The oregon physician orders for life-sustaining treatment registry

A preliminary study of emergency medical services utilization

Terri Schmidt, Elizabeth A. Olszewski, Dana Zive, Erik Fromme, Susan Tolle

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: The Physician Orders for Life-Sustaining Treatment (POLST) form translates patient treatment preferences into medical orders. The Oregon POLST Registry provides emergency personnel 24-h access to POLST forms. Objective: To determine if Emergency Medical Technicians (EMTs) can use the Oregon POLST Registry to honor patient preferences. Methods: Two telephone surveys were developed: one for the EMT who made a call to the Registry and one for the patient or the surrogate. The EMT survey was designed to determine if the POLST form accessed through the Registry changed the care of the patient. The patient/surrogate survey was designed to determine if the care provided matched the preferences on the POLST. When feasible, the Emergency Medical Services (EMS) record was reviewed to determine whether or not treatment was provided. Results: During the study period there were 34 EMS calls with matches to patients' POLST forms, and 23 interviews were completed with EMS callers, for a response rate of 68%. In seven cases (30%) the patient was in cardiopulmonary arrest; one patient had a respiratory arrest with a pulse. Eight respondents (35%) reported that the patient was conscious and apparently able to make decisions about preferences. For 10 cases (44%) the POLST orders changed treatment, and in six instances (26%) they affected the decision to transport the patient. For the 10/11 patients or surrogates interviewed, the care reportedly matched their wishes. Conclusion: This small study suggests that an electronic registry of POLST forms can be used by EMTs to enhance their ability to locate and honor patient preferences regarding life-sustaining treatments.

Original languageEnglish (US)
Pages (from-to)796-805
Number of pages10
JournalJournal of Emergency Medicine
Volume44
Issue number4
DOIs
StatePublished - Apr 2013

Fingerprint

Emergency Medical Services
Registries
Physicians
Emergency Medical Technicians
Patient Preference
Therapeutics
Heart Arrest
Telephone
Medical Records
Patient Care
Emergencies
Interviews

Keywords

  • EMS
  • POLST
  • resuscitation

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

The oregon physician orders for life-sustaining treatment registry : A preliminary study of emergency medical services utilization. / Schmidt, Terri; Olszewski, Elizabeth A.; Zive, Dana; Fromme, Erik; Tolle, Susan.

In: Journal of Emergency Medicine, Vol. 44, No. 4, 04.2013, p. 796-805.

Research output: Contribution to journalArticle

@article{5b9b5435b7c842b6a166b2c5789544a9,
title = "The oregon physician orders for life-sustaining treatment registry: A preliminary study of emergency medical services utilization",
abstract = "Background: The Physician Orders for Life-Sustaining Treatment (POLST) form translates patient treatment preferences into medical orders. The Oregon POLST Registry provides emergency personnel 24-h access to POLST forms. Objective: To determine if Emergency Medical Technicians (EMTs) can use the Oregon POLST Registry to honor patient preferences. Methods: Two telephone surveys were developed: one for the EMT who made a call to the Registry and one for the patient or the surrogate. The EMT survey was designed to determine if the POLST form accessed through the Registry changed the care of the patient. The patient/surrogate survey was designed to determine if the care provided matched the preferences on the POLST. When feasible, the Emergency Medical Services (EMS) record was reviewed to determine whether or not treatment was provided. Results: During the study period there were 34 EMS calls with matches to patients' POLST forms, and 23 interviews were completed with EMS callers, for a response rate of 68{\%}. In seven cases (30{\%}) the patient was in cardiopulmonary arrest; one patient had a respiratory arrest with a pulse. Eight respondents (35{\%}) reported that the patient was conscious and apparently able to make decisions about preferences. For 10 cases (44{\%}) the POLST orders changed treatment, and in six instances (26{\%}) they affected the decision to transport the patient. For the 10/11 patients or surrogates interviewed, the care reportedly matched their wishes. Conclusion: This small study suggests that an electronic registry of POLST forms can be used by EMTs to enhance their ability to locate and honor patient preferences regarding life-sustaining treatments.",
keywords = "EMS, POLST, resuscitation",
author = "Terri Schmidt and Olszewski, {Elizabeth A.} and Dana Zive and Erik Fromme and Susan Tolle",
year = "2013",
month = "4",
doi = "10.1016/j.jemermed.2012.07.081",
language = "English (US)",
volume = "44",
pages = "796--805",
journal = "Journal of Emergency Medicine",
issn = "0736-4679",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - The oregon physician orders for life-sustaining treatment registry

