Cedars-Sinai Medical Center

medical staff pulse newsletter

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Dec. 19, 2014 | Archived Issues

P and T Approvals, FDA Warnings About Alglucosidase Alfa, Methoxy Polyethylene Glycol-Epoetin Beta

Pharmacy Focus

See highlights of the Oct. 7 meeting of the Pharmacy and Therapeutics Committee. Also, the U.S. Food and Drug Administration has issued warnings about alglucosidase alfa and methoxy polyethylene glycol-epoetin beta.

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Meetings and Events


Grand Rounds

Click here to view upcoming grand rounds.


Upcoming CME Conferences

Click below to view a complete list of all scheduled Continuing Medical Education conferences.

CME Newsletter - December 2014 (PDF)


Milestones

Do you know of a significant event in the life of a medical staff member? Please let us know, and we'll post these milestones in Medical Staff Pulse. Also, feel free to submit comments on milestones, and we'll post the comments in the next issue. Click here to email us your milestones and comments.

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Share Your News

Won any awards or had an article accepted for publication? Share your news about professional achievements and other items of interest.

Click here to share your news

POLST Form Gets an Update for 2014

Bright pink POLST forms are available at all nursing units, from the Supportive Care Medicine team and from the Center for Healthcare Ethics.

The California form for Physician Orders for Life-Sustaining Treatment (POLST) has been revised for 2014, after five years of clinical experience and data collection, to be clearer and more accessible to patients and physicians.

Developed in Oregon in the 1990s and legally recognized in California since 2009, the POLST is a physician's order that outlines a plan for end-of-life care reflecting a patient's preferences and current medical condition. The bright pink POLST forms are available at all nursing units as well as from the Supportive Care Medicine team. They also are available on the Intranet and Internet pages of the Center for Healthcare Ethics.

A POLST form allows a physician and patient to establish default orders concerning end-of-life care that can be conveyed succinctly and clearly to other healthcare professionals, facilities and emergency personnel when a patient is at home, in a long-term care facility, in transit between locations, entering an emergency department or being admitted into or discharged from an acute-care facility.

The POLST form is completed by a patient's physician (or by someone who has undergone special training about POLST, such as a member of the Supportive Care Medicine team) in conjunction with thorough conversation with the patient regarding the patient's current and future health conditions and treatment preferences. Both the physician and patient must sign the POLST. If the patient lacks capacity to make medical decisions, the patient's legally recognized decision-maker can participate in completing and signing the POLST form.

For patients who arrive at Cedars-Sinai with a POLST, those orders are to be entered into the patient's medical record and stand until further orders are written, if necessary. Similarly, for patients being discharged to another facility or home, completing a POLST is a way to have the appropriate orders continue beyond the hospital walls.

Completing a POLST would be appropriate for any patient who, while at Cedars-Sinai, has Do Not Attempt Resuscitation (DNAR) status, has been seen by the Supportive Care Medicine team, is being discharged to hospice, or has a metastatic or end-stage organ disease or a terminal diagnosis and for whom death in the next 12 months would not be unexpected. A POLST also may be appropriate for patients permanently residing in long-term care facilities.

If you have additional questions about the POLST form, are interested in further education or would like assistance in having the POLST conversation, please contact the Supportive Care Medicine team (310-423-9520 inpatient, 310-423-7500 outpatient) or the Center for Healthcare Ethics (310-423-9636).

Additional information about POLST, as well as copies of the form and a FAQ sheet in English, Spanish, Russian, Farsi, or Korean, may be found here.