Literature Review

Providence’s joint venture with Compassus likely delayed amid concerns about patient care and rural access Home Health Care News; by Audri Martin; 12/19/24Oregon’s Health Care Market Oversight (HCMO) program is reviewing a proposal to spin off Providence’s home health and hospice services into a joint venture supported by private equity. ... OHA’s HCMO program evaluates health care business transactions to ensure they do not negatively impact citizens or communities. The program also empowers state regulators to impose conditions on acquisitions and mergers or reject deals they find anti-competitive. Critics of the deal argue that the joint venture will result in cost-cutting measures, increased staff workloads and reduced patient services. Providence is the fifth largest nonprofit health care provider in the United States, while Compassus is a private equity-backed provider of home-based care services operating in more than 30 states.

Hospice Special Focus Program ListCMS Announcement; 12/20/24December 20, 2024: Today, the Centers for Medicare & Medicaid Services (CMS) released the list of the initial cohort of 50 hospices selected for participation in the Hospice Special Focus Program (SFP) in 2025. The SFP program, led by the Center for Clinical Standards and Quality, drives hospice quality improvement through increased health and safety oversight. This effort is a continuation of CMS’s commitment to improving hospice care for patients and families by holding hospice agencies accountable to national health and safety standards. [The initial cohort of 50 hospices selected for participation in the SFP can be downloaded here.]

Muslim community-engaged research highlights Muslim Americans' end-of-life-healthcare gaps and needs WisconsinMuslimJournal.org; by Sandra Whitehead; 12/20/24 Few Muslim Americans use hospice care, despite its posited benefits. A multi-sectoral team of academicians and community leaders in southeastern Wisconsin decided to find out why. ... Muslims are one of the fastest-growing religious communities in the United States, numbering between 3 to 5 million, with projections it will double by 2050. “With an aging Muslim population, there is a growing need for specialized healthcare services like hospice and palliative care,” the team’s research explains. ... Through a qualitative descriptive study with a Muslim patient and 10 family caregivers, the research team identified their perceptions of hospice care, ethical concerns and experiences. Among their varied perceptions, many saw it as useful only in the last hours of life. Participants also had ethical concerns about the use of sedative medication and with cessation of feeding terminally ill patients. Some had concerns about how hospice care might lead to unnecessary interventions or even hasten death. ...  The team is developing an informational resource, Islamic Bioethical Considerations for the End of Life: A Guide for Muslim Americans, to help Muslims who struggle when thinking about death and dying. 

Mobile app–facilitated collaborative palliative care intervention for critically ill older adults-A randomized clinical trialJAMA Internal Medicine; Christopher E. Cox, MD, MPH; Deepshikha C. Ashana, MD, MBA, MS; Katelyn Dempsey, MPH; Maren K. Olsen, PhD; Alice Parish, MSPH; David Casarett, MD; Kimberly S. Johnson, MD; Krista L. Haines, DO; Colleen Naglee, MD; Jason N. Katz, MD, MHS; Mashael Al-Hegelan, MD, MBA; Isaretta L. Riley, MD, MPH; Sharron L. Docherty, RN, PNP, PhD; 12/24An automated electronic health record–integrated, mobile application–based communication platform that displayed family-reported needs over 7 days, coached ICU attending physicians on addressing needs, and prompted palliative care consultation if needs were not reduced within 3 study days. In this randomized clinical trial, a collaborative, person-centered, ICU-based palliative care intervention had no effect on palliative care needs or psychological distress compared to usual care despite a higher frequency of palliative care consultations and family meetings among intervention participants.

ProCare Hospice of Nevada names nationally recognized hospice expert Keith Everett as new CEOProCare Hospice press release; 12/9/24In a move that underscores its vision to transform the cultural perceptions of advanced illness care, ProCare Hospice of Nevada (PCH) proudly announces Keith Everett as its new Chief Executive Officer. Everett, a proven leader in hospice care, most recently served as the President and CEO of Hospice of Acadiana in Lafayette, Louisiana.

House of Goshen makes history as Chicago’s first black-owned independent inpatient hospice house G20 News Today, Flossmoor, IL; 12/21/24 House of Goshen, a state-of-the-art inpatient hospice facility and the first Black-owned independent hospice center in the Chicago Southland area, is now officially accepting patients. Located at 19810 Governors Highway in Flossmoor, the center represents a pivotal advancement in equitable, compassionate end-of-life care in Chicagoland, the South Suburbs and beyond. The 14,000-square-foot facility offers 14 private suites designed to provide comfort, dignity, and peace for patients and their families. ... “Our goal is to create a sanctuary where every patient and family member feels supported, seen, and cared for,” said Sade Bello, co-founder of House of Goshen. “Being the first Black-owned hospice center in the region comes with immense pride and responsibility. We are committed to setting a standard of care that reflects the diversity and humanity of the communities we serve.”Editor's note: Thank you to the House of Goshen. Readers, pair this with the significance about hospice locations in "Who gets access to a good death?," an article that we posted on 10/24/24.

