Literature Review

Ah, summer, what power you have to make us suffer and like it. ~ AnonymousHappy mid-July!

Fewer deaths after serious illness in veterans treated with PARC Care Model U.S. Medicine; by LaTina Emerson; 7/11/24 After a serious illness, veterans who received medical care via the Post-Acute Recovery Center (PARC) model experienced fewer deaths and more days outside of the hospital compared to those not treated with PARC, according to a recent study. ...  Using telehealth, PARC is administered by nurse practitioners to address the complex needs of intensive care unit (ICU) survivors as they transition from hospital to home and improve access to post-ICU care for high-risk veterans, ... Each year, “more than 100,000 veterans transition from ICUs to their home after treatment for life-threatening illnesses, but this transition presents many challenges, including unresolved acute medical issues and the lingering effects of acute organ dysfunction,” according to the study authors. ... 

Nathan Adelson Hospice receives $160,000 donation from The Robert Thomas Bigelow Medical Foundation, Inc.Nevada Business; by Nathan Adelson Hospice; 7/11/24 Nathan Adelson Hospice, the leader in hospice and palliative care in southern Nevada, has been selected to receive a $160,000 donation from the Robert Thomas Bigelow Medical Foundation, Inc. through its grant program. The monetary donation will be used to purchase 38 new hospital beds for the hospice’s two in-patient facilities. Each bed has a state-of-the-art mattress that uses a self-adjusting system of synchronized air cylinders and pressure relief valves, which provide the most comfort for hospice patients. Two bariatric beds will be added, one for each in-patient unit. The bariatric beds expand in both length and width and have heavy-duty frames, to provide comfort and dignity to persons of size.Notable mentions: Karen Rubel, Nathan Adelson Hospice President & CEO; Robert T. Bigelow, President of the Robert Thomas Bigelow Medical Foundation, Inc.

What is palliative care, and can you get it at home?

Jim Jenkins: The long, strong, spectacular life of Robert McMillan ends with grace WRAL News, Raleigh, North Carolina; by Jim Jenkins; 7/14/24 Robert McMillan long ago had been decorated with every honor his city and his state could bestow. But it was his private acts of kindness, his advice and the wisdom he offered so privately and the judgment everyone trusted profoundly. ... McMillan maintained his dignity most recently as he knew his time was coming, and he made the decision himself to enter hospice care, saying, “I need to rest.” Over 36 hours, there was time for his children and their children and friends to come to his bedside. Some whispered, some spoke to him strongly and recalled his kindnesses, and again and again, said, “I appreciate all you did for me and I’ll never forget it.”

10 key Medicare Advantage updates in 2024 Becker's Payer Issues; by Rylee Wilson; 6/27/24 The first half of 2024 brought shifting trends for Medicare Advantage. Payers continued to warn of rising medical costs in the MA population, and some are predicting they will lose members next year. Insurers picked up a win in June when CMS said it would recalculate star ratings for 2024. Here are 10 key Medicare Advantage updates to know: 

Supporting the grieving child and family: Clinical reportPediatrics; by David J. Schonfeld, MD, FAAP; Thomas Demaria, PhD; Arwa Nasir, MBBS, MSc, MPH, FAAP; Sairam Kumar, MD, FAAP; Committee on Pyschosocial Aspects of Child and Family Health; Council on Children and Disasters; 6/17/24At some point in their childhood, the majority of children will experience the death of a close family member or friend. Approximately 1 in 20 children in the United States experiences the death of a parent by the age of 16. ... The death of someone close to a child often has a profound and lifelong effect on the child and results in a range of both short- and long-term reactions. ... This clinical report offers practical suggestions on how to talk with grieving children to help them better understand what has happened and its implications. An understanding of guilt, shame, and other common reactions as well as an appreciation of the role of secondary losses and the unique challenges facing children in communities characterized by chronic trauma and cumulative loss will help the [healthcare professional] to address factors that may impair children’s adjustment and to identify complicated mourning and situations when professional counseling is indicated. Advice on how to support children’s participation in funerals and other memorial services and to anticipate and address grief triggers and anniversary reactions is provided. ...Editor's Note: This significant article can be downloaded and shared with your organization's clinicians. For additional, ongoing resources, explore the National Alliance for Children's Grief. If your hospice provides specialized children's grief services, are they listed on the NACG's "Find a Support Center or Camp Near You" search engine? Click here to add or update your listing.

