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POLST

If you are seriously ill or in very poor health, a physician, physician assistant, or advance registered nurse practitioner can use the Portable Orders for Life-Sustaining Treatment to represent your wishes for future care as clear and specific medical orders, indicating what types of life-sustaining treatment you want or do not want in the case of a medical emergency.

Is POLST for You?

If you have poor health from one or more chronic or serious medical conditions, it is important to talk to your physician or advanced practitioner about the risks you face if you were to have a medical emergency. You may want to make decisions about whether you would want to have life-sustaining treatments, such as cardiopulmonary resuscitation, started by emergency responders and be taken to a hospital or intensive care unit. Some people with poor health want to have the choice to not pursue some treatments in an emergency.

Your physician (or PA or ARNP) can use the Portable Orders for Life-Sustaining Treatment, or POLST, to represent your wishes as clear and specific medical orders, indicating what types of life-sustaining treatment you want or do not want in these emergencies.

POLST is not for everyone. POLST is designed for seriously ill individuals, or those who are in very poor health*, regardless of their age.

Learn more about POLST in the frequently asked questions sections at bottom.

How to obtain POLST

Patients are encouraged to ask their physician or health care professional for POLST but may also obtain a form by sending a self-addressed, stamped envelope to the WSMA, Attn: POLST, 2001 6th Ave., Suite 2700, Seattle, WA 98121.

Health care professionals may order a supply of POLST forms as well as a trifold patient information brochure on POLST below. POLST materials are free for WSMA members. Limited quantities are available to clinics and hospitals. A small fee is charged for non-members.

Print your own POLST

Health care organizations and professionals may choose to print their own copies of POLST. We advise that you print the English version of the form on green card stock (Astrobrights terra green, smooth finish, 65 lbs., #22781, or an equivalent). Please keep in mind that copies, digital images, and faxes are valid, as is POLST on different paper. Many institutions use a bright lime green printer-weight paper.

English POLST form for print

English POLST trifold patient brochure

Additional POLST information, including educational videos, is available in the POLST Information for Health Professionals section below.

POLST Form
POLST Form

The Portable Orders for Life-Sustaining Treatment (POLST) form represents a way of summarizing wishes of an individual regarding life-sustaining treatment. The form is intended for any individual with an advanced life-limiting illness.

Non-member price: 0.75
Member price: 0.00
0.75
POLST Brochure
POLST Brochure

This tri-fold brochure is designed for your waiting room and/or to be distributed directly to patients, and contain an overview of and frequently asked questions about the POLST form.

Non-member price: 0.75
Member price: 0.00
0.75

Members may receive up to 100 free copies per member per quarter, and may order more at the rates listed above. Non-member orders of 50 or more POLST forms or POLST brochures are $0.25 each.

POLST Translations

The POLST form and trifold patient brochure are translated into the following languages. These translated forms are provided for educational purposes only. Talk with your health care team if you have questions or need guidance.

Amharic

Arabic

Chinese (Simplified)

Chinese (Traditional)

Chuukese

Farsi

Hindi

Korean

Oromo

Punjabi

Russian

Somali

Spanish

Tagalog

Tigrinya

Ukrainian

Vietnamese

POLST Information for Health Professionals

Welcome to the Washington POLST Clinician Toolkit

This toolkit is designed to assist health care teams identify who should be offered a POLST, how to apply clinical decision-making to know when and how to offer POLST, how to avoid pitfalls in the clinical use of POLST, and how to ensure a POLST reflects an individual’s goals. This toolkit contains resource materials to explain how to use a goals-of-care conversation in conjunction with POLST to provide whole-person care and ensure individuals with serious illness receive care that is consistent with their values and goals.

This toolkit was developed with the support and cooperation of the Washington POLST Task Force, the Washington Serious Illness Care Coalition, the Washington State Medical Association, and the Washington State Hospital Association.

For a video introduction to the toolkit, watch the WSMA Continuing Professional Development webinar, “The Washington POLST Clinician Toolkit: Best Practices to Ensure Person-Centered Care.” This activity has been approved for AMA PRA Category 1 Credit. Watch video and claim CME credit.

Download the toolkit

These documents are intended to be used in conjunction with each other.

Advance Care Planning: Advance Directives and POLST

Advance care planning, advance directives, and POLST all work together to guide an individual’s health care decisions at different stages in their life.

Goals of Care Conversations for Individuals with Serious Illness  

Goals of care conversations for individuals with serious illness are an integral component to person-centered care.

