National Health Care Decisions Day is April 16th
State Department of Health Encourages Providers and Patients to Discuss Care, Treatment Options and Document Patient Preferences in a Medical Health Record
ALBANY, N.Y. (April 15, 2011)– In observance of the fourth Annual National Health Care Decisions Day on April 16, State Health Commissioner Nirav R. Shah, M.D., M.P.H., is encouraging people to discuss potential medical situations and treatment options with their health care provider, and document their preferences in a medical health record.
"Health care decision-making is about planning for the future to make sure a patient receives the care and treatment he or she desires," Commissioner Shah said. "It is important for health care providers to talk to their patients about care and treatment issues that may arise and discuss the patient's prognosis and care options. These conversations will help patients make informed decisions about their course of treatment and ensure their quality of life goals are met."
National Health Care Decisions Day was initiated in 2008 to increase public awareness about advanced care planning, also known as advanced directives or medical orders for life-sustaining treatment (MOLST). These include living wills, health care power of attorney, and other legal tools to ensure that adults have the ability to express their treatment preferences, even in cases where they are incapacitated, and that these wishes are honored by health care providers.
National Health Care Decisions Day also focuses on expanding communication and information sharing between providers and patients to help patients make health care decisions, specifically those related to medical interventions in the last stages of life.
In 2010, the State Department of Health (DOH) developed an updated form to allow patients with serious medical conditions to specify their wishes regarding life-sustaining treatment. The MOLST form serves as a single document that contains a patient's goals and preferences regarding resuscitation, comfort measures and medical interventions. The form is designed for patients who want to document their preference to either receive or avoid life-saving treatments, and for those who are receiving long-term care services, reside in a long-term care facility, or may die within a year.
Before filling out the form, a patient or his/her health care agent or surrogate must have a discussion with a qualified health care professional about the patient's diagnosis and prognosis, values and wishes, and possible treatment options. The physician must sign the form after the patient completes it.
The MOLST form is the only authorized document in New York State that can be used to convey non-hospital Do Not Resuscitate (DNR) and Do Not Intubate (DNI) orders. All health care professionals are required to comply with medical orders in the document.
The form must be reviewed when there is a major change in a patient's health status, the patient or designated decision-maker wants to change treatment preferences, or the patient moves to a new location to receive care. A review may be required to ensure that the orders conform to a health care facility's policies. In addition, physicians should review the orders regularly, at least every 90 days, which is similar to the required review guidelines for non-hospital DNR orders.
The patient will retain the original MOLST form and the physician keeps a copy. It is recommended that the form be printed in bright pulsar pink, heavy-stock paper to make it easier for EMS personnel to recognize the order.
MOLST forms are available at the DOH web site at http://www.health.ny.gov/professionals/patients/patient_rights/molst/.