‘Normalizing’ Trauma-Informed Hospice Care Delivery Hospice News; by Holly Vossel; 7/2/24 Stakeholders and advocacy organizations recently collaborated to develop stronger trauma-informed care delivery guidelines that help hospices better address violence, abuse and neglect among serious and terminally ill populations. The global anti-violence advocacy organization NO MORE in concert with the National Partnership for Healthcare and Hospice Innovation (NPHI) recently unveiled a resource guide to help strengthen hospice providers’ understanding of traumatic experiences and their impact on end-of-life outcomes. “Understanding that elder abuse and domestic violence are two really distinct and prevalent issues in the older population has really become front and center,” NPHI President Carole Fisher told Hospice News. “These victims often suffer in silence, and we need to pay better attention to their issues.” The guide, dubbed Breaking the Silence: Addressing Domestic Violence, Elder Abuse and Neglect, is one of many steps needed in developing more supportive structures for patients and their families, according to Fisher. A main aim is to illuminate the prevalence of abuse and trauma and to arm hospice providers with tools to shape more innovative trauma-informed care models, she said.Editor's Note: NPHI is a sponsor. This significant Guide pairs with readers' "Top Read" articles we posted recently:

New ER program helped more patients get needed hospice care U.S. News & World Report; by Carole Tanzer Miller, HelathDay Reporter; 7/9/24 One hospital's push to transition patients who are nearing the end of life from the emergency room to hospice care appears to be working. After the program went into effect, 54% of ER patients at Brigham and Women's Hospital in Boston transitioned to hospice care within 96 hours. That compared to 22% before the program began in 2021. Their findings suggest that such programs may help adults who present at the ER near the end of life avoid delayed or missed hospice care. "When patients come to an emergency room near end of life, the default is typically to admit them to the hospital, engage them in conversations about goals and end-of-life care and potentially move them into hospice care," said first study author Dr. Christopher Baugh, an emergency department physician at Brigham and Women's. "However, this lengthy progress can take longer than the patient has left to live." He said the new program helps doctors quickly identify patients who are eligible for hospice care and get them there quicker. In hospice care, attempts to cure a person's illness are stopped and the focus shifts to comfort care and family support. ... The findings were reported July 8 in the journal JAMA Network Open.

CMS: GUIDE Model Infographic, Facts, and Participants CMS.gov and various press releases; retrieved from the internet 7/10/24 The Guiding an Improved Dementia Experience (GUIDE) Model is a voluntary nationwide model test that aims to support people with dementia and their unpaid caregivers. The model began on July 1, 2024, and will run for eight years. Editor's Note: Since the release of GUIDE's formal press release on 7/8 and our post yesterday (7/10), numerous press releases have already populated across the internet. We re-share this list of links to the GUIDE's information, participants, paired with new, sample press releases from 3 of the 400 participants. 

3 pillars of effective hospice sales Hospice News; by Jim Parker; 7/8/24Hospices seeking to grow should consider building a culture of compliance driven by data, effective system design and accountability, including for its sales force. Compliance and sales should walk hand-in-hand, according to a recent report from the Transcend Strategy Group. This can help prevent sales staff from running afoul of regulations inadvertently as well as support sustainable growth, according to Tony Kudner, chief strategy officer for Transcend. ... “[Without] understanding of what the rules of the road are, you’re going to run into trouble,” he said. “Though no one-size-fits-all approach exists, providers can adapt three overarching strategies to support this kind of culture.”

Clinician- and patient-directed communication strategies for patients with cancer at high mortality risk JAMA Network Open - Oncology; by Samuel U. Takvorian, MD, MSHP; Peter Gabriel, MD, MSE; E. Paul Wileyto, PhD; Daniel Blumenthal, BA; Sharon Tejada, MS; Alicia B. W. Clifton, MDP; David A. Asch, MD, MBA; Alison M. Buttenheim, PhD, MBA; Katharine A. Rendle, PhD, MSW, MPH; Rachel C. Shelton, ScD, MPH; Krisda H. Chaiyachati, MD, MPH, MSHP; Oluwadamilola M. Fayanju, MD, MA, MPHS; Susan Ware, BS; Lynn M. Schuchter, MD; Pallavi Kumar, MD, MPH; Tasnim Salam, MBE, MPH; Adina Lieberman, MPH; Daniel Ragusano, MPH; Anna-Marika Bauer, MRA; Callie A. Scott, MSc; Lawrence N. Shulman, MD; Robert Schnoll, PhD; Rinad S. Beidas, PhD; Justin E. Bekelman, MD; Ravi B. Parikh, MD, MPP; 7/1/24 Serious illness conversations (SICs) that elicit patients’ values, goals, and care preferences reduce anxiety and depression and improve quality of life, but occur infrequently for patients with cancer. Behavioral economic implementation strategies (nudges) directed at clinicians and/or patients may increase SIC completion. ... In this cluster randomized trial, nudges combining clinician peer comparisons with patient priming questionnaires were associated with a marginal increase in documented SICs compared with an active control. Combining clinician- and patient-directed nudges may help to promote SICs in routine cancer care.