POLST Completion Guide for Clinicians

This POLST Completion Guide is a resource designed to help health care providers (MD, DO, ARNP, PA-C) engage with individuals, or their legal medical decision makers, to meaningfully and effectively complete a POLST. We suggest you review this guide with a printed POLST form.

POLST Best Practices

This document explores best practices for the Washington POLST. These best practices have been selected to guide care, avoid common errors on the POLST, and support the development of systems for goal concordant care.

POLST and Your Practice Newsletter

POLST and Your Practice is sponsored by the Washington POLST Task Force.

Who should have POLST?

It is recommended that physicians and advanced practice clinicians (MD, DO, ARNP, PA-C) ask themselves, “Would I be surprised if this patient died in the next 1-2 years?” If you would NOT be surprised, this person probably has a serious or chronic progressive health condition that is either nearing its end stages or is likely to progress to a life-threatening state suddenly. This person would benefit from a conversation with you about the kind of care they would want in an emergency. When POLST is used to document decisions and preferences about emergency measures and other medical care, with proper signatures, it becomes an actionable order that can be honored across settings, from home to long-term care to the hospital in an emergency.

How is POLST used?

POLST is used to tell health care personnel, especially emergency responders and those working in out-of-hospital settings, what level of care the person would want in an emergency. This includes an actionable "code status" order.

In a health care facility, the form should be the first document in the clinical record and should also be posted in an accessible location close to the patient. It should be recognized as a set of medical orders, to be implemented as any other signed clinician order would. In a non-institutionalized setting (such as a home), the bright green form should be located in a prominent location. It will be recognized by emergency personnel as orders to be followed.

The completed POLST is a portable medical order form; it should remain with the individual if they are transported between care settings, regardless of whether they are in the hospital, at home, or in a long-term care facility. The institution may wish to keep a duplicated copy in the permanent medical record upon discharge.

POLST "dos and don'ts" for clinicians

DO remember to sign and date the form. Signatures of both the signing clinician and the individual (or their legal medical decision-maker) are required.

DO be aware that while POLST can be signed by surrogate decision-makers, it is best if the individual signs the POLST indicating that it represents their wishes. When this is not possible, the physician or health care professional and the surrogate decision-maker should ensure that the POLST agrees with the individual’s prior directives or their known wishes, or is in their best interest, given what is known about their values and goals.

DO make sure that the patient understands the treatment options at each level of care.

DO discuss the person’s preferences regarding medically assisted nutrition i.e., artificial feeding. Indicate on side 2 of the POLST if the patient has preferences that would inform discussions about medically assisted nutrition.

DO recognize that a patient wishing DNR for cardiopulmonary arrest might still want full treatment. This can be indicated by checking DNAR in Section A and Full Treatment in Section B.

DO ensure that if a person chooses to have CPR (YES in Section A), they should be advised to choose Full Treatment in Section B, since CPR frequently includes intubation and ICU care.

DO consider introducing POLST to Alzheimer’s patients while they can consider and sign the documents themselves. Discuss “down the road” scenarios thoroughly, so that patients can opt to amend prior documents to properly instruct their families about what future choices might be.

DO work with administrators in facilities where you are an attending or serve as medical director to ensure that there is a timely process for discussing and completing POLST and policies that outline how members of their team will honor POLST.

DO be aware that, while Medicare requires health care institutions to ask about advance care planning documents, it prohibits them from compelling or requiring patients have these forms, including POLST.

DON’T pre-sign forms for facility settings.

DON’T send the form home with a patient to fill out on their own. If a patient wants to show the form to their family or surrogate decision-makers, DO set up an appointment to have them review it with you for final decisions and signatures.

POLST FAQs for Patients

Review the following frequently asked questions to learn more about POLST. If you still have questions, please speak with your physician or health care professional to learn more and to find out if POLST is right for you.

What is the POLST form?

POLST is a physician order that helps give seriously ill patients more control over their end-of-life care. Produced on distinctive bright green paper and signed by both the clinician and patient, POLST specifies the types of medical treatment that a patient wishes to receive toward the end of life. As a result, POLST can prevent unwanted or medically ineffective treatment, reduce patient and family suffering, and help ensure that patients’ wishes are honored.

How is POLST different from my advance directive? Do I need both?

Every adult can benefit from having conversations with their health care professionals and trusted people in their life about what they might want for medical care if a sudden emergency, accident, or illness were to happen. These conversations, and the decisions you make, should lead to having documents called advance directives.

