title: Implementation of Medical Orders for Life-Sustaining Treatment.
abstract: BACKGROUND
  When an outpatient in a northeastern cancer institute requested a Medical Orders for Life-Sustaining Treatment (MOLST) form, the state's approved resuscitation form in all settings, none were available. A project was undertaken to institute MOLST forms into policy and routine practice. Research supports early discussions of end-of-life care in patients with cancer and the use of MOLST as an effective tool.
  
  
  OBJECTIVE
  The purpose of this article is to discuss the initiation and facilitation of MOLST implementation into practice and policy at a cancer institute.
  
  
  METHODS
  Introducing, overcoming resistance to, piloting, and adopting MOLST in an oncology setting is reported and explained based on the three stages of Lewin's Theory of Planned Change.
  
  
  RESULTS
  A small pilot of MOLST with palliative care providers demonstrated the feasibility and suitability of using MOLST in the oncology setting. MOLST was adopted into policy and routine practice at the cancer institute.
authors.affiliation: Infinity Medical Group.
authors.forename: Janette N
authors.initials: JN
authors.lastname: Evans
authors.affiliation: Daemen College in Amherst.
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Ball
authors.affiliation: Roswell Park Cancer Institute.
authors.forename: Camille P
authors.initials: CP
authors.lastname: Wicher
mesh_terms: D002173:Cancer Care Facilities / Q000458:organization & administration*; D005240:Feasibility Studies; D006801:Humans; D009369:Neoplasms / Q000451:nursing / Q000628:therapy*; D013727:Terminal Care
keywords: Medical Orders for Life-Sustaining Treatment; advance directives; cancer; communication; dying; end of life