What is the Medical Orders for Scope of
Treatment (MOST) ?
A FHA wide Medical Order for Scope of Treatment & Advance
Care Planning (HAMAC) policy that will be implemented on
October 3, 2012 & apply in all settings of care
 New Scope: Greensleeves in all settings of care
 New forms:
 Advance Care Planning Record, &
 Medical Order for Scope of Treatment (MOST)
(Replaces acute care DNR and residential care
Levels/Degrees of Intervention forms)
 New language: MOST designation replaces code status
 New process: Order Entry for MOST designation orders
(delayed to Nov 7, 2012 in Acute & April 1, 2013 Res Care)
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Treat
Site
reversible
Transfer
conditions
Symptom
Control
Resuscitation
Intubation
ICU
DNR M1
✓
X
X
X
X
X
DNR M2
✓
X
X
X
X
✓
DNR M3
✓
X
X
X
✓
✓
DNR C1
✓
X
X
✓
✓
✓
DNR C2
✓
X
✓
✓
✓
✓
CPR C2
✓
✓
✓
✓
✓
✓
2
Advance Care Planning (ACP) cycle
• ACP Plan ( My
Voice)
• Rep Agreement
• Advance Directive
• No CPR or DNR
form
Advance Care
Planning
Goals of Care
conversations
• Diagnosis/Prognosis
• Anticipated
/Feasible outcomes
• Options for care
• Plans for crisis
• MOST form
• ACP Record
• Care Plans
Documentation
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For more information
 Attend an ACP or Physician workshop:
 http://fhpulse/education_and_professional_development/clinic
al_education/advance_care_planning/Pages/Default.aspx
 http://physicians.fraserhealth.ca
 Complete MOST module:https://ccrs.vch.ca/
 Links: http://www.seniorsbc.ca/legal/healthdecisions/
 http://fhpulse/clinical_programs/end_of_life/Pages/AdvanceCa
rePlanning.aspx OR
http://fhpulse/initiatives/scope_of_treatment/Pages/Default.as
px
 Contact Cari Hoffmann: cari.hoffmann@fraserhealth.ca
or Dr Doris Barwich, PMD End of Life Care
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