Advance directives can indicate:

  1. Who you choose to be your legal medical decision-maker (also known as a medical surrogate or health care agent). This is documented in a type of advance directive known as a durable/medical power of attorney for healthcare (DPOA-HC)
  2. Information about what matters to you, what makes your life worth living, and specific decisions you might want to make about:
    — Whether to have life-saving, or life-prolonging treatments such as CPR.
    — What level of care you might want in a hospital, whether to have artificial fluids and feeding, dialysis, or care in an intensive care unit. ICU care usually involves more complicated and invasive kinds of medical care (e.g., machines that support breathing and heartbeat, extreme treatments aimed at keeping you alive).

Some Durable Power of Attorney for Healthcare (DPOA-HC) forms allow you to add this information. Or you may want to complete a type of advance directive known as a health care directive, which will also ask about your choices for medical care if you are diagnosed with a terminal illness or a condition known as a permanent vegetative state.

What are my options for life-sustaining treatment?

You have the power to determine the kind of treatments you want to receive and the kind of treatments you want to avoid. To help you understand your options, visit the new Honoring Choices Pacific Northwest website for information that will help you begin these conversations with your family and health care professionals.

What information is included on the POLST form?

The decisions documented on the POLST form include whether to:

  • Attempt cardiopulmonary resuscitation (CPR).
  • Administer antibiotics and IV fluids.
  • Use a ventilator to help with breathing.
  • Provide artificial nutrition by tube.

Does a POLST form limit the type of treatment I can get? What if I get a simple infection?

POLST gives you more control over receiving treatments you want to receive and avoiding treatments you do not want to receive in the event you are unable to speak for yourself during a medical emergency. If you want everything possible done during a medical emergency, then your health care professional would complete the form showing “CPR” and “Full Treatment.” Conversely, if you want other treatment, your health care professional would complete the form showing “Comfort Measures Only” or “Limited Treatment.”

Additionally, POLST states that ordinary measures to improve the patient’s comfort, and food and fluid by mouth as tolerated, are always provided.

Is POLST required by law?

No. Completing a POLST form should always be voluntary.

Who would benefit from having a POLST form?

POLST is not for everyone. POLST is designed for seriously ill individuals or those who are in very poor health, regardless of their age.

Most people are too healthy to need a POLST. If something suddenly happened, many healthy seniors would want everything done while more was learned about what was wrong and about their chances of recovery. Healthy people should have an advance directive. Later, if the patient became sicker or frailer, they or their surrogate (for example, their power of attorney for health care) can complete a POLST to turn their treatment wishes into medical orders.

Does the POLST form replace traditional advance directives?

POLST complements an advance directive and is not intended to replace that document. An advance directive is still necessary to appoint a legal health care decision-maker, and is recommended for all adults, regardless of their health status.

If someone has a POLST form and an advance directive that conflict, which takes precedence? If there is a conflict between the documents, the more recent document generally would be followed.

Who completes the POLST form?

A health care professional, usually a physician, nurse, physician assistant, or social worker, completes the form after having a conversation with the patient to understand their wishes and goals of care. Once completed, POLST must be signed by both the patient and either their physician (MD/DO), a nurse practitioner (ARNP), or a physician assistant-certified (PA-C). The physician, nurse practitioner, or physician assistant who signs the form assumes full responsibility for its accuracy.

Patients should not be provided a POLST form to complete on their own. A POLST form should never be completed without a conversation with the patient, or their surrogate, about diagnosis, prognosis, treatment options, and goals of care.

Can the physician signing the POLST form be a naturopath or chiropractor?

At this time, a physician signing the POLST should be an MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine). An advanced registered nurse practitioner (ARNP) or physician assistant certified (PA-C) may also sign the form.

What happens to my POLST form after it is completed and signed?

What if my loved one can no longer communicate their wishes for care? A health care professional can complete the POLST form based on family members’ understanding of their loved one’s wishes. The appointed surrogate decision-maker can then sign the POLST form on behalf of their loved one.

The original POLST form, on bright green paper, stays with you at all times. In a hospital, nursing home or assisted living facility, the form will be in your medical record or file. If at home, place your form in a visible location so it can be found easily by emergency medical personnel, usually on a table near your bed or on the refrigerator.

Can I change my POLST form?

Yes, you can change your POLST at any time should your preferences for treatment change. It is a good idea to review the decisions on your POLST form when any of the following occur:

  • You are transferred from one setting to another—for example you go from your home to the hospital or you are discharged from the hospital to a nursing home.
  • There is a change in your overall health or you are diagnosed with an illness.
  • Your treatment preferences change for any reason.

