NEW YORK NURSE: September 2010
by Erin Silk
The Medical Orders for Life-Sustaining Treatment (MOLST) form is a medical order form authorized for use in New York state hospitals and nursing homes since 2005. The form is based on communication between patients, healthcare agents and healthcare professionals to develop treatment plans that reflect patient wishes. Examples of life-sustaining treatments include Cardiopulmonary Resuscitation (CPR), intubation and mechanical ventilation, antibiotics, and artificial hydration and nutrition (feeding tubes). The MOLST form, along with the traditional advance directives (health care proxy and living wills), allows for more comprehensive planning for individual decisions regarding life-sustaining measures and end-of-life care.
MOLST was updated in June 2010 to align with the Family Health Care Decisions Act which allows family members to make healthcare decisions on behalf of patients who lose their ability to make such decisions and have not prepared advance directives indicating their wishes.
MOLST is based on the Physician’s Orders for Life-Sustaining Treatment (POLST) program that originated in Oregon and has been developed and researched since the 1990s. POLST has demonstrated that advance care planning is more effective when information is communicated across the healthcare continuum because patient wishes are more likely to be followed, resulting in reduced unwanted hospitalizations at the end of life.
The Family Health Care Decisions Act renders the 2008 Supplemental MOLST forms obsolete, making the process more user-friendly. Documentation of the clinical process does not need to travel with the patient, unless the patient is mentally disabled and lacks the necessary medical decision-making capacity. For more information, visit www.compassionandsupport.org.