1. POLST Illinois Annual Leadership Meeting Past, Present and Future March 22, 2016

2. Welcome & Introductions

3. And some specific Thank You’s

4. F IRST P HASE ID and document a proxy Consider wishes if faced with catastrophic irreversible neurological injury N EXT P HASE Identify goals of care How/would goals change if condition worsened? Decisions may be specific to condition Discuss with proxy & provider L AST P HASE Reassess goals of care Code status & treatments in case of other emergencies; artificial nutrition Proxy may decide if pt not decisional Document on Power of Attorney form Document on POLST form

5. POLST – Practitioner Orders for Life-Sustaining Treatment POLST Paradigm –is the ideal approach to end-of-life planning. It is a process, not a form to check-off POLST Programs – are how states are implementing the POLST Paradigm POLST Form – the form used by a state to document a person’s wishes. 5Definitions

6. Allows patients to choose all possible life- sustaining treatment, selected life-sustaining interventions, or comfort care only. Is intended for persons of any age for whom death within the next year would not be unexpected – This includes patients with advanced illness or frailty – POLST is not intended for persons with chronic, stable disability, who should not be mistaken for being at the end of life. 6 The POLST Paradigm:

7. 7 POLST Program Evolution through 2015 6

8. 8 POLST Use in the United States The POLST Paradigm is now in the majority of states 6

9. Evolution of the DNR/POLST Form 2000 2005 2006 2013 2015 2016 Orange “DNR” form IDPH Uniform DNR “Order Form” IDPH Uniform DNR “Advance Directive” IDPH released a legislated version “IDPH Uniform DNR Advance Directive” Legislation improves form to include POLST (Practitioner Orders for Life-Sustaining Treatment) in the title, authorizes other practitioners to sign First POLST Illinois Taskforce leadership meeting 2012 Legislation removes “DNR” from title of the form; form officially entitled “POLST”; changes pending

10. Once updated, Illinois form will meet all critical National POLST Paradigm Taskforce form requirements Illinois is currently considered a “developing state” by the National POLST organization Becoming an “endorsed state” would require additional components – Formal organizational home – Plan for ongoing implementation/education and quality assurance – [addressing witness signature] 10 Status of POLST in Illinois

11. Worked with ISMS to pass legislation removing “DNR” from the title of the form, form revision from IDPH pending Worked with EMS state educational committee representative to develop slide deck that will be available to all EMS regions once form revision completed Transitioned communication tools to Mail Chimp Materials revised/added to polstil.org website – Slide presentations (long and short), POLST Summary/Fact Sheet, FAQ’s, General Guidance for clinicians – Narrated 40-minute slide presentation on POLST Illinois Represented POLST Illinois with exhibits at Illinois Public Health Association and Leading Age annual meetings Local co-host of first open national meeting of National POLST Paradigm ISMS webinar with Rob? 11 POLST Illinois Activities in past year

12. The IL DNR/POLST Form version 2015 12

13. Questions? 13

14. Where does POLST Illinois go from here? 14

15. POLST Illinois Organizational Chart- Ideal State POLST Illinois Taskforce POLST “Go To Resource”/Training Sites of Care Hospitals Long-term Care Outpatient Home-Based Care Hospice First Responders EMS Emergency Departments Policy/Legal POLST Form Program Evaluation/ Tracking/ Quality Improvement POLST Registry Marketing and Communications Public Education Healthcare Organizations Executive Team Sustainability/Funding/Home

16. POLST Illinois Organizational Chart- Actual State POLST Illinois Taskforce Executive Team Lots of Interested and Enthusiastic Parties

17. 17 Re-establish Work Groups- Priorities? Education/Training – Healthcare and Community Sustainability/Funding Communications Benchmarks and Quality Registry?

18. 18 Education/Training Education/Training – Healthcare and Community – Bring consistent messaging and training to different parts of the state – Educate consumers and professionals around What POLST is and who it is for Appropriate use of POLST in various settings Goals of Care conversations For professionals, new context: CMS payment for ACP conversations

19. Education/Training- Ideal Chart POLST “Go To Resource”/Training Sites of Care Hospitals Long-term Care Outpatient Home-Based Care Hospice First Responders EMS Emergency Departments

20. 20 Sustainability/Funding – Find a statewide home for POLST Collaborative, Sponsorship fit with mission Maintains the energy of the coalition Potential for support re fiscal management, public relations, educational programming, research and publication resources, communications and social media support Meaningful relationship with the National POLST Paradigm Task Force – Identify funding to support Illinois POLST

21. 21 Communications – Identify personal success stories that will compel the media to cover POLST. – Social media – Website maintenance – Mail chimp/communications with Taskforce and workgroups Communications

22. 22 Benchmarks and Quality – Conduct a baseline survey to determine awareness, use, and quality in different healthcare settings including EMS, nursing homes, hospitals etc. – Develop quality measures

23. 23 Registry Registry – is it too soon to address this?

24. Hub Taskforces? Paid Administrator? 24 Overall Structure

25. Who wants to do what? 25 Step Up!

26. Next Steps

27. Questions?

28. For additional information, please visit www.polstil.org 28

29. Please forward any additional questions, or to volunteer to: polstillinois@gmail.com 29

30. Thank you!!! 30