Literature Review

Recommendations to ensure safety of AI in real-world clinical careJAMA; Dean F. Sittig, PhD; Hardeep Singh, MD, MPH; 11/24As HCOs [health care organizations] adapt their clinical and administrative workflows to new AI [artificial intelligence]-driven technologies, unintended adverse consequences will inevitably occur, particularly during transitions. To address these risks, HCOs and AI/EHR [electronic health record] developers must collaborate to ensure that AI systems are robust, reliable, and transparent. HCOs must proactively develop AI safety assurance programs that leverage shared responsibility principles, implement a multifaceted approach to address AI implementation, monitor AI use, and engage clinicians and patients. Monitoring risks is crucial to maintaining system integrity, prioritizing patient safety, and ensuring data security. 

Hospice volunteering isn't for everyone but a rewarding way to give back News Talk 830 WCCO; by Susie Jones; 12/27/24 Volunteering is big part of the holiday season for some, with people wanting to help others even in difficult times. Being a hospice volunteer isn't for everyone.  It can certainly be scary to sit with someone who is dying. "It's not just a job, it's not just a volunteer gig, and I can always, always welcome new volunteers," says Allina Health hospice program administrator Erika Schuld. However, Schuld says it can be very rewarding. "You're in these really intimate, vulnerable settings, and you just form bonds really quickly, and it really is our honor in hospice to walk along with patients and families," explains Schuld. Doctor Glen Varns is the medical director of the program and he says volunteers do not administer medication. Instead they do other things to support families. Editor's note: The CMS standard 42 CFR §418.78(e) requires hospices to use volunteers for at least 5% of patient care hours. This was waived during the COVID-19 pandemic, and then reinstated May 11, 2023 when the Public Health Emergency (PHE) officially expired. CMS's volunteer requirement is unique to hospice care. Ensure that your hospice provides appropriate selection, background checks, required TB tests, job descriptions for different volunteer roles, matching of the volunteer to the best role, training, supervision, and tracking of hours for CMS's requirement. Additionally, your hospice must adhere to applicable state laws and internal HR Policies and Procedures regarding volunteers. Click here for the CMS standard.

Awards and Recognitions: December 2024

Accept your past without regret, handle your present with confidence, and face your future wtihout fear. ~Nicholas Sansbury Smith

Cheers to a new year and another chance for us to get it right. ~Oprah Winfrey

Head and neck cancer mortality in the Appalachian regionJAMA Otolaryngology-Head and Neck Surgery; Todd Burus, MAS; Pamela C. Hull, PhD; Krystle A. Lang Kuhs, PhD, MPH; 12/24In contrast to non-Appalachian US, where HNC [head and neck cancer] mortality rates declined considerably between 1999 and 2020, HNC mortality rates in the Appalachian region have remained stubbornly stable. Moreover, statistically significant increasing rates of HNC mortality in rural Appalachia provide evidence that the lack of rural HNC mortality improvements nationwide are associated with Appalachian disparities. While the exact factors driving these trends are unknown, the Appalachian region has an increased prevalence of multiple risk factors associated with cancer mortality, such as adverse social determinants of health, heightened alcohol and tobacco use, later stage at diagnosis, and limited access to care. Investments in the Appalachian region—such as through the Bipartisan Infrastructure Law or by expanding coverage of the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program among Appalachian states—could help reduce the burden of HNC mortality by improving cancer surveillance and serving the unique needs and experiences of the Appalachian population. These investments could also aid efforts to improve other cancer sites with known disparities in Appalachia, such as lung and colorectal cancers.

Current challenges in neurocritical care: A narrative reviewWorld Neurosurgery; Safa Kaleem, William T. Harris II, Stephanie Oh, Judy H. Ch'ang; 1/25Neurocritical care as a field aims to treat patients who are neurologically critically ill due to a variety of pathologies. As a recently developed subspecialty, the field faces challenges, several of which are outlined in this review ... [including confusion around] brain death testing or the diagnosis of brain death itself ... Given these difficult scenarios encountered in the neuro-ICU, conversations with patients’ decision-makers are often done with the assistance of palliative care services ... the most common reasons for palliative care consultation in the neuro-ICU were discussing prognosis, eliciting patient and family values, understanding medical options, and identifying conflict. Collaboration with hospital chaplains and palliative care services can be helpful, but cultural humility also needs to be a priority for neurocritical care providers to be able to navigate difficult conversations.

