POLST Illinois Annual Leadership Meeting Past Present and

POLST Illinois Annual Leadership Meeting Past, Present and Future March 22, 2016

Welcome & Introductions

And some specific Thank You’s

Advance Care Planning Life Cycle FIRST PHASE • ID and document a proxy • Consider wishes if faced with catastrophic irreversible neurological injury Healthy and Independent NEXT PHASE • Identify goals of care • How/would goals change if condition worsened? • Decisions may be specific to condition • Discuss with proxy & provider Docume nt on Po wer of A Advancing Chronic Illnesses and Functional Decline ttorney LAST PHASE • Reassess goals of care • Code status & treatments in case of other emergencies; artificial nutrition • Proxy may decide if pt not decisional Multiple Co. Morbidities and Increasing Frailty form Docume nt on PO LST form

Definitions • POLST – Practitioner Orders for Life-Sustaining Treatment • POLST Paradigm –is the ideal approach to end -of-life planning. It is a process, not a form to check-off • POLST Programs – are how states are implementing the POLST Paradigm • POLST Form – the form used by a state to document a person’s wishes. 5

The POLST Paradigm: • Allows patients to choose all possible lifesustaining treatment, selected life-sustaining interventions, or comfort care only. • Is intended for persons of any age for whom death within the next year would not be unexpected – This includes patients with advanced illness or frailty – POLST is not intended for persons with chronic, stable disability, who should not be mistaken for being at the end of life. 6

POLST Program Evolution through 2015 7 6

POLST Use in the United States The POLST Paradigm is now in the majority of states 8 6

Evolution of the DNR/POLST Form Orange “DNR” form 2000 IDPH Uniform DNR “Order Form” First POLST Illinois Taskforce leadership meeting Legislation improves form to include POLST (Practitioner Orders for Life-Sustaining Treatment) in the title, authorizes other practitioners to sign 2005 IDPH Uniform DNR “Advance Directive” 2006 2012 IDPH released a legislated version “IDPH Uniform DNR Advance Directive” 2013 2015 2016 Legislation removes “DNR” from title of the form; form officially entitled “POLST”; changes pending

Status of POLST in Illinois • Once updated, Illinois form will meet all critical National POLST Paradigm Taskforce form requirements • Illinois is currently considered a “developing state” by the National POLST organization • Becoming an “endorsed state” would require additional components – Formal organizational home – Plan for ongoing implementation/education and quality assurance – [addressing witness signature] 10

POLST Illinois Activities in past year • Worked with ISMS to pass legislation removing “DNR” from the title of the form, form revision from IDPH pending • Worked with EMS state educational committee representative to develop slide deck that will be available to all EMS regions once form revision completed • Transitioned communication tools to Mail Chimp • Materials revised/added to polstil. org website – Slide presentations (long and short), POLST Summary/Fact Sheet, FAQ’s, General Guidance for clinicians – Narrated 40 -minute slide presentation on POLST Illinois • Represented POLST Illinois with exhibits at Illinois Public Health Association and Leading Age annual meetings • Local co-host of first open national meeting of National POLST Paradigm • ISMS webinar with Rob? 11

The IL DNR/POLST Form version 2015 12

Questions? 13

Where does POLST Illinois go from here? 14

POLST Illinois Organizational Chart- Ideal State POLST Illinois Taskforce Executive Team Policy/Legal Sustainability/Funding/Home Program Evaluation/ POLST “Go To Resource”/Training Tracking/ Quality Improvement POLST Form Marketing and Communications POLST Registry First Responders Sites of Care Long-term Care EMS Emergency Departments Public Education Hospice Outpatient Home-Based Care Hospitals Healthcare Organizations

POLST Illinois Organizational Chart- Actual State POLST Illinois Taskforce Executive Team Lots of Interested and Enthusiastic Parties

Re-establish Work Groups- Priorities? • Education/Training – Healthcare and Community • Sustainability/Funding • Communications • Benchmarks and Quality • Registry? 17

Education/Training – Healthcare and Community – Bring consistent messaging and training to different parts of the state – Educate consumers and professionals around • • What POLST is and who it is for Appropriate use of POLST in various settings Goals of Care conversations For professionals, new context: CMS payment for ACP conversations 18

Education/Training- Ideal Chart POLST “Go To Resource”/Training Sites of Care First Responders Long-term Care EMS Emergency Departments Hospice Outpatient Home-Based Care Hospitals

Sustainability/Funding – Find a statewide home for POLST • Collaborative, Sponsorship fit with mission • Maintains the energy of the coalition • Potential for support re fiscal management, public relations, educational programming, research and publication resources, communications and social media support • Meaningful relationship with the National POLST Paradigm Task Force – Identify funding to support Illinois POLST 20

Communications – Identify personal success stories that will compel the media to cover POLST. – Social media – Website maintenance – Mail chimp/communications with Taskforce and workgroups 21

Benchmarks and Quality – Conduct a baseline survey to determine awareness, use, and quality in different healthcare settings including EMS, nursing homes, hospitals etc. – Develop quality measures 22

Registry – is it too soon to address this? 23

Overall Structure • Hub Taskforces? • Paid Administrator? 24

Step Up! Who wants to do what? 25

Next Steps

Questions?

For additional information, please visit www. polstil. org 28

Please forward any additional questions, or to volunteer to: polstillinois@gmail. com 29

Thank you!!! 30