COMFORT CARE/DNR FOLLOW-UP QUESTIONS
In the last "MGH Community News" we invited readers to submit follow-up questions about the Comfort Care/DNR
Order Verification Program. These questions, and the answers supplied by Marianne Bitner, NREMT-P, Clinical Director of
Trinity EMS, Inc., are below.
Do we have information about what percentage of PCP's/MDs are knowledgeable about the Comfort Care program?
Are interns/residents educated about the existence of the Comfort Care program?
How often/frequently has it been utilized thus far in the field?
7/00
When did the Comfort Care program go into effect?
It was introduced to MA physicians in the Spring of 1997 when an information packet with copies of the Comfort Care Forms
was sent to all MA licensed physicians. All the EMS field providers were trained to look for the Comfort Care forms and
bracelets during their recertification classes in 1997, but they could accept either the Comfort Care form or a physician
written DNR until the end of December 1999. It became mandatory for all field EMS personnel to only accept the Comfort Care
form/bracelet for field verification of a DNR on January 1, 2000.
100% of MA licensed MD's have received letters and informational packets explaining the program and how to get the forms since
the Spring of 1997, but we believe that probably only 50% of the MD's have knowledge of the program or have started to use the
correct procedure and forms.
I (Marianne Bitner) spoke to the Tufts Family Practice Residents/Interns of Comfort Care this Spring, but I am not aware of
any other formal presentations to interns/residents being done on Comfort Care. This needs to be done, but the State Office
of EMS staff has not taken any steps that I am aware of to address this need.
Comfort Care forms are being used much more now then back before the mandatory implementation on January 1, 2000. Since
January 1 different areas of the state and the EMS agencies in those areas have taken a proactive position to aggressively go
out to do the education of MD's, nurses, nursing home staff, discharge planners, VNA's and social service personnel on who need
Comfort Care forms/bracelets, where to get them and who can order them.