Literature Review

Advance Directives: How to make sure your end-of-life decisions are followed Bottom Line Inc; by Mathew D. Pauley, JD; 10/24/24 Nearly 40% of older Americans have some form of advance directives, such as a living will to communicate wishes about life-saving treatment…or a medical power of attorney appointing a loved one as proxy if they’re incapacitated.  Problem: Your wishes may not always be followed in real-world situations. Examples: Emergency paramedics typically provide CPR to restart a patient’s heart even if that patient’s living will says otherwise. And complex medical circumstances at the end of life often arise that force your loved ones to make judgment calls about what you really want. Bottom Line Personal spoke to clinical ethicist Mathew Pauley about how to make sure hospitals, medical providers and family members follow your medical wishes.

Patient, staff satisfaction biggest ROIs of trauma-informed hospice care Hospice News; by Holly Vossel; 10/23/24 Improved patient and staff satisfaction are among the most significant returns on investment for hospices that are pouring greater resources into trauma-informed training. The ability to build a trusting relationship with patients and their families is a key skill set for any hospice professional to possess, but one that takes on a profoundly different meaning when caring for survivors of abuse, violence and trauma. This is according to Amber Ash, pediatric hospice and palliative care social worker at Ohio-based Hospice of the Western Reserve. Trauma-informed education should be a normalized part of hospice’s interdisciplinary training to help staff recognize and respond to a range of experiences, Ash indicated. This type of training can help provide opportunities for improved goal-concordant care while also aligning with staff’s professional goals and personal values, she stated. 

Anxiety grows over telemedicine flexibility extension The Hill; by Joseph Choi; 10/24/24 Lawmakers and physicians are growing anxious for COVID-era telemedicine flexibility measures to be extended for a third time, as federal regulators signal a potential tightening of the rules ahead of a deadline at the end of the year. Since 2020, the Department of Health and Human Services and the Drug Enforcement Administration (DEA) have allowed physicians to prescribe schedule II to V controlled substances without in-person medical evaluations. ... Last year, the two agencies extended these flexibility measures through the end of 2024. With December fast approaching, a bipartisan group of lawmakers in both the House and Senate want another round of extensions secured. 

Safety first: How to ward off health care facility violence SmartBrief; by Julia M. Johnson; 10/23/24Panelists on an American Hospital Association webinar highlight ways in which hospitals and practices can protect their patients and themselves. ... The American Hospital Association recently hosted a webinar about what hospitals and practices need to know to protect themselves, staff members and patients. “Understanding Origins of Violence in Health Care Facilities” featured Jason Grellner of Evolv Technology and Drew Neckar of Cosecure. Both panelists spoke candidly about technology, terminology and steps that can be taken to dial down the danger at health care facilities.  

Busting palliative care misconceptions in cancer care Cure; by Alex Biese; 10/22/24 Palliative care can serve a crucial function for patients living with serious illnesses such as cancer, as an expert explained in an interview with CURE®. “Palliative care is sub-specialized health care for patients living with serious illness, where we're really focused on alleviating the symptoms and the stress associated with illness, and our goal is to improve quality of life for patients and their families,” said Dr. Cari Low of the University of Utah Huntsman Cancer Institute. ... However, some misconceptions persist regarding palliative care — most prominently that it is synonymous with hospice care. ... "We [i.e., palliative care] follow patients from the time of diagnosis through their curative cancer treatment and throughout their journey and into survivorship. ... Hospice is really focused on end-of-life care and comfort when cancer treatments no longer make sense. So, I really think of palliative care as this great big umbrella of support throughout the entire journey, where hospice is just a tiny piece of that umbrella.”

Funding approved for homeless hospice program SacCountyNews, Sacramento, CA; by Janna Haynes; 10/22/24 The Board approved, at its Oct. 22nd meeting, up to $1,137,788 in funding to complete construction on Joshua House, a facility that provides end-of-life comfort care for homeless individuals with terminal illnesses, after being discharged from an acute care hospital. Joshua’s House specifically provides a location for homeless patients to receive home-like hospice services when they, by definition, do not have a home to receive such care and may otherwise be unsheltered at the time of passing. Joshua’s House provides shelter, food, clothing and certain volunteer comfort services. In addition, YoloCares will provide licensed expert/specialized end-of-life care for individuals and families facing a life-limiting illness. Yolo Cares has provided high-quality hospice care across the six-county region for nearly 50 years. YoloCares also recently became an enhanced Care Management and Community Supports provider through CalAIM.

