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Article ; Online: The "PSOST": Providers' Signout for Scope of Treatment.

Newport, Kristina Braine / Patel, Shejal / Lyckholm, Laurie / Bobb, Barton / Coyne, Patrick / Smith, Thomas J

Journal of palliative medicine

2010  Volume 13, Issue 9, Page(s) 1055–1058

Abstract: Palliative care provides open and honest communication, medically appropriate goal setting, and meticulous attention to symptom assessment and control. The Physicians Orders for Life Sustaining Treatment (POLST) is a growing movement to allow health care ...

Abstract Palliative care provides open and honest communication, medically appropriate goal setting, and meticulous attention to symptom assessment and control. The Physicians Orders for Life Sustaining Treatment (POLST) is a growing movement to allow health care providers to indicate, with their patients, what they want done in specific situations, such as feeding tubes, mechanical ventilation, or transfer to an intensive care unit. We have developed an internal signout tool used by palliative medicine fellows in our institution to specify similar interventions-or not-with seriously ill palliative care patients, the Providers Signout for Scope of Treatment (PSOST). We have found that this situation-specific tool enables smooth transitions of care on nights and weekends, especially when the patient is near death, and may help prevent both overescalation of care and underuse of life saving treatments such as resuscitation. The PSOST differs from other signout tools in that it gives clear direction regarding the patient's medical goals and desire for escalation of care, or not. We present it here for open access and use anywhere. This tool has also assisted in building team communication with the nursing shifts, especially nights and weekends, as all team members are able to deliver a consistent message, while meeting the goals of care for patients and families. We believe this tool could be useful with a broader patient population, outside of Palliative Medicine, to provide clearer direction for hospitalized or nursing home patients whose care is often directed by multiple providers. It could also be used as a template for signouts on other inpatient services, as care goals are important for all patients.
MeSH term(s) Advance Directives ; Continuity of Patient Care/organization & administration ; Efficiency, Organizational ; Humans ; Life Support Care ; Medical Records ; Palliative Care ; Patient Care Planning ; Patient Care Team ; Process Assessment (Health Care) ; Software ; Terminal Care
Language English
Publishing date 2010-09
Publishing country United States
Document type Journal Article
ZDB-ID 1427361-5
ISSN 1557-7740 ; 1096-6218
ISSN (online) 1557-7740
ISSN 1096-6218
DOI 10.1089/jpm.2010.0103
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