An approach to end-of-life planning
for South Carolinians.
About the POST Project:
The South Carolina POST Pilot Project began on April 16, 2014, and was completed on May 31, 2017. The pilot was developed by the South Carolina Coalition for the Care of the Seriously Ill (SC CSI) to help in providing excellent communication between seriously ill patients in South Carolina, their families and physicians, as well as identifying the active voice for their health care decisions.
The pilot took place initially in Charleston and Greenville Counties, with expansion into Anderson and Richland Counties. The participating health care systems were Medical University of SC, Roper St. Francis Healthcare, Greenville Hospital System and Bon Secours Hospital-Greenville. The expansion participants were AnMed Health and Palmetto Richland. The POST pilot was supported by the Department of Health and Environmental Control (DHEC). Currently, the POST form is in the legislative process while the forms continue to be used in the following counties: Charleston, Berkeley, Dorchester, Greenville, Anderson, and Richland.
In all states in the U.S., people can complete advance directives that appoint a person to make medical decisions on their behalf if they are unable to speak for themselves. In South Carolina, this is called a Healthcare Power of Attorney (HCPOA). People can also complete an advance directive that can guide the physicians and hospital staff when a person is terminally ill and death is imminent. In South Carolina, this is called a declaration of desire for a natural death, frequently called a Living Will. The limitation of a Living Will is that while it indicates a person’s wishes if he/she cannot speak for themselves, it is not a physician order.
The patient’s condition may not allow for the time needed to review the Living Will. For a patient with an advanced serious illness who presents to an emergency department in crisis, another way to communicate with the physician in a timely fashion is a Physician Orders for Scope of Treatment (POST) form. The POST form documents a seriously ill person’s goals of care into a medical order in a highly visible, portable way prior to a crisis situation. All states in the U.S. and the District of Columbia are either using some version of POST or preparing to use one.