During the period 1999–2002, the West Virginia Initiative to Improve End-of-Life Care, Morgantown, Va., encouraged a process of policy change to aid physicians in treating patients at the end of their lives according to patients' wishes and to help patients to make those wishes clear.

The West Virginia project also helped fund palliative care teams at four hospitals and a hospice in the state.

The project was part of the Robert Wood Johnson Foundation's (RWJF) national program Community-State Partnerships to Improve End-of-Life Care.

Key Results:

• Project staff helped establish palliative care teams operating in four hospitals and a hospice in West Virginia.
  • From 1999 to 2001, a hospital system served by this project's palliative care team increased referrals to hospices by 25 percent.
  • In 2001, the project's palliative care team members established the West Virginia Palliative Care Network. Network members share what they have learned, collaborate on data collection and help others establish palliative care teams.
• Project staff helped inform legislators about the need for professional education in end-of-life care, including pain management.
• To help patients communicate their wishes about end-of-life care and to assure that health professionals follow patient wishes, project staff in 2001 introduced the Physician Orders for Scope of Treatment (POST) form, a standardized form that incorporates a patient's advance directive and is signed by a physician.
• In 2002, the state legislature incorporated the POST form into law as the West Virginia Health Care Decisions Act, which also consolidated several laws addressing advance directives and medical power of attorney, making these provisions consistent and easier to use.