Literature Review

Interdisciplinary strategies for establishing a trusting relation as a pre-requisite for existential conversations in palliative care: a grounded theory study BMC Palliative Care - Part of Springer Nature, Open Acces; by Annica Lagerin, Christina Melin-Johansson, Bodil Holmberg, Tove Godskesen, Elin Hjorth, Lena Junehag, Carina Lundh Hagelin, Anneli Ozanne, Johan Sundelöf & Camilla Udo; 2/19/25... This study aimed to gain an in-depth understanding of healthcare professionals’ (HCPs) experiences of existential conversations with patients with PC needs and their next-of-kin by generating a theoretical model. ... To emphasize the importance of ethical competence for quality patient care, particularly in PC, a combination of care ethics, clinical proficiency, relational skills and effective communication is essential. ... The potential obstacles we identified that require attention include the need for managers ... to support HCPs by allowing time for reflection, developing new routines, and providing education focused on existential conversations in PC. However, the main contribution of this study is the description of the interdisciplinary strategies HCPs used to establish meaningful, existential conversations by maintaining presence, as this paved the way for trusting conversations with patients and next-of-kin. Editor's note: Pair this with today's article, "Why being trustworthy is a leadership hack that drives success."

Research priorities in neuropalliative care-A consensus statement from the International Neuropalliative Care SocietyJAMA Neurology; Winnie K. Lau, MD; Corey R. Fehnel, MD, MPH; Zachary A. Macchi, MD; Ambereen K. Mehta, MD, MPH; Manon Auffret, PharmD, PhD; Jori F. Bogetz, MD; Jori E. Fleisher, MD, MSCE; Jerome J. Graber, MD, MPH; Heather E. Leeper, MD, MS; Heena R. Manglani-Terranova, PhD; Susanne Muehlschlegel, MD, MPH; Emily L. Mroz, PhD; Elizabeth J. Pedowitz, MD; Usha Ramanathan, MSc, MD; Max Sarmet, SLP, MSc; Nathan A. Shlobin, BA; Leonard Sokol, MD; Susan Allyson Weeks, MA; Jiayun Xu, PhD, RN; Helen Bundy Medsger; Claire J. Creutzfeldt, MD; Ana-Maria Vranceanu, PhD; Darin B. Zahuranec, MD, MS; David Y. Hwang, MD; 2/25The International Neuropalliative Care Society Research Committee convened an interdisciplinary panel of experts, including clinicians, scientists, people with neurologic disease, and care partners, to identify priority research areas for the advancement of neuropalliative care as a field. Three priority areas highlighted in this review include (1) patient- and care partner–centered symptoms and outcomes specific to neurologic illness and tools for their assessment, (2) development of effective neuropalliative care interventions and delivery models, and (3) methods to support the ability to foster, deliver, and measure goal-concordant care over time.

Executive Personnel Changes - 2/21/25

Forget perks—leadership starts with asking employees what they need Forbes; by Benjamin Laker; 2/25/25 Employee well-being isn’t just a perk—it’s a business imperative. As organizations struggle with high turnover, burnout, and shifting workforce expectations, leaders must rethink how they engage and support employees. Research consistently shows that investing in well-being leads to measurable gains in productivity, retention, and performance. A recent study published by BMJ Leader examined how a structured, data-driven approach to improving workplace culture can yield transformative results—using the well-being initiative at Royal Free Hospital as a case study. ... The program, which was the focus of the BMJ Leader study, incorporated systematic conversations based on the Joy in Work Framework, identifying key challenges and implementing targeted solutions. Following implementation, workplace satisfaction surged by 76%, highlighting the significant impact of addressing staff concerns directly. Employees became more engaged in organizational initiatives, fostering a culture of active participation rather than passive compliance. 

