Literature Review

Effectiveness of an Advance Care Planning intervention in adults receiving dialysis and their families: A cluster randomized clinical trialJAMA Network, by Mi-Kyung Song, PhD, RN; Amita Manatunga, PhD; Laura Plantinga, PhD; 1/29/24In this randomized clinical trial, the [Advanced Care Planning] ACP intervention implemented by health care workers at dialysis centers improved preparation for EOL decision-making but showed mixed effectiveness on bereavement outcomes. The ACP intervention implemented in dialysis centers may be an effective strategy to the dyad preparation for end-of-life care as opposed to the current focus on advance directives.

Predictors of early hospice or death in patients with inoperable lung cancer treated with curative intentClin Lung Cancer, by Siddharth Ramanathan, Kimberly A Hochstedler, Anna M Laucis, Benjamin Movsas, Craig W Stevens, Larry L Kestin, Michael M Dominello, Inga S Grills, Martha Matuszak, James Hayman, Peter A Paximadis, Matthew J Schipper, Shruti Jolly, Thomas P Boike; Michigan Radiation Oncology Quality Consortium; NCBI published 1/31/24Introduction: Treatment for inoperable stage II to III non-small cell lung cancer (NSCLC) involves chemo-radiotherapy (CRT). However, some patients transition to hospice or die early during their treatment course. We present a model to prognosticate early poor outcomes in NSCLC patients treated with curative-intent CRT.

The new source of power is not money in the hands of a few, but information in the hands of many. - John Naisbitt

Northwestern’s medical residents and fellows vote to unionizeChicago Sun Times, by Violet Miller; 1/29/24Interns, residents, chief residents and fellows at the McGaw Medical Center voted 794 to 148 in favor of union representation, an NLRB spokesperson said.

Medical aid in dying waiting period would shorten from 15 days to 48 hours under Colorado billThe Denver Post, by Meg Wingerter; 1/28/24A bill (SB 24-068) in the Colorado legislature would shorten the mandatory waiting period for medical aid in dying from more than two weeks to two days, opening the option to more critically ill people, but raising concerns for some about rushed decisions. It would also allow people who aren’t Colorado residents to end their lives under the state’s law, and let advanced practice registered nurses prescribe the drug cocktail.Publisher's note: The Denver Post is the source article. If you run into a paywall, the Greeley Tribune is running the same story without a paywall. A similar story is running in the Colorado Sun without a paywall.

Has Medicare Advantage lost its luster?Becker's Payer Issues, by Rylee Wilson; 1/29/24Though Medicare Advantage enrollment keeps climbing, the program may not have the profitability it once did for insurers. In a January analysis shared with Becker's, Moody's analysts wrote that the program "seems to be losing some of its luster," facing a significant increase in medical costs and lower reimbursement rates from CMS. Earnings in Medicare Advantage shrunk by 2.1% among the insurers Moody's rated from 2019 to 2022, despite premiums and members growing by 40% in the same time period.

NJ Governor signs Medicaid palliative care bill into lawC+TAC press release; 1/23/24New Jersey Governor Phil Murphy signed AB 5225 into law on December 21, 2023, requiring the development of a palliative care services benefit aimed to improve the quality of life for Medicaid beneficiaries with serious illness and their caregivers. 

Introducing the expanded JAMA Internal Medicine Editorial FellowshipJAMA Intern Med, by Michael A. Incze, MD, MSEd; Kenneth E. Covinsky, MD, MPH; Sharon K. Inouye, MD, MPH; 1/29/24We are pleased to announce the launch of our new Editorial Fellowship program at JAMA Internal Medicine. Educating clinicians and future leaders in internal medicine is a core part of JAMA Internal Medicine’s mission, and the journal has had a robust Fellowship program for medical trainees since 2015. This year, we will grow our Fellowship program, inviting early-career faculty to apply for an immersive 1-year program that provides longitudinal mentorship and hands-on experience in learning how to work as a member of the editorial team at a leading, widely read, high-impact internal medicine journal.

Seniors spend the equivalent of 3 weeks a year on health care, study saysThe Washington Post, by Linda Searing; 1/29/24Older adults spend an average of three weeks every year on doctor’s appointments and other health care outside their homes, according to research published in the Annals of Internal Medicine. Of those 21 “health care contact days,” 17 involve ambulatory services, such as office visits with primary-care doctors or specialists, testing and imaging, procedures, treatments and therapy. The remaining four days included time spent in an emergency room, hospital, skilled nursing facility or hospice.

Viewpoint: Care fragmentation, care continuity, and care coordination—How they differ and why it mattersJAMA Intern Med., by Lisa M. Kern, MD, MPH; Julie P. W. Bynum, MD, MPH; Harold Alan Pincus, MD; 1/29/24Health care in the US is characterized by fragmentation, with many patients seeing multiple physicians. Indeed, 35% of Medicare beneficiaries saw 5 or more physicians in 2019.1 Having multiple physicians may be appropriate, but it may also lead to medical errors, unnecessary visits, avoidable hospitalizations, and suboptimal care if all of the physicians do not have complete information about the patient and each other’s care plans.

In the hospital? Don't overlook the chaplainNext Avenue, by Alice Tremaine; 1/30/24Chaplains are the hospital's best-kept secret. Best-kept secret from patients, that is. Most of the hospital staff has figured out just how helpful chaplains can be, and will call the chaplain for everything that's difficult, scary or just plain weird: an unruly patient, a patient who received terrible news, a nurse who believes a hospital room is haunted, a mistress who showed up while the patient's wife is in the room.Editor's Note: Click here for "Common Qualifications and Competencies for Professional Chaplains," by the Board of Chaplaincy Certification, Inc.

Recommendations for supporting healthcare workers' psychological well-being: Lessons learned during the COVID-19 pandemicHealthc Manage Forum, by Melissa B Korman, Lisa Di Prospero, Tracey DasGupta, Mark Sinyor, Samantha J Anthony, Monika Kastner, Janet Ellis, Rosalie Steinberg, Robert Maunder; 1/30/24 Healthcare workers are at risk of adverse mental health outcomes due to occupational stress. Many organizations introduced initiatives to proactively support staff's psychological well-being in the face of the COVID-19 pandemic, ... [such as] the STEADY wellness program, ... in a large trauma centre in Toronto, Canada. Program implementors engaged teams in peer support sessions, psychoeducation workshops, critical incident stress debriefing, and community-building initiatives. ... [This] article describes recommendations for future hospital wellness programs.