The Oregon POLST Registry

1
The Oregon POLST Registry

• Submitting POLST forms to the Registry

2
The Oregon POLST Registry

• A secure database of patients POLST forms.
• EMS will have immediate access to a patients
  POLST orders if they cannot be found.

3
Submission Requirements

• Patient first and last name
• Date of Birth
• MD, NP or PA printed name
  signature
• Date signed
• Section A completed

4
New June 2009 POLST Form

• New Additions
• Patient demographics
• Patient name and signature
• Registry opt out box
• Registry instructions

Back of form
5
Completing Patient Demographics

• Do not use internal patient identification labels
  .
• Demographic box needs to be completed by hand to
  respect its use across health systems.
• If needed hand write health system record number
  across top.

A better method
6
Submitting to the Registry

• Fax a COPY of both sides to 503-418-2161
• Unless opt out box is checked, Oregon Statute
  requires the POLST form be submitted to the
  Registry.
• Original POLST goes home with patient.

Can also be submitted by mail.
7
Previously completed forms

• Older POLST forms may be submitted to the
  Registry, but require additional demographics.
• All changes, including voided forms, must be
  submitted to the Registry.

8
Confirmation Letter Registry ID

• Sender patient will receive confirmation from
  Registry.
• Patient will be assigned Registry ID number.
• Patient will receive Registry ID magnets and
  stickers.

9
More Information
www.polst.org

• Phone [phone]
• Fax [phone]
• Email polstreg_at_ohsu.edu