About the POST Pilot Project:
The South Carolina POST Pilot Project began on April 16, 2014 and was developed by the South Carolina Coalition for the Care of the Seriously Ill. The Coalition believes that is a needed next step in providing excellent communication between seriously ill patients in South Carolina and their physicians as well as identifying the active voice for their health care decisions.
The pilot will be administered in two counties, Charleston and Greenville, and will include the Greenville Hospital System, Bon Secours Hospital – Greenville, the Medical University of South Carolina, and Roper-St. Francis Healthcare. The Department of Health and Environmental Control (DHEC) has reviewed the POST form and the pilot proposal and will be notifying the Emergency Medical Systems in the affected counties. As the pilot progresses over the next year, we hope to identify areas of the decision making process prompted by POST that need improvement. Then, we expect all of South Carolina will benefit from this important tool as we seek to take the best care of our seriously ill patients.
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 POLST form. A POLST form helps combine a patient’s wishes with a physician order and is prepared in advance by the patient (or the legally authorized representative) and physician working as a team to document the patient’s wishes.POLST is the acronym for Physician Order for Life-Sustaining Treatment (www.POLST.org).
The POLST form documents a seriously ill person’s goals of care into a medical order in a highly visible, portable way. More than forty (40) states in the U.S. are either using some version of POLST or preparing to use one. The South Carolina Coalition for the Care of the Seriously Ill is working with the South Carolina Department of Health and Environmental Control (DHEC) to prepare a document for use in South Carolina that will be called POST (Physician Orders for Scope of Treatment). A pilot study of POST will begin in the Charleston and Greenville areas in 2014.