Literature Review

Mass General Brigham union could shape hospital-at-home’s future Modern Healthcare; by Diane Eastabrook; 6/17/24 Nurses at one of the nation’s largest hospital-at-home programs have unionized, a move they hope could influence the future of in-home acute care and encourage more people working in home healthcare to join unions. The union vote at Boston’s Mass General Brigham comes as hospitals push aggressively to expand care outside of their walls, while a worker shortage and increased demand for healthcare contribute to rising labor strife among caregivers. Approximately 80 Mass General Brigham home hospital nurses voted overwhelmingly on May 16 to join the Massachusetts Nurse Association. The National Labor Relations Board certified the union to represent the nurses on May 24 and they are in the midst of selecting a bargaining team that will begin negotiating a contract with the hospital system within the next few months. ...  The hospital system is set to expand the number of patients the program can accommodate from 50 patients a day to 200 over the next few years. 

NAHC, NHPCO ink deal completing affiliation Hospice News; by Holly Vossel; 6/18/24 The National Hospice and Palliative Care Organization (NHPCO) and the National Association for Home Care & Hospice (NAHC) have announced the completion of their affiliation agreement. The affiliation joins two of the largest organizations representing, educating and advocating for home health and hospice providers that serve millions of disabled, elderly and dying Americans across the country. Board chairs and c-suite executives at NAHC and NHPCO recently met in Washington D.C. to ink the deal. The affiliation is rooted in a shared belief that unification will benefit their respective members and ultimately the patients and families they serve, according to NAHC President and CEO William Dombi.  

Boy, 7, takes on 145-mile challenge for hospice BBC News, Peterborough, United Kingdom; by Shariqua Ahmed; 6/15/24 A seven-year-old boy has taken on a mythical-themed challenge to raise funds for a hospice. Isaac Yates from King's Cliffe in Northamptonshire is scooting, walking and cycling 145 miles (233km) through a Lord of the Rings Virtual Conqueror Challenge for Sue Ryder Thorpe Hall Hospice in Peterborough [United Kingdom]. His mum, Zoë Hopkinson, works as a physiotherapist at the hospice which inspired Isaac's mission as he wants to “help people who are suffering and dying.” 

AFT launches new union physicians’ organizing effort: Doctors across the country are joining together for rights and respect American Federation of Teachers; by Alexis Lopez; 6/18/24  AFT President Randi Weingarten announced the launch of a brand-new doctors’ organizing initiative and division: Union Physicians of AFT. Doctors across the country are faced with crippling burnout from administrative overload, frustration over financial barriers affecting their patients’ capacity to pay, and lack of respect from corporate owners who put profits over patients—and now they’re organizing with the AFT to fight back. ... These challenges are apparent across the healthcare sector, but less than 10 percent of all U.S. doctors have formed unions. The tide is rapidly turning. ... The ranks of AFT’s physicians have already grown at an unprecedented rate—with over 3,200 new members, from New York to Oregon, joining the union over the last year. The AFT is the fastest growing healthcare union and the second-largest nurses union in the U.S.

Children’s hospices risk being ‘hugely reduced’ due to funding and cost issues Jersey Evening Post - UK News; by UK News; 6/19/24 Children’s hospice services are at risk of being “hugely reduced” amid a lack of long-term sustainable funding and rising costs, a charity has warned. ... Some 66.7% of children’s hospices said this was due to a hike in energy bills, while 86.1% said it was due to higher costs associated with recruiting and retaining staff. According to the report, some 54% of children’s hospices in the UK ended the 2023/24 financial year in a net deficit. Together for Short Lives extrapolated the figure across all 39 hospice organisations to estimate a total shortfall of £8.5 million.

Other Business Headlines of Interest, updated 6/20/24 per nasdaq.com

University Hospitals to cut more than 300 positions Modern Healthcare; by Paige Bennett; 6/19/24 University Hospitals is eliminating more than 300 positions amid challenges in the healthcare industry. The health system announced Wednesday, June 19, that it was reducing its leadership structure by more than 10% as part of an organizational reset. The move comes at a time when healthcare systems across the U.S. are grappling with rising costs and labor shortages. UH Chief Operating Officer Dr. Paul Hinchey said in a phone interview with Crain’s that the cuts focused on leadership and support services, not frontline workers. Affected employees began being notified by the health system on Monday, he said. The health system said the vast majority of the cuts were non-clinical and will not impact patient care. The move “complements a plan over the past three years to increase efficiency, consolidate service lines and close hospitals in Bedford and Richmond Heights,” according to UH. 