Home health, hospice CEO average pay tops $400K: report McKnights Home Care; by Adam Healy; 2/19/25 The Hospital & Healthcare Compensation Service’s newly released 2024-2025 Multi-Facility Corporate Compensation Report offered an in-depth look at home health  and hospice executives’ average earnings. The average CEO salary at a multifacility home health and hospice firm was $403,000, with the top 10% earning $603,000 and the bottom 10% making $278,000. Average salaries varied among other C-suite executives, with chief operating officers earning $247,000, top financial executives earning $265,000, and chief medical officers earning $285,000, on average, according to the report. 

North Texas doctor helps parents facing infant loss deal with the unimaginableCBS News - Texas; by Andrea Lucia, Lexi Salazar, Katie Standing; 2/25/25[Background story for parents Yvette and Thoms Ngo upon dealing with the news that their in-utero baby girl Zoe was diagnosed with Trisomy 13, would likely miscarry, or die soon after birth. Dr. Terri Weinman, their neonatologist offered rich palliative care interventions and support.] "When we met Dr. Weinman and her team the first time, she would say things like, 'So, what are we going to do when Zoey is here,' which changed my mindset completely," Yvette Ngo said. ... For the first time, the Ngos began to consider what Zoey's life, short as it might be, could look like. "It made us more comfortable with the situation, I mean as comfortable as you can be," Thomas Ngo said. "She just gave us hope." Zoey was born on April 18, 2024. She met her parents, her siblings and her grandparents. She was baptized. "They made us little crafts and mementos for us to take home, like footprints, really ways to help cherish Zoey's life," Yvette Ngo said. "They took her heartbeat and recorded it for us. Little things that we wouldn't necessarily think of." Zoey even had a chance to go home. But after 36 hours of life, Zoey passed away in her father's arms. The perinatal palliative care Zoey received remains rare. But for families like the Ngos, it provides a small sense of control when it's needed most. "Being able to plan so much in advance and think about all the different scenarios and how we wanted it," Yvette Ngo said. " I think, looking back on our time with Zoey..." "We wouldn't have done anything differently," Thomas Ngo said. Editor's note: Pair this with "Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing students," posted 2/24/25.

New ACS research finds low uptake of supportive care at the end-of-life for patients with advanced cancer EurekAlert! - American Association for the Advancement of Science (AAAS); Peer-Reviewed Publication by American Cancer Society; 2/21/25  Despite considerable efforts to improve the quality of end-of-life care in the United States, a new retrospective study led by American Cancer Society (ACS) researchers revealed that close to half of patients with advanced cancer received potentially aggressive care at the end-of-life at the expense of supportive care. The findings are out today in the Journal of the American Medical Association (JAMA) Health Forum. ... Study results showed only one-quarter of patients diagnosed with advanced cancer received any palliative care in the last 6 months of life, and those who received it did so mainly in the month of death. Overall, 45% of decedents experienced any indicator of potentially aggressive care. There was an increase in the mean number of acute care visits (from 14.0 to 46.2 per 100 person-months), hospice use (from 6.6 to 73.9 per 100 person-months), palliative care (from 2.6 to 26.1 per 100 person-months), and advanced care planning (from 1.7 to 12.8 per 100 person-months) over the last 6 months of life. ... Editor's note: Click here for the research article, "Contemporary Patterns of End-of-Life Care Among Medicare Beneficiaries With Advanced Cancer."

Don’t let yesterday take up too much of today. ~ Will Rogers

New FDA policies could limit the full value of AI in medicineJAMA Health Forum; Scott Gottlieb, MD; 2/25Some experts within the [AI] field predict that in the next several years, developers may realize artificial general intelligence (AGI)—a revolutionary form of AI capable of understanding, learning, and applying knowledge across various tasks with human-like proficiency. Unlike today’s narrow AI systems that excel at tasks such as image recognition or language translation, AGI can tackle any intellectual challenge a human can, demonstrating a deep comprehension of diverse disciplines. Artificial intelligence tools with advanced analytical capabilities used in clinical practice, especially tools that synthesize complex clinical information from distinct sources, may automatically be classified as medical devices ... [by the US Food and Drug Administration]. This could deny health care clinicians access to AI tools that have the potential to transform the productivity and safety of medical care. 

