Literature Review



Carolina Caring’s second hospice resale shop location in Mountain View opens 8/28

09/01/24 at 03:05 AM

Carolina Caring’s second hospice resale shop location in Mountain View opens 8/28 FOCUS Newspaper; 8/21/24 Carolina Caring is delighted to announce the grand opening of its second Hospice Resale Shop location on Wednesday, August 28, at 10 a.m. This new shop will be located at 2920 S. Highway 127 in Mountain View, just a few miles from the nonprofit serious illness provider’s Catawba Valley Hospice House. ... Carolina Caring, founded in 1979, is an independent, community-based, nonprofit healthcare provider. ... Carolina Caring serves 12 counties across western North Carolina and the Charlotte Region.

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Sunday newsletters

09/01/24 at 03:00 AM

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

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Today's Encouragement

09/01/24 at 03:00 AM

Imagination is more important than knowledge. Knowledge is limited. Imagination encircles the world. ~Albert Einstein

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Fraudulent hospices reportedly target homeless people, methadone patients to pad census

09/01/24 at 03:00 AM

Fraudulent hospices reportedly target homeless people, methadone patients to pad census Hospice News; by Jim Parker; 8/23/24 Fraudulent hospices in California reportedly have been targeting homeless people and methadone patients, promising them a steady supply of opioids in exchange for enrolling in hospice. Three hospice leaders came forward to Hospice News to report these practices. According to their reports, unscrupulous providers have canvassed both homeless encampments and methadone clinics seeking to sign up patients who are not terminally ill. In many cases, the sources said, these operators offer patients free access to board-and-care facilities and a daily supply of morphine. Another frequent practice among these hospices is to offer patients cash or other items in addition to drugs, they said. “This conduct raises serious fraud concerns on kickbacks or gifts to beneficiaries who do not appear to qualify for hospice,” Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), told Hospice News. “More importantly, this conduct is predatory, taking advantage of individuals in addiction. Jail time is not enough punishment for the harm that such conduct creates.”Editor's Note: We are reposting this from our Saturday 8/24 issue, to ensure our weekday readers see it. This is abhorable. Click on the title's link to read more. While John Oliver's "Last Week Tonight" episode on 8/18/24 gained criticism from many hospice leaders, these fraudulent unethical behaviors (and others') lay the groundwork for such dire distrust from the public. These behaviors must be stopped. These persons and organizations must be held accountable. 

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Today's Encouragement

08/31/24 at 03:55 AM

Success is walking from failure to failure with no loss of enthusiasm. ~ Winston Churchill

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[Australia] Maybe for unbearable suffering: Diverse racial, ethnic and cultural perspectives of assisted dying. A scoping review

08/31/24 at 03:55 AM

[Australia] Maybe for unbearable suffering: Diverse racial, ethnic and cultural perspectives of assisted dying. A scoping reviewPalliative Medicine; Melissa J Bloomer, Laurie Saffer, Jayne Hewitt, Lise Johns, Donna McAuliffe, Ann Bonner; 8/24Perspectives on assisted dying are dynamic and evolving. Even where assisted dying is legalised, individual's cultural attributes contribute to unique perspectives of assisted dying as an end-of-life option. Thus, understanding a person's culture, beliefs, expectations and choices in illness, treatment goals and care is fundamental, extending beyond what may be already considered as part of clinician-patient care relationships and routine advance care planning.

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Clinical reasoning and artificial intelligence: Can AI really think?

08/31/24 at 03:50 AM

Clinical reasoning and artificial intelligence: Can AI really think? Transactions of the American Clinical and Climatological Association; Richard M. Schwartzstein, MD; 2024Artificial intelligence (AI) in the form of ChatGPT ... holds great promise for more routine medical tasks, may broaden one’s differential diagnosis, and may be able to assist in the evaluation of images, such as radiographs and electrocardiograms, the technology is largely based on advanced algorithms akin to pattern recognition. One of the key questions raised in concert with these advances is: What does the growth of artificial intelligence mean for medical education, particularly the development of critical thinking and clinical reasoning? AI will clearly affect medicine in the years to come and will change the ways in which doctors work. It will also make the ability to reason, to think, to analyze problems, and to know how best to apply principles of human biology at the bedside more important.

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Site-of-Care shifts and payments—A viable strategy to control health care costs?

08/31/24 at 03:45 AM

Site-of-Care shifts and payments—A viable strategy to control health care costs?JAMA Open Network; Lee A. Fleisher, MD, ML; Sheila P. Burke, RN, MPA; 8/24The authors sought to determine what proportion of care was currently being performed in hospital-based settings and investigated how much could be shifted to nonhospital settings today and 7 to 10 years in the future with technological advances. They found that the major barriers to site-of-care shifts were economic arrangements, ownership models, and perceived loss of continuity of care at alternative sites. These results affirm their view that to reduce health care spending and protect Medicare trust funds, it will be critical to develop financial incentives and, just as importantly, eliminate financial disincentives to drive care to the safest and lowest-cost site of service.

