DNR versus [P]MOLST

Of Differences and Distinctions

By Dr. David Edward Marcinko MBA

By Hope Rachel Hetico RN MHA

DNR Definition

A Do Not Resuscitate Order (DNR) is a refusal of cardiopulmonary resuscitation in the event of cardiac or pulmonary arrest.  A DNR, which is signed by a physician upon your consent, applies only if you are in a hospital or nursing home. If you are in your residence, a hospice, a clinic, or anywhere else and do not wish to be resuscitated, you must have a “Non-Hospital” DNR signed by your physician.

Sample form: http://www.ochealthinfo.com/docs/forms/ems_dnr_form.pdf

P-MOLST Definition

A P-MOLST (Physician – Medical Orders for Life-Sustaining Treatment) can be used to document your wishes concerning various forms of life-sustaining medical treatment, including DNR, endotracheal intubation and mechanical ventilation, artificial nutrition and hydration, future hospitalization, antibiotics, and other instructions. It is designed to improve the quality of end of life care for those with serious health conditions or those who wish to define their care wishes when facing the end of life. The form must be completed by both you and your physician. It is intended to apply immediately, and not upon a trigger of future incapacity. The form may be completed in stages as a medical condition deteriorates.

Sample form: http://www.compassionandsupport.org/pdfs/professionals/molst/DOH-5003_06.10_.FINAL__.pdf

Assessment 

Subsequent to the publication of the Institute of Medicine Report “Approaching Death: Improving Care at the End-of-Life”, the Rochester Individual Practice Association and BlueCross BlueShield Rochester Region End-of-Life/Palliative Care Professional Advisory Committee was formed to address these and related issues.

Link: http://www.compassionandsupport.org/index.php/about_us

Conclusion

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Seeking Medical Director [HRMC]

Heartland Regional Medical Center

By Deedra Hartung

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Dear Dr. Marcinko,

Cejka Executive Search has been exclusively retained by Heartland Health, a physician-led, integrated health care system in St. Joseph, Missouri, to recruit a physician leader who will serve as Medical Director of Heartland Regional Medical Center (HRMC).

About HRMC

HRMC is a 491-bed medical center comprised of a 250-member medical staff, including 125 employed physicians, and is a 2009 Malcolm Baldrige National Quality award winner. Heartland Health is rapidly moving towards becoming an Accountable Care Organization and will likely be a Medicare ACO Pilot Site. Heartland Health includes a large physician clinic, foundation, health plan and other ventures and affiliations.

Responsibilities

In collaboration with the Administrator of HRMC, the Medical Director will be responsible for providing clinical and operational oversight, communicating the vision of the medical center, building partnerships with key stakeholders and advocating quality and safety measures within clinical and ancillary departments. Additionally, the Medical Director will serve as a mentor and coach to the medical staff and the leadership team. The Medical Director position is ideal for a physician leader wanting additional operational experience in preparation for a future in a position as a CEO.

Qualifications

Candidates must be board certified, eligible for a Missouri license and possess a minimum of ten years clinical experience.  An MBA or MHA is highly preferred. Ideal candidates will have experience with peer review, credentialing, population health, clinical research and the development of a residency program.

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Qualified candidates may submit their CV’s or contact:
Deedra Hartung
Executive Vice President, Managing Principal
Cejka Executive Search
800-209-8143, Extension 63518
Email: jkliethermes@cejkasearch.com

www.cejkaexecutivesearch.com