A Gamechanger for Living Well with Serious Illness

October 4, 2019

We are at an exciting crossroads for improving the way we help adults live well with serious illness. Since Massachusetts joined the National POLST Paradigm in 2017, the MA MOLST (Medical Orders for Life-Sustaining Treatment) Advisory Committee has been working diligently to bring our serious illness care and MOLST process into compliance with the national standard.

The National POLST Paradigm has been hard at work too. Representatives of this 43 state collective have lent their expertise to create the first ever national form with accompanying materials. Each state can now choose to adopt the new form to further strengthen our national standard of care, create reciprocity across states, and improve delivery of care for adults all through serious illness.

Adopting the national form is a game changer for Massachusetts. It puts us on the path of immediate compliance with the national standard and provides a standardized, evidence-based form and process at no extra cost to the state. There are multiple benefits to implementing a new national standard of care and national form, including:

  •  Improved, responsive process where each individual, their Health Care Agent and Guardian, can engage in planning discussions with clinicians for quality care from first diagnosis of a serious illness, through managing treatments, to end of life care;
  • New form has clear treatment decisions that foster early  and on-going effective care discussions as health needs change;
  • New standard of care helps aligns the policies & procedures of all major stakeholders in all care settings;
  • Access free multilingual documents and downloadable tools for consumers and care providers;
  • Creates key implementation components such as on-line professional education, consumer education, and quality monitoring.

Joining the National POLST Paradigm and adopting the national form is the next natural step in our rich history of building a high quality, serious illness care process.

To date, the 28 member MA MOLST Advisory Committee, a subcommittee of the Department of Public Health (DPH) Palliative Care & Quality of Life Interdisciplinary Advisory Council, has completed a comprehensive review of our rich history and our current problematic, often dysfunctional MOLST process. The MOLST Advisory Committee has represented the state in contributing to several draft versions of the new national form including the improved treatment decisions section.

The MA MOLST Advisory Committee voted to recommend to DPH that we adopt the national form and process for use in Massachusetts, to be accompanied by a MA Implementation Guide that reflects our improved governing structure and key implementation components.

Once the new form is adopted, the MA MOLST committee will get right to work to:

  • build-in the necessary governing structure with key implementation components of professional training, consumer information, policies and procedures and quality control;
  • work with all stakeholders-Emergency Medical Services, hospitals, skilled nursing facilities, community  groups and Probate and Family Court- align protocols & procedures under the new form;
  • coordinate with National POLST to access education materials, video and webinars;
  • create a simple MA Implementation Guide with MA terms, regulations and procedures.

Ideally, once we have established a comprehensive collaborative statewide process, a measured roll-out of the new form and process can begin.

Next Steps: The Department of Public Health is reviewing the MA MOLST Advisory Committee’s recommendation and will make a determination of adopting the national form and process shortly.

What can you do?