History of the Nevada POLST
In the early 1990s health ethicists in Oregon realized that preferences for life-sustaining treatments of patients with advanced illness were often not found or not transferred and therefore not honored. A task force was formed with stakeholders throughout Oregon’s health care community. Their efforts resulted in development of the first Physician Orders for Life-Sustaining Treatment (POLST) form and program.
Along with extensive statewide health care provider training, the program involves continuing quality improvement and research.
As knowledge of the success of the Oregon POLST program spread, other states began to adopt similar programs, variously called Medical Order for Scope of Treatment (MOST), Medical Order for Life-Sustaining Treatment (MOLST), Clinician’s Order for Life-Sustaining Treatment (COLST), etc. In order to set and assure standards for these programs, the National POLST Paradigm Task Force (NPPTF) was created.
In Nevada, The Nevada Center for Ethic & Health Policy (NCEHP) began to investigate the Oregon POLST program when they realized the POLST addressed issues that Nevada was also experiencing. After surveying and interviewing health care providers and patients across Nevada, NCEHP formed a coalition of stakeholders to develop a Nevada POLST. There were many iterations of the Nevada form, each one improving the form and addressing concerns of various constituents.
When NCEHP lost state funding in the economic down turn, the Nevada POLST Coalition leadership transferred to the Nevada State Medical Society. With the support and encouragement of the Nevada health care community the POLST form was introduced in the 2013 Nevada Legislative session as AB344 and passed both houses unanimously. In December 2013 the Nevada Division of Health and Human Services approved the Nevada POLST form without objection.