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Pediatric complex chronic condition system

08/31/24 at 03:40 AM

Pediatric complex chronic condition systemJAMA Open Network; Lisa C. Lindley, PhD, RN; 7/24The pediatric complex chronic condition (CCC) system is the gold standard in classifying patients younger than 18 years who are seriously ill in pediatric research. Feinstein et al report on the development and comparison of the most recent revision (V3) of the CCC system [which includes] modifications to new, missing, and retired ICD-10-CM and procedure codes. The authors recommend using the newest V3 of the CCC system for research because it incorporates the evolving ICD-10 system. ICD-10 codes are continually being added, deleted, and modified, and the CCC system, which is based on the ICD and procedure codes, needs to keep pace. Feinstein et al are to be commended for their significant effort to update codes, especially ahead of the imminent US transition to the International Classification of Diseases, 11th Revision (ICD-11).

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Reviewing ethical guidelines for the care of patients with Do-Not-Resuscitate orders after 30 years: rethinking our approach at a time of transition

08/31/24 at 03:35 AM

Reviewing ethical guidelines for the care of patients with Do-Not-Resuscitate orders after 30 years: rethinking our approach at a time of transition Anesthisiology; Matthew B. Allen, M.D.; Shahla Siddiqui, M.D., D.A.B.A., M.Sc.; Omonele Nwokolo, M.D.; Catherine M. Kuza, M.D.; Nicholas Sadovnikoff, M.D., H.E.C.-C.; David G. Mann, M.D., D.Be.; Michael J. Souter, M.B., Ch.B., D.A.; 9/24The American Society of Anesthesiologists (ASA) opposes automatic reversal of do-not-resuscitate orders during the perioperative period, instead advocating for a goal-directed approach that aligns decision-making with patients’ priorities and clinical circumstances. Implementation of ASA guidelines continues to face significant barriers including time constraints, lack of longitudinal relationships with patients, and difficulty translating goal-focused discussion into concrete clinical plans. These challenges mirror those of advance care planning more generally, suggesting a need for novel frameworks for serious illness communication and patient-centered decision-making.

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Clinician-and patient-directed communication strategies for patients with cancer at high mortality risk-A cluster randomized trial

08/31/24 at 03:30 AM

Clinician-and patient-directed communication strategies for patients with cancer at high mortality risk-A cluster randomized trialJAMA Open Network; Samuel U. Takvorian, MD; Peter Gabriel, MD, MS; 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, MPH1; 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; 7/24Serious 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.

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Feasibility of a serious illness communication program for pediatric advance care planning

08/31/24 at 03:25 AM

Feasibility of a serious illness communication program for pediatric advance care planningJAMA Open Newtwork; Danielle D. DeCourcey, MD, MPH; Rachelle E. Bernacki, MD, MS; Brett Nava-Coulter, MPH; Sithya Lach, BS; Niya Xiong, MSPH; Joanne Wolfe, MD, MPH; 7/24Children and adolescents and young adults (AYAs) with serious illness often have a variable clinical course with periods of stability alternating with life-threatening deteriorations; consequently, many children and AYAs experience health crises without opportunities to discuss preferences for medical care. Furthermore, bereaved parents report a lack of preparation to address their child’s medical and emotional needs at end of life (EOL). Advance care planning (ACP) is an iterative process to honor patient and family goals and values involving communication about prognosis and the formulation of care plans addressing symptom management, quality of life, preferences for life-sustaining interventions, and anticipatory guidance about EOL. Pediatric advance care planning (ACP), which aims to ensure care is aligned with family goals and values, is associated with better end-of-life outcomes; however, ACP in pediatrics remains uncommon. This pilot cohort study found that the PediSICP [Pediatric Serious Illness Communication Program] was feasible, acceptable, and highly valued by clinicians and parents of children with serious illness.

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Reducing central nervous system–active medications to prevent falls and injuries among older adults-A cluster randomized clinical trial

08/31/24 at 03:20 AM

Reducing central nervous system–active medications to prevent falls and injuries among older adults-A cluster randomized clinical trialJAMA Open Network; Elizabeth A. Phelan, MD, MS; Brian D. Williamson, PhD; Benjamin H. Balderson, PhD; Andrea J. Cook, PhD; Annalisa V. Piccorelli, PhD; Monica M. Fujii, MPH; Kanichi G. Nakata, PhD; Vina F. Graham, BS; Mary Kay Theis, MA, MS; Justin P. Turner, PhD; Cara Tannenbaum, MD, MSc; Shelly L. Gray, PharmD, MS; 7/24This cluster randomized clinical trial found that a health system–embedded deprescribing intervention was no more effective than usual care in reducing medically treated falls among community-dwelling older adults prescribed CNS-active medications. For health systems that attend to deprescribing as part of routine clinical practice, additional interventions may confer modest benefits on prescribing without a measurable effect on clinical outcomes.

