At the national level “POLST” is referred to as “portable medical orders” or POLST for short. National POLST abandoned the acronym for several reasons though most states continue to use them and other terms like MOLST, MOST, POST, etc. Conceptually, POLST is an approach to advance care planning for patients who are considered to be at risk for a life-threatening clinical event because they have a serious life‐limiting medical condition, which may include advanced frailty. The POLST process emphasizes eliciting, documenting, and honoring patients’ preferences about the treatments they want to receive during a medical emergency or as they decline in health. At the end of the process, a health care professional may document these treatment preferences in a portable medical order called a POLST form. POLST forms must be completed by health care professionals and signed by a physician, advanced practice registered nurse, or physician assistant in line with their scope of practice and state law.
A POLST form is a medical order: it is neither an advance directive nor a replacement for advance directives. The POLST form is intended as a complement to advance directives in that it serves as a translational tool and a continuity of care assurance. It communicates patient treatment preferences to other health care professionals, including emergency personnel (EMS), when the patient lacks the capacity to speak for themselves. It is not solely for emergencies. POLST forms also provide guidance to:
• hospitals for creating in-hospital resuscitation status and other treatment order sets;
• facilities for transfer care upon discharge; and
• other health care professionals. The POLST form provides goals of care statements in the medical intervention section of the form to help health care professionals provide treatments not covered by the form to align with the patient’s goals.