What happens if I don’t have a POLST form?

Without a POLST form, emergency medical personnel, nurses, and physicians would not know your treatment wishes. You will most likely receive all possible treatments, whether you want them or not. Talking about your treatment choices with your loved ones and physician before a problem occurs can guide them and help ensure you get the care you want.

Are faxed copies and/or photocopies valid? Must green paper be used?

Faxed copies and photocopies are valid. Bright green paper is used to distinguish the form from other forms in the patient’s record; however, the form will be honored on any color paper.

Is POLST available as a wallet card or bracelet?

At this time, the Washington state POLST is only available in its standard size—some facilities have on occasion created on their own “pocket” versions of POLST, but these variations of the standard size form are not officially sanctioned by the POLST-sponsoring organizations (the WSMA and the Department of Health).

In Washington state, the Department of Health instructs their paramedics to be guided by the POLST form and only the POLST form. While a “pocket” POLST, or bracelets and necklaces could alert a first responder as to a person's wishes and may encourage them to find the POLST form, medics in Washington are not allowed to act on directions found on that pocket card or bracelets/necklaces alone.

Can I request a DNR (Do Not Resuscitate) bracelet from my provider?

While some states allow bracelets to serve as instructions to be followed by paramedics in the field, in Washington state, the POLST form is the only set of medical orders approved by the Department of Health that paramedics and emergency medical services teams can follow outside of a medical facility. Bracelets and necklaces could alert a first responder as to a person's wishes and could certainly encourage them to find the POLST form, but Washington state medics are not allowed to act directions found on bracelets or necklaces alone.

Where is POLST used now?

POLST was originally developed in Oregon. There are a number of states that currently have POLST programs in place or that are developing POLST programs. For more information on the national POLST effort, visit its website.

What if I travel to another state—will my POLST be valid?

If you are traveling to another state, it is a good idea to take both your advance directive and your POLST form with you. Both documents, even if not legally binding, will help physicians and health care professionals know your wishes.

What if I move to another state—will my POLST be valid?

If you are moving, you should bring your POLST with you to your first appointment with your new physician or health care professional to put your wishes on that state’s POLST form (for a list of states with POLST programs, visit the national POLST program website. You should also talk to your attorney about updating your advance directive, as some states require you use a specific form in order for your advance directive to be valid.

Do emergency responders in Washington honor the Oregon POLST and vice/versa?

EMTs in Washington state will do their best to honor other state's POLST forms as long as the other state form has the basic elements of the Washington form. One significant difference between the Oregon and Washington forms is that a patient signature is required on the Washington state form, but not on the Oregon form. Physicians and patients/surrogates need to be aware that if they choose not to sign an Oregon POLST, it may be harder for EMS or physicians in Washington to honor it.

The Washington POLST will be accepted and honored in Oregon by both EMS and local hospitals.

It’s recommended that a patient fill out a form for the state where they reside.

Is there a state registry for POLST?

There is not a state registry in Washington state at this time.

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The Washington State Department of Health is conducting a sunrise review of House Bill 2116, which would expand prescriptive authority for pharmacists. The bill, brought forward by the Washington State Pharmacy Association, would move our state away from the collaborative drug therapy agreement currently being utilized and would instead grant the Pharmacy Quality Assurance Commission the ability to determine a pharmacist's prescriptive authority. We are not aware of any precedent in our state for this level of legislative delegation of authority for setting scope of practice to a board or commission.

The proposal contemplates pharmacists treating "minor ailments, initiating and modifying treatment for chronic conditions, providing preventative care, and managing emergency situations that present in a pharmacy." There are no specifically stipulated additional education or training requirements for pharmacists providing these services.

We have concerns not limited to patient safety and care coordination, as this proposal doesn't include any meaningful safeguards. Furthermore, the Legislature-not a regulatory board-is responsible for setting a profession's scope of practice, and this bill would set a precedent for both the practice of pharmacy and other professions.

Written comments and due back to the DOH by April 1. If you share our opposition to this proposal, we encourage you to share your comments by emailing the department of health. The DOH will also be holding a public hearing on the proposal on Wednesday, March 14 at 1 p.m. via Zoom. If you have questions on this sunrise review or how to best engage, please contact WSMA Associate Policy Director Billie Dickinson.

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Negotiating Contracts: Ask the Right Questions

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Evaluating a potential job and employer is all about asking the right questions. The more answers you can find, the better equipped you will be to negotiate a contract and make the final decision to sign or not. You obviously want to know your salary, benefits package, or paid time off. However, there are other inconspicuous terms of employment that you'll want to know about sooner rather than later. Here are a few questions to ask your future employer.

