The Indiana POST* Program

*Physician Orders for Scope of Treatment


The Indiana Physician Orders for Scope of Treatment (POST) Program is a new advance care planning tool that helps ensure treatment preferences are honored. It is designed for patients with serious illness. Preferences for life sustaining treatments including resuscitation, medical interventions (e.g., comfort care, hospitalization, intubation, mechanical ventilation), antibiotics, and artificial nutrition are documented as medical orders on the POST form. It must be reviewed and signed by a physician to be activated. This form transfers throughout the health care system and the orders are valid in all settings.

POST form

The Indiana POST form is a standardized form containing orders by a treating physician based on a patient's preferences for end-of-life care. The form provides physician orders regarding CPR-code or no code status; level of medical intervention (comfort measures, limited additional interventions, or full intervention); use of antibiotics (for comfort only or full treatment); and use of medically administered nutrition. The comfort measures level stipulates: "Patient prefers no transfer to the hospital for life-sustaining treatment. Transfer only if comfort needs cannot be met in current location." Use of this form should lead to better identification and respect of patients' preferences for treatment at life's end. The Indiana POST form is based on the POLST (Physician Orders for Life-Sustaining Treatment) Paradigm Program (www.polst.org).

The official Indiana POST form can be found on the Indiana State Department of Health website at http://www.in.gov/isdh/25880.htm. It is strongly recommended that the form be printed on Astrobrights Pulsar Pink 65 lbs (cardstock) or an equivalent. Black and white versions as well as photocopies and faxed versions are considered valid.

History

The Indiana Patient Preferences Coalition (IPPC) is a coalition of professionals in health care, ethics, law, and senior services committed to honoring patient treatment preferences. The group first formed in August 2010 to explore the development of the Indiana version of the POLST Paradigm (www.polst.org). Legislation was introduced by Representative Tim Brown, MD (R - Crawfordsville) in 2012 and reintroduced in 2013. HB 1182 passed the house unanimously (95 to 0) and was passed nearly unanimously in the Senate (48 to 1) before being signed into law in May 2013. The Indiana POST will become legally valid throughout the state of Indiana on July 1, 2013.

More information about the Indiana POST program can be found at:
www.indianapost.org