Orders for
Patient Preferences (TPOPP/POLST)

Special Notice

National POLST has provided all POLST Programs throughout the US, guidance related to executing POLST documents during a time of COVID-19 Pandemic especially when Crisis Standards of Care may be invoked.


TPOPP is an endorsed program under National POLST

TPOPP, even during pandemic conditions, is designed for those who meet the Intended Population criteria.

In addition to the resources for COVID-19 guidance for POLST/TPOPP, the links on the Center’s Pandemic Resources page include other tools and resources to assist in your discussions with patients and families amid the current pandemic. 


TPOPP is based on the belief that individuals have the right to make their own health care decisions.  The Transportable Physician Orders for Patient Preferences (TPOPP) initiative is designed to honor values and goals of care for persons living with serious illness. TPOPP is an endorsed  POLST Paradigm program for the states of Kansas and Missouri. It is designed to address the needs of patients of serious ill patients by translating patient goals and preferences into medical orders, whether the person is in a hospital setting, skilled nursing facility or living independently in their own community.


TPOPP is modeled on the Physician Orders for Life Sustaining Treatment (POLST) paradigm, one of more than 45 such efforts currently underway nationally to address these important issues. For more information about national efforts, please see TPOPP aims to improve the communication of a person’s preferences regarding life-sustaining treatments and, thereby, generate high quality medical care. In order to accomplish this aim, TPOPP was designed to:

  • Elicit and document a person’s preferences regarding CPR and the use of mechanical intervention for breathing/ventilation along with other life-sustaining treatment such as tube feedings, etc.
  • Translate those preferences into a set of actionable physician orders;
  • Communicate the person’s care preferences across health settings by transporting these physician orders;
  • Reduce redundant documentation while complying with state laws and the Federal Patient Self-Determination Act.

Research has shown that successful implementation of a POLST-paradigm program like TPOPP is supported by community-level organizations. Creating or joining an existing community task force is integral to ensuring that the TPOPP initiative incorporates the patient’s preferences into an actionable set of physician orders, regardless of the patient’s location.

A 2010 pilot study conducted in Topeka, Kansas confirmed the importance of the community organizing efforts in both Missouri and Kansas. More than two dozen community task forces have since formed and are now in various stages of planning and implementation.

For more information about TPOPP and community task forces, check out the TPOPP toolkit below or contact the Center at 816-979-1366 or email


Please contact us for information about these resources.

A. Overview of Initiative – Leadership Team
B. Kansas-Missouri TPOPP Coalition Structure
C. Endorsements


A. Hospital Implementation Overview
B. Hospital Policy Implementation Elements
C. Sample Policy: University of Kansas Hospital


A. LTC Implementation Overview
B. Fast Facts for LTC


A. Fast Facts for EMS
B. Sample Policy: Oregon AD, POLST, DNR
C. Missouri DHSS OHDNR Clarification


A. Introduction to TPOPP – Plain Language
B. Caring Conversations Continued
C.TPOPP Form for Educational Use


If you are interested in working in your community to implement TPOPP, please email or call 816-979-1366.


Caring Conversations Continued is a small booklet that educates the public about TPOPP (includes a Durable Power of Attorney for Healthcare Decision forms and a TPOPP form (education version).
A. Order Caring Conversations Continued



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