Literature Review

Statement by the American Nurses Association on the importance of nursing specific science and research and the leaked FY 2026 HHS Budget Proposal American Nurses Association; Press Release, newsroom@ana.org; 4/17/25 Nursing-specific science and research is uniquely positioned to inform the health care delivery system on evidence-based approaches to patient-centered, quality care that meets the needs of patients as effectively and efficiently as possible. ... “The American Nurses Association (ANA) is deeply concerned about the recent reports surrounding the leaked draft FY 2026 proposed budget for the Department of Health and Human Services (HHS), specifically the elimination of National Institute of Nursing Research (NINR) and deep cuts to Title VIII Nursing Workforce Development Programs," expressed American Nurses Association President Dr. Jennifer Mensik-Kennedy, PhD, MBA, RN, NEA-BC, FAAN. “ANA firmly believes that NINR plays a vital role in ensuring that research guided by nurses’ education, experiences, and clinical training continue to enable our overall health care system to improve and be driven by evidence.” ... Further, ANA is grateful for the broad bipartisan support these programs have historically received from Congress and will work closely with lawmakers to safeguard funding for these programs during the FY2026 appropriations process.  ...

How physician CEOs are reenergizing later-career cliniciansBecker's Hospital Review; by Kristin Kuchno; 4/9/25 While much attention has been paid to recruiting top talent amid workforce shortages, retaining physicians later in their careers is also a key focus for health systems. Mentorship, flexible scheduling and leadership development opportunities can help energize experienced physicians and reduce burnout in the years leading up to their retirement, health system CEOs told Becker’s. Physician CEOs are uniquely positioned to understand the challenges around burnout and retention. Sunny Eappen, MD, president and CEO of The University of Vermont Health Network in Burlington [described], “Having experience being in front of a patient and having to either have difficult conversations or make difficult decisions is at the core of what we do,” Dr. Eappen said. “People understand that I can really speak from the heart and truly be in their shoes.”

What's at stake if CDC's Infection Control Practices Committee is cut MedPage Today; by Alexander Sundermann, DrPH; 4/17/25 Whether you are placing a central line, managing a Clostridioides difficile case, or keeping a surgical field sterile, you're likely following standards influenced by the Healthcare Infection Control Practices Advisory Committee (HICPAC). While it may not be widely known outside of infection prevention circles, HICPAC plays a central role in shaping the evidence-based guidelines that frontline clinicians use every day to protect both patients and healthcare workers. ... Frontline clinicians ... rely on HICPAC guidance every day. Its recommendations shape the protocols used to prevent device-related infections, respond to emerging outbreaks, and meet regulatory and accreditation requirements. ...Eliminating HICPAC wouldn't just slow progress -- it would erode the foundation of infection prevention in U.S. healthcare.

Transforming communities through leadership with Quint StuderTeleios Anatomy of Leadership podcast; by Chris Comeaux, Quint Studer; 4/9/25In this episode, Chris sits down with Quint Studer, Founder of Healthcare Plus Solutions Group and one of his most trusted mentors, to dive deep into the transformation of Pensacola, Florida. Quint reveals his powerful framework for community change, sharing essential leadership insights and the challenges of driving real transformation.

A mother’s goodbye-Barriers to microtransitions in careJAMA Internal Medicine; Aval-Na’Ree S. Green, Benjamin E. Canter; 3/25After a long, debilitating battle with lupus, my cousin died at the doorsteps of our health system. The funeral was at 11:00 am. I arrived at the facility at 8:45 am. Although the catheter was in place, my aunt was undressed, with remnants of breakfast on her gown. She had not been bathed. The staff and I wheeled my aunt outside and attempted to load her into the van. Once my aunt was in the chair, it could not fit through the van door. Because this transition was not a medical health care appointment, the facility did not coordinate the resources, including use of the van, that were necessary for it to occur successfully. In contrast, had this been a medical outing, such as a weekend dialysis appointment, the facility would have been required to provide transportation. If this microtransition had been treated like a major health care transition, perhaps it would have had a better chance of success. Nursing teams use checklists during major care transitions; similar procedures should apply to microtransitions.

Hospitalists in a bind when cancer prognosis hasn’t sunk inMedscape; by Jake Remaly; 4/15/25 When a patient with cancer is admitted to the hospital, the reason might not be related to the malignancy. But the hospitalist in charge sometimes becomes aware of a major disconnect: The patient, who they just met, does not grasp the severity of their cancer prognosis. On the one hand, the hospital medicine team and patient have advance directives and goals of care to consider, which may steer the course of the hospitalization and any use of hospice. The cancer prognosis — the patient might only have months to live, for example — could be a key component of those conversations. On the other hand, explaining the cancer situation should fall to the oncologist, right? ...Editor's notes: Pair this with today's posts, 

Today is National Healthcare Decisions Day - Make your advance care plans Institute for Healthcare Improvement - The Conversation Project; retrieved from the internet 4/14/25The links and resources [provided in this article] explore a variety of resources to help make, discuss and document future healthcare wishes and decisions in your advance care planning. ... The Conversation Project offers free tools, guidance, and resources to begin talking with those who matter most about your and their wishes.

Community Catalyst leads national response against new rule that threatens health care access Community Catalyst, Boston, MA; by Jack Cardinal; 4/11/25 Today, Community Catalyst organized hundreds of local, state and national partners to submit comments to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) opposing a new proposed rule from the Trump administration that would make it harder and more expensive for people to buy their own insurance on Affordable Care Act (ACA) Marketplaces and increase their medical debt. ... The administration’s own estimates suggest that as many as 2 million people will lose their coverage under this proposal, ...

Proposed FY26 Hospice Wage Index and Payment RateCMS press release; 4/11/25On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that proposes updates to Medicare payment policies and rates for hospices under the Fiscal Year (FY) 2026 Hospice Wage Index and Payment Rate Updated Proposed Rule (CMS-1835-P). [Major provisions include:]

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

Never allow a person to tell you no who doesn’t have the power to say yes. ~Eleanor Roosevelt

TIEC, trauma capacity, and the moral priority of surrogate decision makers in futility disputesThe Journal of Clinical Ethics; Autumn Fiester; Spring 2025In the past 15 years, trauma-informed care (TIC) has evolved as a new paradigm in healthcare that recognizes the impact of past traumas on patients' and families' healthcare experience while seeking to avoid inducing new trauma during clinical care. A recent paper by Lanphier and Anani extends TIC principles to healthcare ethics consultation (HEC) in what they label "trauma-informed ethics consultation" (TIEC), which calls for the "addition of trauma informed awareness, training, and skill in clinical ethics consultation." While Lanphier and Anani claim that TIEC is "novel, but not radical" because it builds on the approach to HEC endorsed by the American Society for Bioethics and Humanities, I believe that TIEC has radical implications, particularly regarding ethical obligations to surrogate decision makers (SDMs). Given what I call the SDM's "trauma capacity," I argue that TIEC accords moral priority to SDMs over patients in certain types of end-of-life cases, particularly futility disputes, which is a radical departure from the conventional HEC approach to SDMs.