title: Factors associated with implementation of the POLST paradigm: results from a survey of Florida physicians.
abstract: OBJECTIVE
  To investigate physicians' awareness and attitudes regarding the Physician Orders for Life-Sustaining Treatment (POLST) concept and to identify barriers and opportunities for its expansion.
  
  
  METHODS
  Cross-sectional questionnaire, using electronic survey instrument.
  
  
  METHODS
  Community.
  
  
  METHODS
  212 physicians from three Florida medical associations and the Florida State University College of Medicine clinical faculty responded to the survey. Of those, 67.9% were familiar with the concept of POLST.
  
  
  RESULTS
  Data were collected using a web-based survey, completed in June-July 2012, consisting of qualitative and quantitative questions. Most (95.8%) agreed or strongly agreed that it was a physician's responsibility to discuss end-of-life care and treatment options with patients. Satisfaction with current advanced directives was highly variable. However, a consensus about potential benefits of POLST exists, including assisting the discussion of end-of-life care, decreasing unwanted treatment, and lowering costs. More than 70% of respondents reported they would be more likely to use the POLST form if provided civil and criminal immunity; however, data analysis rendered the apparent association statistically insignificant. Qualitative data were also collected in the form of respondents' recommendations and additional comments.
  
  
  CONCLUSIONS
  Physicians vary in their knowledge and opinions regarding the POLST paradigm. Broad opportunities may exist to improve physician knowledge and attitudes toward POLST. Dissemination of educational materials to physicians involved in the end-of-life planning process may increase physician support and use of POLST.
authors.affiliation: Department of Geriatrics, Florida State University College of Medicine, USA. jm11m@med.fsu.edu
authors.forename: Juliana J
authors.initials: JJ
authors.lastname: Matthews
authors.affiliation: Florida State University College of Law, USA.
authors.forename: Carly Elizabeth
authors.initials: CE
authors.lastname: Souther
mesh_terms: D000328:Adult; D016223:Advance Directives / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D005431:Florida; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010820:Physicians / Q000523:psychology*; D016414:Resuscitation Orders / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*