Conscience at the end of lifeNursing Reports; Ralph Neil Baergen, James Skidmore; 12/24Caring for patients at the end of life can involve issues that are ethically and legally fraught: withholding or withdrawing artificial nutrition and hydration, pain control that could hasten death, aggressive treatment that is continued when it seems only to be prolonging suffering, patients who request medical assistance in dying, and so forth. Clinicians may find that their deeply held ethical principles conflict with law, institutional policy, or patients' choices. In these situations, they may consider either refusing to participate in procedures that they find morally abhorrent (conscientious refusal) or providing care that they believe to be ethically obligatory despite being contrary to law or policy (conscientious commitment). Healthcare providers who refuse to provide medical services should be expected to explain their reasons, make prompt referrals, and bear some of the resulting costs or burdens.

[China] Family members' experiences of surrogate decision-making in hospice care: A systematic review of qualitative studiesInternational Journal of Nursing Studies; Ting Yu, Yijing Li, Ziyi Hu, Shanshan Liu, Cong Wang, Qian Chen, Yan Jiang; 12/24Determining whether patients receive hospice care at end of life is complex for family members. This process begins with the coexistence of rational and emotional motives for decision-making, involves preparation for decision-making through the acquisition of knowledge and experience about hospice care, and culminates in reflection on the entire decision-making process. These findings underscore the importance of providing sufficient informational and emotional support to family decision-makers, which can improve decision-making and promote more compassionate end-of-life care. Future research should focus on developing effective strategies to strengthen these support systems.

[Italy] Features of the nurse-patient relationship: Insights from a qualitative review using artificial intelligence interpretationCurrent Oncology; Elsa Vitale, Luana Conte, Roberto Lupo, Stefano Botti, Annarita Fanizzi, Raffaella Massafra, Giorgio De Nunzio; 12/24This qualitative literature review explored the intersection of art, creativity, and the nurse-patient relationship in the context of oncology nursing. It delved into the perceptions and reflections of nurses as captured by Generative Artificial Intelligence (GAI) analysis from two specialized nursing databases. The analysis revealed profound considerations regarding the role of nurses in oncology and palliative patient care. Nurses acknowledged the spiritual dimension through religious and spiritual practices, while emphasizing authentic presence and empathic communication. The insights from the GAI interpretation underscored the significance of empathy, creativity, and artistry in nurturing meaningful nurse-patient connections. 

[UK] Hospice to run Christmas tree removal fundraiser BBC News, United Kingdom; by Jacob Panons; 1/1/25 A hospice in Kent is once again offering Christmas tree removals to help raise funds. In 2023, Heart of Kent Hospice raised more than £9,000 by receiving donations to recycle Christmas trees. Between 3-5 January, the Aylesford-based charity will run the service for the third time, collecting in and around Chatham, Maidstone, Staplehurst, Paddock Wood, Borough Green and the surrounding areas. A donation of £15 for each tree is suggested and people are urged to book a slot online before the new year. 

Top Modern Healthcare stories of 2024 Modern Healthcare; by Mary Ellen Podmolik; 12/31/24 Ups and downs in healthcare kept Modern Healthcare reporters plenty busy in 2024, and 2025 is shaping up as a critical year for the industry, particularly as a new administration takes over in Washington, D.C. Our reporters this year did what Modern Healthcare excels at — bringing readers the news along with the context and analysis our audience needs to stay ahead. Get ready for 2025 by catching up on some hot topics during 2024.

The next health system C-suite obsessionBecker's Hospital Review; by Laura Dyrda; 12/30/24 Health system executives spent the last few years building financial stability after the pandemic and adjusting to workforce shifts. Those areas will remain important in 2025, but a new obsession for C-suite executives is emerging. Or, more accurately, re-emerging. Solving capacity issues and becoming more efficient with patient throughput is a top priority for next year, several CEOs and top health system executives recently told Becker's. Many are operating at or near capacity, especially with workforce challenges persisting, and leadership teams are looking for immediate solutions. ... A recent survey from Vizient shows 52.8% of hospital and health system leaders see patient access, throughput and capacity as top focus areas for 2025. Volumes are still elevated compared to pre-pandemic levels, according to Kaufman Hall's "National Hospital Flash Report," and while growth has slowed this year, leaders are still contending with big capacity issues.