Challenges to video visits for patients with non–English language preference-A qualitative studyJAMA Network Open; Marianna Kong, MD; Francine Rios-Fetchko, BA; Madelyn Olmos-Rodriguez, BA; Linda Branagan, PhD; Bradley Iott, MPH, MS, PhD; Therese Chan Tack, DO, MPH; Carol Yarbrough, MBA; Kevin Grumbach, MD; Alicia Fernandez, MD; 2/25Telemedicine, or synchronous video or audio-only visits, has made clinical encounters more convenient and accessible for many patients. Prior to the COVID-19 pandemic, video and telephone visits comprised a small minority of primary care visits, but by April 2020, approximately one-half of US physicians were treating patients virtually and nonurgent telemedicine video visits increased by more than 600%. In this qualitative study, participants with NELP [non-English language preference] perceived multiple barriers to video visits, including greater communication difficulties, lower medical evaluation quality, and technical issues. These findings suggest that addressable technical challenges associated with language barriers hamper access to video visits and decrease motivation for use and that interventions are needed to increase telehealth equity. 

Influence of culture and spiritual tradition on support for families of children dying in intensive care unitsJournal of Pediatric Nursing; Sung-Jin Jeanie Ju, Janie Ito, Aubree Lin, Dagmar Grefe, Jennifer Baird, Rebecca Ortiz La Banca Barber; 2/25Parents utilize spirituality as a means of coping during and after a child's death. Complexity of grief associated with loss of a child suggests the paramount importance of providing appropriate support for parents while experiencing their child's critical illness or end of life. Findings indicated three themes that illustrate the end-of-life and bereavement process: 1) Coping during hospitalization and the end-of-life stage; 2) coping during the bereavement stage; and 3) advice for parents and staff. To integrate the results into practice, hospital-wide education for staff on the importance of cultural and spiritual sensitivity is recommended. Additionally, collaboration with spiritual care teams, especially for patients and families facing complex diagnoses or advance care planning, will enhance the provision of culturally and spiritually sensitive care.

“You sure feel like you’re alone, kind of flailing away out there”: Family caregiver perspectives of caring for an individual with glioblastoma multiformeCambridge University Press; by Christy Muasher-Kerwin, Abby Baumbach, Yujun Liu, M. Courtney Hughes; 2/25Glioblastoma multiforme (GBM) is the most common and aggressive form of brain cancer... Nineteen current and former family caregivers for individuals with GBM participated in semi-structured interviews from October 2023 through January 2024... Three themes emerged from the interview analysis: (1) overwhelming caregiver burden, (2) difficulties coping with the caregiver role, and (3) gaps in caregiver support... Family caregivers for individuals with GBM desire more straightforward and proactive information and education about their care recipients from their medical providers. There is an opportunity for more utilization of hospice, palliative, and rehabilitation services to provide necessary training to GBM patients and their caregivers.

[UK] Supporting the bereaved child in the adult ICU: A narrative reviewIntensive Care Medicine; Annelies Rowland, Carole Boulanger, Louise Dalton; 2/25Childhood bereavement is a significant issue globally, affecting millions of children each year, with incidence rates significantly increasing following the COVID-19 pandemic. The loss of an important adult, particularly in the ICU environment, can lead to lasting psychological and behavioural challenges for children. Both families and healthcare professionals (HCPs) often feel unprepared and uncomfortable engaging in honest, supportive conversations with children about bereavement, further complicating children's grief processing. This narrative review examines the pivotal role ICU HCPs can play in facilitating child-centred bereavement support, focusing on promoting honest communication, supportive visitation practices, creating a child-friendly and humanised ICU environment, and encouraging child involvement during end-of-life care. The review also advocates for specialised training to equip ICU staff with the necessary skills to support grieving children and families.