The Origin of POLST

In 1991, leading medical ethicists in Oregon discovered that patient preferences for end-of-life care were not consistently honored. Recognizing that advance directives were inadequate for the patients with serious illness or frailty — who frequently require emergency medical care — a group of stakeholders developed a new tool for honoring patients’ wishes for end-of-life treatment. After several years of evaluation, the program became known as Physician Orders for Life-Sustaining Treatment (POLST).

The POLST Name

As the movement has expanded, POLST is no longer referred to as “Physician Orders for Life Sustaining Treatment” following the acronym, but rather “POLST, portable medical orders.” This move was made because POLST focuses on much more than life-saving treatments such as CPR to encompass patient wishes for the level of care on an ongoing basis. Every state initiative has chosen its own name for its POLST work and the organization overseeing POLST in its state.

The History of National POLST Collaborative

In September 2004, the National POLST Advisory Panel, later known as the National POLST Paradigm Task Force, convened to establish quality standards for POLST forms and programs and to assist states in developing POLST as a model process (or “paradigm”). At that time only six states had POLST programs: New York, Oregon, Pennsylvania, Washington, West Virginia and Wisconsin. Leaders from those states served as original members along with several consultants who advised on topics critical to the development of the POLST Paradigm. Many of our founding members still serve in National POLST governance today.

Original Members of the National POLST Paradigm Task Force

  • Chair: Patrick (Pat) Dunn, MD, Legacy Health Systems (Oregon)
  • Patricia (Pat) Bomba, MD, Excellus BlueCross BlueShield (New York)
  • Judith (Judy) Black, MD, Highmark Blue Cross Blue Shield (Pennsylvania)
  • Sally Denton (Washington)
  • Bernard (Bud) Hammes, PhD, Gundersen Lutheran Health System (Wisconsin)
  • Alvin (Woody) Moss, MD, West Virginia University (West Virginia)
  • James (Jim) Shaw, MD, Providence Health (Washington)
  • Susan Tolle, MD, Oregon Health & Science University (Oregon)
  • Margaret (Margie) Carley, JD (Long-term Care)
  • Malene Davis, MBA, MSN (Hospice)
  • Susan Hickman, PhD (Research)
  • Charlie Sabatino, JD (Legal)
  • Terri Schmidt, MD (EMS and Emergency Medicine)

In 2022, the National POLST Paradigm Task Force was restructured as National POLST Collaborative. Originally headquartered at the Oregon Health & Science University (OHSU) Center for Ethics in Health Care, National POLST Collaborative moved to the Louisiana Health Care Quality Forum in Baton Rouge, LA. National POLST Collaborative has now become an independent 501c3.

Learn About Membership in National POLST Collaborative

The National POLST Collaborative brings together state leaders, healthcare organizations, and individual clinicians who are committed to improving care for people living with serious illness or frailty. As a member, you gain access to exclusive tools, expert guidance, policy updates, and opportunities to shape the future of POLST. Whether you’re building a program, delivering care, or advocating for better conversations at the bedside, your voice belongs in this movement.