T2 - A preliminary study of emergency medical services utilization

AU - Schmidt, Terri

AU - Olszewski, Elizabeth A.

AU - Zive, Dana

AU - Fromme, Erik

AU - Tolle, Susan

PY - 2013/4

Y1 - 2013/4

N2 - Background: The Physician Orders for Life-Sustaining Treatment (POLST) form translates patient treatment preferences into medical orders. The Oregon POLST Registry provides emergency personnel 24-h access to POLST forms. Objective: To determine if Emergency Medical Technicians (EMTs) can use the Oregon POLST Registry to honor patient preferences. Methods: Two telephone surveys were developed: one for the EMT who made a call to the Registry and one for the patient or the surrogate. The EMT survey was designed to determine if the POLST form accessed through the Registry changed the care of the patient. The patient/surrogate survey was designed to determine if the care provided matched the preferences on the POLST. When feasible, the Emergency Medical Services (EMS) record was reviewed to determine whether or not treatment was provided. Results: During the study period there were 34 EMS calls with matches to patients' POLST forms, and 23 interviews were completed with EMS callers, for a response rate of 68%. In seven cases (30%) the patient was in cardiopulmonary arrest; one patient had a respiratory arrest with a pulse. Eight respondents (35%) reported that the patient was conscious and apparently able to make decisions about preferences. For 10 cases (44%) the POLST orders changed treatment, and in six instances (26%) they affected the decision to transport the patient. For the 10/11 patients or surrogates interviewed, the care reportedly matched their wishes. Conclusion: This small study suggests that an electronic registry of POLST forms can be used by EMTs to enhance their ability to locate and honor patient preferences regarding life-sustaining treatments.

AB - Background: The Physician Orders for Life-Sustaining Treatment (POLST) form translates patient treatment preferences into medical orders. The Oregon POLST Registry provides emergency personnel 24-h access to POLST forms. Objective: To determine if Emergency Medical Technicians (EMTs) can use the Oregon POLST Registry to honor patient preferences. Methods: Two telephone surveys were developed: one for the EMT who made a call to the Registry and one for the patient or the surrogate. The EMT survey was designed to determine if the POLST form accessed through the Registry changed the care of the patient. The patient/surrogate survey was designed to determine if the care provided matched the preferences on the POLST. When feasible, the Emergency Medical Services (EMS) record was reviewed to determine whether or not treatment was provided. Results: During the study period there were 34 EMS calls with matches to patients' POLST forms, and 23 interviews were completed with EMS callers, for a response rate of 68%. In seven cases (30%) the patient was in cardiopulmonary arrest; one patient had a respiratory arrest with a pulse. Eight respondents (35%) reported that the patient was conscious and apparently able to make decisions about preferences. For 10 cases (44%) the POLST orders changed treatment, and in six instances (26%) they affected the decision to transport the patient. For the 10/11 patients or surrogates interviewed, the care reportedly matched their wishes. Conclusion: This small study suggests that an electronic registry of POLST forms can be used by EMTs to enhance their ability to locate and honor patient preferences regarding life-sustaining treatments.

KW - EMS

KW - POLST

KW - resuscitation

UR - http://www.scopus.com/inward/record.url?scp=84875730424&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875730424&partnerID=8YFLogxK

U2 - 10.1016/j.jemermed.2012.07.081

DO - 10.1016/j.jemermed.2012.07.081

M3 - Article

VL - 44

SP - 796

EP - 805

JO - Journal of Emergency Medicine

JF - Journal of Emergency Medicine

SN - 0736-4679

IS - 4

ER -