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Welcome to Hospice & Palliative Care Today, a daily email summarizing numerous topics essential for understanding the current landscape of serious illness and end-of-life care. Recent TCN Talks podcasts / videos reviewing Hospice & Palliative Care Today monthly content available for 2024: January; February; March; April, May, June, July, and August.
Dozens of CarePartners patients in Asheville transferred to other facilities after HCA temporarily shuts down rehab, hospice center
Asheville Watchdog; by Andrew R. Jones; 10/14/24
Hundreds of employees uncertain about their jobs after facility is closed to ease pressure on Mission Hospital. Mission Health’s CarePartners Health Services is temporarily closed following the pressures Hurricane Helene put on Asheville’s health care system, disrupting rehabilitative care for more than 50 patients and forcing more than 250 employees to take temporary jobs elsewhere in the system, according to employees and internal emails obtained by Asheville Watchdog. ... The closing affected nearly 50 inpatient rehab patients, several long-term acute care patients, and eight hospice patients, all of whom were sent to home caregivers, skilled nursing facilities, other inpatient rehab programs, and UNC Health Caldwell in Lenoir, more than an hour’s drive to the east, according to one employee.
The quiet, transformative power of introverted leaders
Forbes; by Benjamin Laker; 10/14/24
When workplaces celebrate loud voices, charismatic personalities, and the “move fast, break things” attitude of leadership, introverts may seem out of place. Leadership, we’re told, belongs to the extroverts—the ones who command rooms, deliver inspiring speeches, and thrive in the spotlight. But what if we’ve been overlooking a quieter form of leadership all along? Introverted leaders are often the unsung heroes of organizations, possessing a unique power that’s grounded in thoughtfulness, empathy, and a deep understanding of their team. The truth is, the quiet power of introverted leaders is not just an alternative leadership style—it’s a vital force for creating sustainable success. ... Introverted leaders may not be the ones dominating the conversation, but they are often the ones listening, analyzing, and thinking deeply before they act. Their approach is slower, more deliberate, and often more thoughtful, which can lead to better decision-making and a more cohesive team.
Editor's note: This important interpersonal dynamic applies not only to (1) leadership teams, but also to (2) patient care interdisciplinary teams and to (3) clinical visits with patients and their caregivers/family members.
Researchers raise concerns about the financial sector's rising role in US illness care
Medical Xpress; by Mary Ann Liebert, Inc; 10/16/24
The authors of a new article in Journal of Palliative Medicine state that the "growing role of the financial sector in home health and hospice, a reflection of larger trends in U.S. health care, is concerning and has major implications for care quality unless reforms are undertaken." Co-authors Lauren Hunt, Ph.D., RN, FN, with the University of California, San Francisco, and R. Sean Morrison, MD, with the Icahn School of Medicine at Mount Sinai in New York, observe that home health and hospice began as nonprofit organizations with close ties to their communities. However, the overwhelming majority are now for-profit entities, many of which have become targets for private equity buyouts. The authors note that "big business's emphasis on maximizing profit can be at odds with patient welfare. Indeed, a substantial body of evidence now demonstrates that care quality is consistently worse in for-profits as compared to nonprofits," they state. The authors further express concern that "pressure to achieve high returns on very short-term time horizons may conflict with the need for longer-term investments in quality, training, and staffing, thus reducing care quality.
What the heck is a PBM, and why does it matter?
Forbes; by Web Golinkin; 10/14/24
... [Pharmacy Benefit Managers] PBM Basics
Unless you are a healthcare industry insider—and even if you are— it’s difficult to understand exactly how PBMs work. While they are essentially invisible to the average health plan member, PBMs have a tremendous impact on which medications are covered, the prices paid for these medications, and how patients access them.
Here’s a summary of key PBM functions: Formulary Management. ... Negotiating Discounts and Rebates. ... Pharmacy Network Management. ... Claims Processing. ... Clinical Management. ...
How PBMs Influence Drug Costs: Rebate System. ... High Deductible Health Plans. ... Prior Authorization and Step Therapy. ... Spread Pricing. ...
What Are the Alternatives? ...
Hospice of the Western Reserve receives $3M gift
Cleveland Jewish News; 10/16/24
Hospice of the Western Reserve announced a landmark $3 million leadership gift from The James and Angela Hambrick Foundation to the Quality of Life capital campaign, according to a news release. The gift to the capital campaign will help build a new Hospice Care and Community Center on Lake Erie in Cleveland, the release said. “The ideal of nonprofit superior end-of-life care for our community runs strong through us,” James Hambrick, retired chairman and CEO of Lubrizol Corp., said in the release. “My wife, Angela, and I are very pleased to make a major leadership gift toward the new Hospice Care center.” ... “We are profoundly grateful to James and Angela Hambrick for their extraordinary generosity,” Bill Finn, president and CEO of Hospice of the Western Reserve, said in the release. ... The new Hospice Care and Community Center, scheduled to open in 2026, will feature 32 private patient rooms, all with views of Lake Erie, enhanced family spaces and state-of-the-art technology to support the increasing complexity of end-of-life care, the release said.