New hospice special focus programAmerican Health Association / National Center for Assisted Living; by Amy Miller; 10/22/23 ​​As required under the Consolidated Appropriations Act of 2021, CMS has established a hospice special focus program (SFP) in the Calendar Year (CY) 2024 Home Health Prospective Payment System (HH PPS) final rule (88 FR 77676). Through increased regulatory oversight and enforcement of the selected poor performing hospice programs, the SFP will address issues that could place hospice beneficiaries at risk of receiving poor quality of care. The hospice SFP is like the current Special Focus Facility (SFF) program in place for nursing homes. As many nursing homes refer residents to hospice programs and may receive questions from residents or their families, it will be important to keep informed if there are noted quality of care issues. 

Palliative care pharmacist discusses how building relationships with patients leads to rewarding career Drug Topics - Voice of the Pharmacist; by Killian Meara; 10/22/24 A discussion with Madison Irwin, PharmD, BCPS, clinical pharmacist specialist in palliative care at University of Michigan Health and clinical assistant professor at the University of Michigan College of Pharmacy. ... Irwin currently works as a clinical pharmacist specialist in palliative care in both inpatient and outpatient settings. She supports a palliative care consult team and outpatient palliative care clinics by seeing patients who are transitioning out of the hospital or patients who have more complex medication management needs. Although there are plenty of challenges that she faces in her practice, Irwin said that really getting to know patients through her work is extremely rewarding. ... In a conversation with Drug Topics, Irwin discussed how her career has unfolded, a program that she worked on that exemplifies the value of pharmacists in patient care, opportunities out there for pharmacists to expand their role, and how high rates of chronic pain will impact the pharmacy profession in the coming years.

Customizing a palliative program to patient, payer priorities Hospice News; by Jim Parker; 10/23/24 While some palliative care programs mirror the hospice model, more operators are working to tailor their services to patients’ specific needs, with varying intensity. This is increasingly important as payment shifts towards value-based payment models in which demonstrating cost savings is crucial to success. Providers need to demonstrate strong performance on quality scores as well as a track record of effectively preventing avoidable hospitalizations, readmissions and emergency department visits. This is particularly the case when negotiating contracts with Medicare Advantage plans, Accountable Care Organizations (ACOs) and other value-based payment arrangements, Sue Lynn Schramm, a partner of the hospice and palliative care consulting company Confidis, LLC, said in a presentation at the National Hospice and Palliative Care Organization Annual Leadership Conference. [Click on the title's link to continue reading.]

If opportunity doesn't knock, build a door. ~ Milton Berle

What the best leadership teams do right Harvard Business Review; by Ron Carucci, Mindy Millward, and Eric Hansen; 10/22/24 Given the unique responsibilities of executive teams, it would seem obvious that they require a specialized set of skills and approaches to be effective. And yet few have cracked the code on building and sustaining such effectiveness. There are three critical, highly interdependent roles they must play to have lasting impact on the company’s performance, culture, and ability to adapt. Executive teams often perform one or two of these reasonably well but fall short in integrating all three. The good news is that, with persistent effort, executive teams willing to put in the work can learn to play all three of these roles — setting themselves apart from the many willing to settle for much less.

Dombi scholarship established HomeCare, Tampa, FL; 10/21/24The National Alliance for Care at Home and its legacy organization have established a scholarship fund in honor of retiring National Association for Homecare and Hospice (NAHC) President Bill Dombi, leaders announced Monday at the organization’s transitional conference in Tampa, Florida. ... The William A. Dombi Scholarship Fund at the University of Connecticut, Dombi’s alma mater, topped its initial fundraising goal of $50,000 and was on the way to $100,00, said Marcylle Combs, a NAHC board member who organized the gift. NAHC and the National Hospice and Palliative Care Organization (NHPCO) merged this year to create the new Alliance, ... The scholarship announcement followed a moving video send-off to Dombi, who has been with NAHC since 1987, when he came aboard as lead counsel and helmed the landmark lawsuit that reformed the Medicare home health services benefit. (Read his retirement interview with HomeCare here.)

Lawsuit filed against Visiting Nurse Service entities and individual defendant for assault of hospice patient NewRamp; by NewRamp Editorial Staff; 10/22/24 The Law Offices of Robert E. Brown has filed a lawsuit against three Visiting Nurse Service entities and individual defendant Joy Odunze-Matthew following the violent assault of Carolyn Albanese, a terminally ill hospice patient under their care. The complaint alleges gross negligence by VNS and its affiliates for failing to properly vet, train, and supervise their staff, specifically the defendant Odunze-Matthew. The lawsuit seeks compensatory and punitive damages to address the physical, emotional, and psychological harm suffered by Ms. Albanese and her family.