Intalere Member Best Practice Spotlight-New York City Health + Hospitals Sea View-Commitment To Resident-Centered Care: Medical Orders for Life-Sustaining Treatment MOLST Documentation

Issue

Medical Orders for Life-Sustaining Treatment (MOLST) formulation is the cornerstone of true resident-centered plans of care. This essential document allows practitioners to treat and care for residents according to their own known wishes. Via a quality assurance process, New York City Health + Hospitals/Sea View recognized a large percentage of residents lacked this essential document.

Solution

Sea View implemented an interdisciplinary quality improvement/resident satisfaction initiative targeted at increasing the number of residents completing MOLST documentation. To be able to complete MOLST documentation, you must be fully aware of the components of the form. An explanation of the purpose and sections of each part of the documentation was reviewed with each resident/surrogate by a member of Sea View’s healthcare team. The opportunity to watch educational videos regarding DNR, IV fluids, tube feeding, treatment in place, palliative care and end of life issues was also afforded. The discussion of the MOLST principles has become ingrained in practice and is now discussed at admission and during each interdisciplinary conference.

Outcome

Prior to implementing this initiative, only 21% of the residents in the project test unit had MOLST documentation in place. After a 12-month period utilizing the new process, 100% of the residents in the test unit have this important document in place. Residents are treated in place offering care and services as defined in the MOLST documentation where wishes are respected and quality of life is of utmost importance.

About New York City Health + Hospitals/Sea View

New York City Health + Hospitals/Sea View is a 304-bed post-acute care facility located in Staten Island, New York, on a 60-acre campus. Specialty services include state-certified dementia and brain injury units. Sea View is the proud recipient of the CMS Five-Star rating.

Check out the project video and view the  New York City Health + Hospitals Sea View page in the 2019 Intalere Best Practices Compendium.

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