About the National POLST Paradigm

The National POLST Paradigm is an approach to end-of-life planning that emphasizes patients’ wishes about the care they receive. The POLST Paradigm – which stands for Physician Orders for Life Sustaining Treatment – is an approach to end-of-life planning emphasizing: (i) advance care planning conversations between patients, health care professionals and loved ones; (ii) shared decision-making between a patient and his/her health care professional about the care the patient would like to receive at the end of his/her life; and (iii) ensuring patient wishes are honored. As a result of these conversations, patient wishes may be documented in a POLST Form, which translates the shared decisions into actionable medical orders. The POLST Form assures patients that health care professionals will provide only the treatments that patients themselves wish to receive, and decreases the frequency of medical errors.

POLST is not for everyone. Only patients with serious illness or frailty, for whom a health care professional would not be surprised if they died within one year, should have a POLST Form. For these patients, their current health status indicates the need for standing medical orders. For healthy patients, an Advance Directive is an appropriate tool for making future end-of-life care wishes known to loved ones. Click here for more information about the difference between POLST and Advance Directives.

The National POLST Paradigm embodies and promotes the essential elements of a POLST Program; individual states and regions implement POLST Programs. As a result, state programs vary in name (e.g. MOLST, COLST, MOST, and POST), how their programs are implemented, and in the appearance of their Forms. Although these POLST Programs may be identified by the NPPTF as “Developing Programs” and/or use the term “POLST” or a similar term, they do not represent the POLST Paradigm until they have been endorsed by the NPPTF. Only state programs that have demonstrated to the NPPTF that their POLST Program and Form meet NPPTF standards can be endorsed.