10 Years of making the world a more livable place for all bereaved people Evermore; by Joyal Mulheron, Executive Director; 12/21/24   Fourteen years ago today, I was sitting on my couch, trying to make sense out of what just happened to our family. Our terminally ill daughter, Eleanora, had died a few weeks prior. While others sang holiday songs and gleefully exchanged gifts, it was a profoundly painful, dark, and isolating time for me. Within a few short years, I quit my career because I saw tragedies saturating our national headlines, leaving a trail of unseen and unsupported bereaved people in their wake, and I believed our nation should prioritize the needs of all bereaved people. ... This is what I set out to change. ... Evermore’s groundbreaking advocacy efforts resulted in our nation’s first Report to Congress, which provided an overview of grief and bereavement services in the United States. Next year, a report analyzing more than 8,000 scientific studies will be published, reviewing the highest quality interventions for bereaved people — which was championed by Evermore and endorsed by Congress. Editor's note: Click on the title's link to continue reading Evermore's trailblazing, state-of-the-art leadership and advocacy with Congress, with the government's Substance Abuse and Mental Health Services Administration (SAMHSA), Newsweek, PBS, Harvard's Public Health magazine, Penn State, the University of California, and more. Click here to join Evermore's mailing list, and to learn from Joyal Mulhuron, Evermore's innovative, inspirational Founder/Executive Director. 

In the end, it's not the years in your life that count. It's the life in your years. ~Abraham Lincoln 

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. 

Evolution in documented goals of care at end of life for adolescents and younger adults with cancerJAMA Network Open; Rosemarie Mastropolo, Colin Cernik, Hajime Uno, Lauren Fisher, Lanfang Xu, Cecile A Laurent, Nancy Cannizzaro, Julie Munneke, Robert M Cooper, Joshua R Lakin, Corey M Schwartz, Mallory Casperson, Andrea Altschuler, Lawrence Kushi, Chun R Chao, Lori Wiener, Jennifer W Mack; 12/24Little is known about the nature of change in goals of care (GOC) over time among adolescents and younger adult (AYA) patients aged 12 to 39 years with cancer near the end of life. Understanding how GOC evolve may guide clinicians in supporting AYA patients in making end-of-life decisions. In this cross-sectional study of AYA patients who died of cancer, palliative goals were rarely documented before the last month of life, highlighting the need for timely and ongoing GOC discussions.

Behavioral symptoms and treatment challenges for patients living with dementia: Hospice clinician and caregiver perspectivesJournal of the American Geriatrics Society; Karolina Sadowska BA; Molly Turnwald BA; Thomas O'Neil MD; Donovan T. Maust MD, MS; Lauren B. Gerlach DO, MS; 12/24Dementia affects one in three older adults over age 85 and individuals with dementia constitute the fastest growing population of patients entering hospice care. While cognitive impairment is the hallmark of dementia, behavioral symptoms are reported in nearly all patients with advanced dementia, contributing to both the complexity of end-of-life care and caregiver burden. Behavioral symptoms of dementia are highly prevalent among the US hospice population and are often managed with psychotropic medications prescribed off-label. There are limited treatment guidelines in this population, so the appropriate risk and benefit balance may be highly individual. This qualitative study can help to inform the decision-making of hospice clinicians and caregivers regarding anticipated behavioral changes and limitations of treatment options in dementia end-of-life care. 

Estimation of cancer deaths averted from prevention, screening, and treatment efforts, 1975-2020JAMA Oncology; Katrina A. B. Goddard, PhD; Eric J. Feuer, PhD; Jeanne S. Mandelblatt, MD, MPH; Rafael Meza, PhD; Theodore R. Holford, PhD; Jihyoun Jeon, PhD; Iris Lansdorp-Vogelaar, PhD; Roman Gulati, MS; Natasha K. Stout, PhD; Nadia Howlader, PhD; Amy B. Knudsen, PhD; Daniel Miller, BA; Jennifer L. Caswell-Jin, MD; Clyde B. Schechter, MD; Ruth Etzioni, PhD; Amy Trentham-Dietz, PhD; Allison W. Kurian, MD, MSc; Sylvia K. Plevritis, PhD; John M. Hampton, MS; Sarah Stein, PhD; Liyang P. Sun, MS; Asad Umar, DVM, PhD; Philip E. Castle, PhD; 12/24Overall US mortality has declined over time for most major cancer sites because of progress in prevention, screening, and treatment. Nevertheless, the reignited Cancer Moonshot goal to reduce the age-adjusted cancer mortality rate by 50% in the next 25 years will not be achieved without accelerating progress. In this model-based study using population-level cancer mortality data, an estimated 5.94 million deaths were averted from these 5 cancers [breast, cervical, colorectal, lung, and prostate] combined. Prevention and screening accounted for 8 of every 10 averted deaths, and the contribution varied by cancer site. A comprehensive plan to reduce cancer mortality includes interventions in cancer prevention, detection, diagnosis, treatment, and survivorship care.