New Maryland MOLST Form

Memo

TO:All Holy Cross Health Employees

FROM:Yancy Y Phillips, MD, Chief Quality Officer

DATE:August 22, 2013

SUBJECT:New Maryland MOLST Form

Maryland MOLST (Medical Order for Life Sustaining Treatment) is a portable and enduring medical order form signed by a physician or nurse practitioner (also, effective October 2013, by a physician assistant). The MOLST contains orders about cardiopulmonary resuscitation and other life-sustaining treatments (e.g., dialysis and mechanical ventilation). Page one of the MOLST form is required; page two may be used if appropriate. The MOLST form became available January 1, 2013 and is now required as of July 1, 2013.

Admissions: We need to be aware of MOLST orders that come with patients upon admission. These orders are fully valid whether or not the ordering physician is on staff at the receiving “health care facility” or at Holy Cross Health. A copy or fax is as valid as the original. A matching Power Chart order needs to be entered so that other members of the team are aware of the order and carry it out.

Discharges: Patients are required to have a MOLST order upon discharge only if they are discharged to a “health care facility” — defined by the state as an assisted living facility, a home health agency, a hospice, a hospital, a kidney dialysis center, a nursing home — or for anyone who wants limitations on CPR or life-sustaining treatments in any setting.

For example, a HolyCrossHospital physician discusses with a patient, or his/her surrogate decision maker, options regarding cardiopulmonary resuscitation and other treatment. Based on the conversation the physician writes appropriate orders on the MOLST order form (in addition to Power Chart orders). The MOLST orders are valid for the hospital, the EMS staff in the ambulance, and the nursing home where the patient goes at transfer.

The original copy of a newly completed MOLST form must be given to the patient or surrogate within 48 hours of completion, or sooner if the patient is transferred or discharged. A copy will be kept in the patient’s medical record and a copy will be given to the receiving health care facility.
Policy: Please refer to our new policy, “MOLST: Maryland Medical Orders for Life-Sustaining Treatment,” attached and available herein PolicyTech (logon required).

Questions: If you have questions about MOLST, please call Cathy Livingston (ext. 7692) or me (ext. 7095). Thank you.

Additional Information:

• Maryland MOLST Order Form (two pages)
• Maryland MOLST Order Form with Instructions (three pages)
• Additional MOLST information and resources

A New Generation of MedicineSM