February 2021

National POLST Endorsement

Pennsylvania POLST has been endorsed by the National POLST Plenary Assembly. Originally endorsed in 2010, the Program Standards Committee voted to reaffirm their endorsement of PA POLST for the current cycle (2021 – 2023). With the endorsement, National POLST provided considerations for the Pennsylvania POLST program including adapting or adopting National POLST Form to emphasize the voluntary nature of POLST. Additionally, it was recommended to consider updating the POLST Form to address the following:

• Include the language “medical orders” to be more explicit and descriptive of POLST’s intended use.
• Add a HIPAA as is found on almost all other POLST Forms.
• Remove “patient goals/medical condition” and hydration from form.

PA POLST is proud to be endorsed again by National POLST and will continue efforts to improve the quality of POLST in Pennsylvania.

Upcoming CQEL Meeting

The Coalition for Quality at End-of-Life (CQEL) is convening their quarterly meeting on Wednesday, March 3 with a focus on incorporating diversity and inclusion best practices into end-of-life and palliative care. The goal of the meeting is to share current efforts aimed at decreasing health disparities and understand the impact of racism in end-of-life care. Members were encouraged to complete the American Bar Association reading list for the 21-Day Racial Equity Habit-Building Challenge which can be accessed here. 

OHSU Center for Ethics Webinar: POLST & COVID-19

On January 22nd, Dr. Susan Tolle, Chair of the Oregon POLST Coalition and Director of the Center for Ethics in Healthcare, presented a webinar POLST & COVID-19: Supporting those who are Frail and Seriously Ill in Challenging Times as part of the Oregon Statewide Lecture Series. Dr. Tolle reviewed the likelihood of a frail elder surviving COVID-19 before discussing how providers can assure that existing POLST orders match their patient’s current treatment wishes and strategies for overcoming the logistical challenges of completing POLST virtually. Dr. Tolle’s lecture can be found on the Oregon POLST website or accessed directly here. 

Jewish Healthcare Foundation & WQED Special

The Jewish Healthcare Foundation produced a documentary entitled What COVID-19 Exposed in Long-term Care. As the COVID-19 pandemic ravaged senior residential facilities, blame was directed at the easiest target: the organizations and their operators. But where does the responsibility actually lie for the failure to protect tens of thousands of frail seniors? This documentary, the roots of the many mortalities in even the best long-term care facilities. The challenges faced by these organizations before COVID-19 weakened them during the crisis and will demand our attention even after the pandemic has ceased its fury.

On Wednesday, February 24 at 7:00pm WQED and Lynne Hayes Freeland will be hosting a documentary screening followed by a national panel of experts to discuss current trends in long-term care, what it means for seniors and their families, and what changes need to occur to support seniors in the future. You can register here to join the free hour-long program that will feature an expert panel that includes: 

• Stuart Altman, PhD, Brandeis University; and Chair of the Health Policy Commission, Commonwealth of Massachusetts
• Alice Bonner, PhD, RN, FAAN, Senior Advisor for Aging, Institute for Healthcare Improvement; and Director of Strategic Partnerships, Center for Innovative Care in Aging
• Karen Wolk Feinstein, PhD, President and CEO, Jewish Healthcare Foundation
• Terry Fulmer, PhD, RN, FAAN, President and CEO, John A. Hartford Foundation
• Bill Thomas, MD, Founder and Chairman, Minka; Founder, Green House Project; and Co-founder, ChangingAging.org
• Long-Term Care Industry Leaders from Presbyterian SeniorCare and Jewish Association on Aging, among others.

Personal Thank You 

Pennsylvania POLST wishes to acknowledge the contributions of Marian Kemp, RN, BSBA the PA POLST coordinator who recently announced her retirement.

Marian Kemp, RN, BSBA, worked many years in hospital nursing, eventually moving to Highmark Inc. In her role as Senior Markets project manager, she was responsible for multiple initiatives that targeted the senior population. This includes leading the annual flu immunization initiative; promoting programs to physicians and members to decrease the prescribing of “drugs to be avoided” in the elderly population, working to encourage physical activity and engaging in numerous other projects to improve the quality of life of members, including the award-winning Advanced Illness Services (AIS) program.

Over that time a major focus evolved around improving care at the end of life. Formal training as an advance care planning facilitator led to a twenty- year history advancing the use of the Physician Orders for Life-Sustaining Treatment (POLST) in Pennsylvania. Following retirement from Highmark in 2011, she was appointed POLST coordinator of the Coalition for Quality at the End of Life under the auspices of the Jewish Healthcare Foundation. In this role she led the efforts to provide statewide information and education on the POLST process. She had a leadership role in the development of the POLST Training: Doing it Right, designed to help assure the quality of the POLST conversation and the design of the PA POLST website https://www.papolst.org/.

“On our twenty- year journey in advocating and advancing POLST Marian was the true visionary who worked tirelessly behind scenes and I cannot thank her enough for her contributions,” said Judith Black MD, Medical Advisor Jewish Healthcare Foundation. Daniel Kimball, MD of Circle of Life Coalition of Berks County described Marian as a “nurturing, loving, gracious, enduing, encouraging presences for the PA POLST program” and sends his best wishes and continuing health as she moves into the next chapters of her life. Alexander Nesbitt, MD, Medical Director at Susquehanna Health Supportive and Palliative Care Williamsport and National POLST Plenary Assembly Representative expressed his gratitude for her work stating “I am sad to lose Marian in the role she has done such important work so well, but glad for her that she is stepping into her well-deserved retirement. Thank you, Marian for all you have done, you have helped to create an enduring legacy of understanding and use of the POLST all across the state.”

As stated in her final POLST Notes her wish is that the work continues and greater understanding of the value of POLST to patients and families and health care professionals is achieved. Marian will continue to be a member of CQEL representing community consumers.

Thank you for your continuing support of POLST.

Judith Black, MD, MHA

National POLST Plenary Assembly

Jewish Healthcare Foundation Medical Advisor

blackjs352@gmail.com

Nicole Greer, MPH, MPA, RN

PA POLST Coordinator

info@papolst.org

Coalition for Quality at the End of Life (CQEL)

Jewish Healthcare Foundation

EQT Plaza

625 Libery Ave, Ste. 2500

Pittsburgh, PA 15222

412-594-2550

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