What are the other physicians like, and how do you fit in?

Getting to know who you would be working alongside will absolutely give you a better idea of how the practice functions. If you're able to speak with physicians and other current employees directly, you could also gain some insight into what they do or don't like about their workplace.

Most importantly, you want to understand where you fit with the other physicians from a scheduling standpoint. The way they are scheduled will affect when you work, and vice versa. Find out how many other physicians are working and how you share call time with them. Ideally, call time should be equal and rotating between all physicians involved. Whether or not this is the case, also investigate capping your call time to avoid taking an unnecessary amount.

Finally, know what happens when another physician must be absent. Will there be a backup, or will you have to pick up the slack? Similarly, what happens if someone leaves the practice entirely? Find out how the employer plans to handle these situations, and ensure your contract protects you from taking on any excess workload.

What patient volumes can be expected?

Production bonuses are great, but only if you can meet the threshold. When your earnings are dependent on the number of patients you see, you must either see more patients or lower the expectations defined by your employer. While the former is mostly out of your control, the latter can be changed in your employment contract.

Inquire about patient volumes early in your talks with an employer. If you get the chance, ask other employees as well, so you get a more neutral view of the situation. Once you receive a contract, if you know what volumes to expect, you can determine whether the proposed bonus rate and threshold are reasonable. You don't want to sign a contract with a bonus threshold you will never realistically reach.

What happens in the event of a buyout?

Questioning these more unassuming contract details helps you prepare for the "what-ifs," and a buyout is a big what-if to plan for. Even if it seems unlikely, do not write off the possibility of a buyout or acquisition taking place.

Your contract should include specific language designed to protect you in such situations. For example, if your contract includes a non-compete, that clause should be written in a way that it is waived in the event of a buyout. When you sign the contract, you agree to non-compete terms relative to your employer's current location(s). You don't want the clause applied to additional locations owned by an acquiring company, and you may want to leave the practice altogether if you don't like the new direction. Being unrestricted by a non-compete allows you the freedom to change jobs without changing location.

Malpractice tail coverage also becomes a topic of concern when ownership changes. It's ideal that your employer is responsible for 100% of your tail coverage costs if a buyout happens, provided they aren't already. Like waiving the non-compete, this gives you additional flexibility if you decide to leave the practice, since you won't have to worry about paying for tail coverage.

Additionally, ensure your path to partnership is uninterrupted, and preferably accelerated as well. You don't want to put a lot of time into a practice, get close to obtaining partnership, and then have a buyout postpone or even negate everything. The effects of a buyout on your partnership should also be specified in your contract.

It's all in the details

When searching for a new job, you can save a lot of time and avoid trouble down the road by ironing out the small details early. Don't be afraid to ask questions, even if they regard situations that seem insignificant or unlikely to happen. Some employers may downplay the possibility of a buyout or staffing changes. Even so, after you've found sufficient answers to your questions, ensure that you have protection written into your contract. Although you may be able to renegotiate later, it's always best to fully understand your employment terms and negotiate them before you sign.

--This article is brought to you by WSMA's preferred partner, Resolve, providing WSMA members discounts on employment contract review services and salary data.

You may also find WSMA's Career Center of interest in your job search. Find out more here.

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Scope of Practice Bills Among Legislation No Longer Advancing in the Legislature

Several cutoff deadlines have passed in the 2025 legislative session, narrowing the field of bills eligible for further consideration this year. Over1,800 bills have been introduced on a wide variety of issues, including the practice of medicine, housing reform, and redesigning the state flag. Only those bills that have passed the deadlines will continue on in the legislative process (though bills that are considered necessary to implement the budget are not subject to the Legislature's cutoff deadlines).

Nothing is truly "dead" in Olympia until session adjourns, but at this time a number of WSMA-opposed bills related to scope of practice and the business of medicine are not expected to receive further consideration this year including:

  • HB 1888: Would have granted naturopaths prescriptive authority for Schedules III-V drugs, and stimulant medications contained in Schedule II, without detailing specific education and training requirements.
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  • HB 1507: Would have generally prohibited physicians and practitioners from entering into non-disclosure and non-disparagement agreements with patients, adversely impacting the ability of physicians to enter into voluntary settlements of medical malpractice actions.
  • HB 1881/SB 5704: Would have established numerous restrictions under which health care entities may enter into partnerships such as mergers and sales.
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