In 2014 Special Act 14-5 “An Act Concerning the Department of Public Health's Recommendations Regarding Medical Orders For Life-Sustaining Treatment” was passed that gave the CT Department of Public Health (CTDPH) the authority to create a Medical Orders for Life-Sustaining Treatment (MOLST) pilot program in selected areas of the state. The pilot program which was launched on April 16, 2015, National Health Care Decisions Day served 142 individuals in thirteen facilities and hospitals throughout t the State.
What is MOLST?
The Connecticut MOLST was developed from the national Physician Orders for Life Sustaining Treatment (POLST) Paradigm. The Connecticut MOLST is a voluntary adjunctive planning tool to an advance health care directive. (Some patients may have already completed a living will and may have both documents). MOLST orders are for patients who are at the end stage of a serious life limiting illness or in a condition of advanced chronic progressive frailty as determined by a physician or advance practice registered nurse. The MOLST form documents patients’ decisions in a clear manner that can be quickly understood by all providers, including first responders and emergency medical services (EMS) personnel.
Based upon the ethical principle of respect for patient autonomy and the legal principle of self-determination, A "CT medical order for life-sustaining treatment" is a written medical order by a physician, advanced practice registered nurse, or physician assistant that records a patient’s treatment preferences in writing on a bright green form approved by the CT DPH.
The MOLST form is completed after a conversation or series of conversations have taken place between the patient (and if the patient chooses their loved ones) and the patient’s health care provider or providers. The MOLST is an actionable medical order that reflects the patient’s goals of care for full medical treatment, limited medical treatment or comfort measures only. It is designed to enable patients to document their preferences for medical treatments as they near life’s end, and assists their loved ones and health care providers to better understand the patient’s wishes. The form identifies the patient’s medical condition as well as their treatment preferences and goals and accompanies the patient across all settings. The documentation makes it easier for health providers at one care setting to know the wishes of a patient previously documented in another care setting.
For questions about the MOLST Initiative please contact Barbara Cass at 860-509-7406 or firstname.lastname@example.org.
The MOLST Conversation
Physicians, advanced practice registered nurses or physician assistants who intend to write a Medical Order For Life-Sustaining Treatment
30-45 minutes to complete and upon successful completion a certificate is issued to the health care provider.
How to Access the Online MOLST Course
- Use Firefox or Internet Explorer as your browser
- Go to https://www.train.org/connecticut
- Once on the website, select "Create an Account: and the the required information. NOTE: New users must register for a user name and password.
- After creating an account, click on the magnifying glass, type in "MOLST" or enter the Course ID# 1076530, and click on search to bring you to the MOLST course page.
- Click on "launch".
- Complete the course and short test.
- Click on "exit".
- Click on "close window".
- Once you click on "close window" you are brought back to the MOLST course page.
- Click on "print certificate".
- Hospitals or large facilities that have their own electronic training system (e.g., Healthstream, SABA, or similar) may contact Danny White at 860-509-7557 to access the MOLST training module from an FTP server to download onto their system.
- Proof of staff completing the training program may be requested by DPH from time to time.
- Please email DPH.MOLST@ct.gov