How Coastal Hospice improved clinical outcomes with AIHospice News; by Holly Vossel; 3/6/24Coastal Hospice & Palliative Care recently began exploring ways to improve clinical outcomes during the last days of life, an important quality measure in end-of-life care. The organization has found success utilizing an AI program that analyzes patient data using a palliative performance scale (PPS) indicator, according to Monica Escalante, president and CEO at Coastal Hospice. This window into a patient’s conditions has helped hospice teams better assess approaches to care delivery, Escalante said.Publisher's Note: I recently came across this article from a couple months ago and wanted to share it. An interesting article with impressive outcomes, I've also had positive experience with the PPS. Is your hospice using it?

Top oncologists say everyone with advanced cancer needs early palliative care. Here are 6 things to know ABC News, New York; by Lindsey Ulin, MD; 6/20/24This year, the American Society of Clinical Oncology — the world’s leading oncology organization — recommended palliative care for everyone with advanced cancer at the time of diagnosis and while receiving treatment. ... By next year, 693,000 people in the United States will have advanced breast, prostate, lung, colorectal, bladder, or skin cancer. ... “What I’m really excited to see is that these guidelines are taking a step back and thinking about [palliative care] from the time of diagnosis,” Dr. Arif Kamal, chief patient officer for the American Cancer Society and an associate professor at Duke University specializing in oncology and palliative care, told ABC News. “It should particularly be used in areas to help people stay on treatment, such as in clinical trials or hematologic malignancies.” Here are six things to know about palliative care:

Cancer therapy at end of life may not boost survival Cure; by Brielle Benyon; 6/17/24 Patients with advanced solid cancers who received systemic therapy toward the end of life typically did not live any longer than patients who did not receive treatment, according to research published in JAMA Oncology. Because cancer treatments can damper quality of life, it is crucial that patients and their loved ones discuss goals of care and prognosis with their oncology team, two experts emphasized. “I think once we progress to advanced and metastatic cancer when cure is no longer feasible, it’s important to consider goals-of-care conversations,” said study author Maureen Canavan, associate research scientist at Yale School of Medicine.

When your parents die: Becoming an adult orphan The Montecito Journal; by Deann Zampelli; 6/18/24 Shortly after I got married, my 64-year-old mother lost her battle with breast cancer. Seven years later my father joined her. The loss isn’t any less painful just because you are a grown-up. ... Many don’t realize that grief isn’t linear. We don’t go through a neat little phase, checking off each stage as we complete it. The famous (and somewhat debunked) five stages of grief introduced by Elisabeth Kübler-Ross in the 1960s (Denial, Anger, Bargaining, Depression, Acceptance) were from a study she did on the emotional states of patients who were dying. It was their stages she was referencing, not ours. ... I came to a frightening realization. ...  It suddenly dawned on me that my siblings and I were next in line to kick it. [Click on the title's link to continue reading.]Editor's Note: While serving in your hospice leadership roles, you experience the ongoing aging, changes and likely even deaths of your own family members, friends, and mentors. Do you, your hospice communications, and/or your grief services rely on the outdated "Stages of Grief" model? These "stages" opened the door in the 1960's for talking about death and dying, but became overpopularizd for surviving and healing after the loss. These have been replaced with extensive bereavement/loss/grief research, clinical best practices, and more. For expert information, resources, and bereavement professionals, examine www.adec.org,  the Association for Death Education and Counseling. 

‘I tried to get into their shoes and their culture’. Care worker experiences in cultural end-of-life care: Interpretative phenomenological analysis Journal of Clinical Nursing / Early View; by Elizabeth Lambert RN, BN (Hons), Jo Gibson RN, BN, PhD, MAdvNsgPrac, Kasia Bail RN, BN(Hons), GCHE, PhD Aim: What are care workers' lived experiences caring for people of culturally and linguistically diverse backgrounds during end-of-life care?What does this paper contribute to the wider global community? This study highlights the importance of understanding care workers’ experiences in providing culturally appropriate end-of-life care.

CMS - Roadmap to Better Care: Tribal Version CMS; 6/17/24This version of the Roadmap has been updated to help members of the American Indian and Alaskan Native community connect to their health care, including benefits provided through the Indian Health Service (IHS), Medicare, Medicaid, Marketplaces, or private insurance. Unlike Medicare, Medicaid, the IHS is not an insurance program or an established benefits package. IHS cannot guarantee funds are available each year, and as a result sometimes needs to prioritize patients of greatest need. The preservation of legacy, heritage, and traditions is vital. This roadmap is designed to help sustain cultural richness and strengthen the well-being of present and future American Indian and Alaska Natives for generations. To learn more about enrollment in Marketplace, Medicare, or Medicaid see pages 4 and 5 or visit ihs.gov/forpatients.