Transportable Physician Orders for Patient Preferences (TPOPP/POLST)
Transportable Physician Orders for
Patient Preferences (TPOPP/POLST)
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.
Want to Learn More about TPOPP/POLST?
For more information about TPOPP/POLST, check out the TPOPP/POLST Resources below or contact the Center at 816-979-1366 or email TPOPP@practicalbioethics.org.
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.
Interested in Implementing TPOPP/POLST?
If you are interested in implementing the TPOPP/POLST program, contact the Center at 816-979-1366 or email TPOPP@practicalbioethics.org.
Clinical Guidebook
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
Be advised: by ordering TPOPP/POLST forms, you agree to be in a position to properly implement and execute TPOPP/POLST forms in accordance with the National POLST and state law. If you are interested in implementing the TPOPP/POLST program at your healthcare system, contact TPOPP@practicalbioethics.org.
TPOPP/POLST Resources
I. OVERVIEW
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)
II. ACUTE CARE FACILITIES
A. Hospital Implementation Overview
B. Hospital Policy Implementation Elements
C. Sample Policy: University of Kansas Hospital (2015)
III. LONG TERM CARE (LTC) FACILITIES
A. LTC Implementation Overview
B. Fast Facts for LTC
IV. EMERGENCY MEDICAL SERVICES (EMS)
A. Fast Facts for EMS
B. Missouri DHSS OHDNR Clarification (2018)
V. CONSUMER INFORMATION
A. Introduction to TPOPP/POLST – Plain Language
B. TPOPP/POLST Caring Conversations Continued (under revision)
C. TPOPP/POLST Form for Educational Use
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
Questions: TPOPP@practicalbioethics.org
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