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Physician Orders for Life-Sustaining Treatment: Recommendations for Implementation in Pennsylvania

Robertson, Jamie Michelle (2009) Physician Orders for Life-Sustaining Treatment: Recommendations for Implementation in Pennsylvania. Master's Thesis, University of Pittsburgh. (Unpublished)

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The Physician Orders for Life-Sustaining Treatment (POLST) form was designed to help individuals in the last stages of life express their wishes regarding life-sustaining treatment. End-of-life care is often provided in a multitude of health care settings including hospitals, skilled nursing facilities, hospice centers, and in patients' homes. Communication failure between these facilities and patients or their families often leads to care that is in opposition to the patient's desires. In addition, living wills and advance directives that are currently in use do not provide health care workers with the information needed to properly carry out the patient's last wishes specific to life-sustaining treatment. POLST seeks to overcome these barriers by creating a simple, understandable form that is easily transferred between care settings. The POLST form was created in Oregon in 1991 and has since been used throughout the state. Numerous studies conducted in the state have found that the use of POLST ensures that patients receive the desired level of care during the end stages of life. The Commonwealth of Pennsylvania has been using the POLST form in a limited number of settings since 2000; however, widespread use of the form has yet to occur. As Pennsylvania has an aging population, quality care for those in the end stages of life is of particular public health importance. This paper examines the literature surrounding the development and implementation of POLST in Oregon, its spread throughout the United States, and its current status in Pennsylvania in order to answer the following questions: 1) Should Pennsylvania adopt widespread use of the POLST? And (2) if yes, how should the Commonwealth go about overcoming the barriers to implementation?


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Robertson, Jamie
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairNolan, Bethban17@pitt.eduBAN17
Committee MemberAlbert, StevenSMAlbert@pitt.eduSMALBERT
Committee MemberRohrer, Wesleywmrun@pitt.eduWMRUN
Date: 29 June 2009
Date Type: Completion
Defense Date: 13 April 2009
Approval Date: 29 June 2009
Submission Date: 8 April 2009
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: end-of-life care; advance directives; palliative care
Other ID:, etd-04082009-231045
Date Deposited: 10 Nov 2011 19:35
Last Modified: 15 Nov 2016 13:39


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