Video: North Hawaii Hospice holds lantern floating ceremony
Big Island Video News; 10/15/24
The annual floating lantern ceremony was held Sunday evening at the Fairmont Orchid. ... The event was organized by North Hawaii Hospice, ... “The goal is to honor and remember those who have passed, in a group setting,” said North HawaiĘ»i Hospice executive director Faye Mitchell. “We get to share in our grief, but also in our joy about the people that we’ve loved and who are no longer with us.” ... “When people come, they have a lantern paper which they get to decorate and write messages for their loved ones. And then they put that lantern paper onto a base, and at sunset we helped them light a candle in that lantern. ... “I am an organizer of this event, but I am definitely also a participant,” Mitchell said. “I lost my son Geno in February of this year. He was 24 years old. I have to say, one of the key things I learned from the experience is that grief shouldn’t be kept to myself. ... There’s something about sharing your grief with others who know what it’s like. So that’s why I share it even now, with everyone watching, because if … you’ve lost someone you’re not alone, and if you share this experience with others you’d be surprised how many people have gone through this. It’s so much better not to be alone in this."
Hospice Sabbath
Progressive Journal; by Hospice of Chesterfield County Foundation; 10/14/24
As you attend your place of worship the weekend of November 1-3, 2024, you may see a single white carnation displayed in a prominent location. Hospice of Chesterfield County Foundation has chosen the white carnation as a symbol for the observance of Hospice Sabbath. Churches are being asked to participate by displaying a white carnation in memory of all who have received Hospice services. ... These individuals were significant to their families and to our community. They were our neighbors, our co-workers, our friends, and our loved ones. ... In its simple elegance, the white carnation symbolizes the hope and dignity which Hospice helped to ensure for these individuals and for their families. In its fragile beauty, the carnation reminds us of the sacredness of life and the mystery of death. Hospice recognizes that endings are inevitable; yet, life is affirmed as persons are encouraged to live each moment to its greatest capacity.
Stratis Health builds framework for expanding rural community-based palliative care
Hospice News; by Jim Parker; 10/16/24
The health care performance improvement company Stratis Health has developed a framework for expanding access to palliative care in rural communities. The company’s strategy convenes resources and organizations that already exist in a given community to help meet patient’s palliative care, psychosocial, spiritual and social determinants of health needs. It leverages those resources to offer a wraparound suite of services for seniors and seriously ill patients. Hospice News spoke with Karla Weng, senior program manager for Stratis Health, about how health care providers and other stakeholders serving rural communities can come together to better serve their patients and clients. ... The field has shifted in more recent years, so that community-based really means anywhere but the hospital. It might be in a clinic. It might be home care. We’re not that prescriptive. So we have sometimes shifted to using the language “community centric.” The way that we work with communities who are interested in going down this path is helping them first to do a gap analysis and assessment of the resources that are already there in their community. ... [Click on the title's link to continue reading.]
Communication gaps among clinicians may limit conversations about prognosis, hospice
Healio - HemOncToday; by Jennifer Byrne; 10/16/24
Clinicians in acute or post-acute care settings may delay or avoid serious illness conversations with patients whose cancer prognoses are worsening out of deference to the patient’s oncologist, according to study findings. Researchers conducted 37 semi-structured interviews with physicians and leaders in hospital medicine, oncology, palliative care, home health care and hospice. Investigators coded and analyzed the interviews using thematic content analysis. Evaluation of the responses yielded insights into how care silos, lack of clear clinical roles and other factors may affect communication between oncologists and other clinicians. ... "We know that the 3-month window after an older adult with cancer is discharged to a skilled nursing facility can be comprised of complex medical decision making and changing preferences of care. Lack of appropriate serious illness communication during this time can result in unwanted hospitalizations and unwanted, aggressive care at the end of life."
Palliative medications: what works in practice for symptom control?
Nursing Times, authors from Marie Curie Palliative Care Research and University College London, UK; by Sally-Anne Francis, Eunice Sirkett, Emily Anderson and Sarah Yardley; 10/14/24
This article explores the real-life challenges of managing symptoms with medication at the end of life. ... Key points:
Editor's note: Calling all non-clinical executives: read and develop your understanding of "why" medications matter. This article provides practical, user-friendly information for non-clinical executives who make decisions related to ensuring effective management of symptoms with medication. For example: staffing, on-call, contracts with pharmacies, EMR technology, systems and processes for timely response, website/caregiver information, more.
Music therapist helps patients navigate end-of-life journey on Long Island
CBS New York / YouTube; by Jenna DeAngelis; 10/15/24
The healing power of music is being brought to hospice patients on Long Island, by Yuzuko DeGrottole, LCAT, MT-BC, a board-certified music therapist with MJHS Hospice. “Everyone has a song that takes them to a special place. “Are you going to sing with me?” [Sings a beautiful Jewish song.] That's the power of music. It moves us. It connects us, and for Sarah Jacobowitz it just makes her feel good. “I like it. It makes me happy.” The 95-year-old Holocaust Survivor is proud of her Jewish Heritage which she celebrates in song since she's bedridden. Yuzuko brings the music to her, even learning to sing in many languages for her patients. Music communicates with you directly to your heart. Music brings up a lot of emotion, with or without words. … Sarah's son who often sits bedside says music therapy hits all the right notes. Sarah is attentive instead of just sleeping all day or just doing nothing. Music brings back memories and it gives her pleasure just to be alive.
Editor's note: Having a board-certified music therapist is significantly more valuable--therapeutically, clinically, meaning-making, mission-oriented--than simply having musicians play music. For more information visit "Facts for Music Therapy in Hospice Care" by American Music Therapy Association and the Certified Board for Music Therapists.
4 trends in healthcare executive pay
Becker's Hospital Review; by Kelly Gooch; 10/15/24
A 2024 survey conducted by SullivanCotter highlights a range of trends in healthcare executive pay, including a year-over-year jump in median base salaries. The consulting firm's "2024 Healthcare Management and Executive Compensation Survey" is based on data from more than 3,300 organizations representing nearly 45,110 executives and managers. Here are four trends from the survey, which was conducted from January to April:
Mass General Brigham tests drones for 'hospital at home': 6 things to know
Becker's Health IT; by Giles Bruce; 10/15/24
Somerville, Mass.-based Mass General Brigham has tested out drone delivery for its hospital-at-home program. Here are six things to know:
How physicians can navigate ethical conflicts when caring for patients
Physician's Weekly; 10/14/24
... According to the president of The Physicians Foundation, Gary Price, MD, ethics in medical care are particularly complicated regarding end-of-life choices. While decades ago, a patient’s primary care provider (PCP) would have been involved in that patient’s hospitalized care and their end-of-life decisions within the hospital, the fragmented nature of today’s healthcare system has all but eliminated PCPs from involvement in hospitalized patient care. As such, patients often make end-of-life decisions based on the guidance of doctors with whom they have no pre-existing relationship. Other factors that blur ethical lines in healthcare, adds Dr. Price, are the new state of healthcare ownership and financing. Dr. Price mentions, for instance, conflicts of interest due to the US’s biggest employer of physicians, Optum, being a subsidiary of the same company that owns UnitedHealthcare. This situation allows for an insurer who controls reimbursement and who could, as the physician’s employer, influence decisions made regarding patient care. Sadly, this influence largely comes from financial concern instead of concern for the patient’s best health outcomes.
Exploding physician union membership signals a significant labor market shift
NJToday.net; 10/16/24
As of 2022, about 70,000 medical doctors in the United States, or about 8% of the physician workforce, belonged to a union—a notable increase of 26.8% since 2014. This shift reflects significant changes in the employment landscape for doctors, with nearly half of all physicians now working for health systems or large medical groups. The rise in union membership comes amidst broader labor movements in healthcare, highlighted by the 2023 Kaiser Permanente strike, recognized as the largest healthcare worker strike in U.S. history. While nurses have typically led these efforts, physicians and residents are increasingly exploring unionization as a means to advocate for improved pay, benefits, and working conditions.
The Fine Print:
Paywalls: Some links may take readers to articles that either require registration or are behind a paywall. Disclaimer: Hospice & Palliative Care Today provides brief summaries of news stories of interest to hospice, palliative, and end-of-life care professionals (typically taken directly from the source article). Hospice & Palliative Care Today is not responsible or liable for the validity or reliability of information in these articles and directs the reader to authors of the source articles for questions or comments. Additionally, Dr. Cordt Kassner, Publisher, and Dr. Joy Berger, Editor in Chief, welcome your feedback regarding content of Hospice & Palliative Care Today. Unsubscribe: Hospice & Palliative Care Today is a free subscription email. If you believe you have received this email in error, or if you no longer wish to receive Hospice & Palliative Care Today, please unsubscribe here or reply to this email with the message “Unsubscribe”. Thank you.