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Patient-Reported outcome measures help patients with cancer

08/31/24 at 03:15 AM

Patient-Reported outcome measures help patients with cancerMichael J. Hassett, MD, MPH; Christine Cronin, BS; 8/24Outside of cancer medicine, there is ample evidence that care management interventions improve patient-related, therapy-related, and health care utilization outcomes, especially when PROMs [patient recorded outcome measures] are incorporated. Altogether, these findings led to the hypothesis that symptom-focused care management programs that rely on PROMs could have a substantial positive impact for patients with cancer. Over the past 2 decades, dozens of clinical trials have explored this question. The analysis by Balitsky and colleagues adds further support to the argument that PROMs should be used routinely in oncology practice.

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Fairness in predicting cancer mortality across racial subgroups

08/31/24 at 03:10 AM

Fairness in predicting cancer mortality across racial subgroupsJAMA Open Network; Teja Ganta, MD; Arash Kia, MD; Prathamesh Parchure, MSc; Min-heng Wang, MA; Melanie Besculides, DrPH; Madhu Mazumdar, PhD; Cardinale B. Smith, MD; 7/24In this cohort study, a machine learning [ML] model to predict cancer mortality for patients aged 21 years or older diagnosed with cancer ... was developed. ... The lack of significant variation in performance or fairness metrics indicated an absence of racial bias, suggesting that the model fairly identified cancer mortality risk across racial groups. The findings suggest that assessment for racial bias is feasible and should be a routine part of predictive ML model development and continue through the implementation process.

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Trends in post-acute care use in Medicare Advantage versus Traditional Medicare: A retrospective cohort analysis

08/31/24 at 03:05 AM

Trends in post-acute care use in Medicare Advantage versus Traditional Medicare: A retrospective cohort analysisJournal of the American Medical Directors Association; by Robert E Burke, Indrakshi Roy, Franya Hutchins, Song Zhong, Syama Patel, Liam Rose, Amit Kumar, Rachel M Werner; 8/24We sought to describe national trends in hospitalization and post-acute care utilization rates in skilled nursing facilities (SNFs) and home health (HH) for both Medicare Advantage (MA) and Traditional Medicare (TM) beneficiaries, reaching up to the COVID-19 pandemic (2015-2019). We found hospitalizations, SNF stays, and HH stays were all decreasing over time in both populations. Although similar proportions of MA and TM beneficiaries received SNF or HH care, MA beneficiaries received fewer days. The largest difference we found was in the number of post-acute care providers used in TM and MA, with MA using far fewer; however, quality ratings were similar among post-acute care providers used in each program.

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Saturday newsletters

08/31/24 at 03:00 AM

Saturday newsletters focus on headlines and research - enjoy!

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Modeling nursing home harms from COVID-19 staff furlough policies

08/31/24 at 03:00 AM

Modeling nursing home harms from COVID-19 staff furlough policiesJAMA Open Network; by Sarah M Bartsch, Colleen Weatherwax, Bruce Leff, Michael R Wasserman, Raveena D Singh, Kavya Velmurugan, Danielle C John, Kevin L Chin, Kelly J O'Shea, Gabrielle M Gussin, Marie F Martinez, Jessie L Heneghan, Sheryl A Scannell, Tej D Shah, Susan S Huang, Bruce Y Lee; 8/24What is the tradeoff between COVID-19–related harms and non–COVID-19–related harms when allowing nursing home staff with mild COVID-19 to work while masked? The findings of this study suggest that allowing nursing home staff who were mildly ill with COVID-19 to work while masked was associated with less harm from alleviated missed tasks, outweighing increasing harm from COVID-19 transmission.

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Updated Care Compare for Hospice released

08/30/24 at 03:05 AM

Updated Care Compare for Hospice ReleasedCMS website; 8/28/24Publisher's note: See link above to access updated Care Compare for Hospice publicly reported quality measures.

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Meet Germany’s biographer of the dying

08/30/24 at 03:00 AM

Meet Germany’s biographer of the dying WhatFingerNews, WhatFinger.com; YouTube video with English voiceover; 8/26/24 Sabrina Görlitz writes biographies about people on their deathbeds. In a hospice, she meets Gisela—an 87-year-old woman sharing her personal story for posterity.

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Bon Secours Mercy Health partners with private equity-owned provider

08/30/24 at 03:00 AM

Bon Secours Mercy Health partners with private equity-owned provider[VA] VPM; by Adrienne Hoar McGibbon; 8/27/24There is a growing demand for hospice care in Virginia. 40,000 people received hospice care in the state in 2023, according to the U.S. Centers for Medicare and Medicaid Services. The joint venture with Compassus plans for expanded hospice and home health care. Bon Secours Mercy Health’s home health and hospice care division is teaming up with national home health care provider Compassus as part of a newly minted partnership. The home health and hospice program will now be called Bon Secours Home Care and Hospice by Compassus... The merger will also impact BSMH locations in Florida, Illinois, Kentucky, Ohio and South Carolina.

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Today's Encouragement: There is no wisdom without ...

08/30/24 at 03:00 AM

There is no wisdom without leisure. ~ W. B. YeatsEditor's Note: Hospice & Palliative Care News Today wishes you a wonderful Labor Day weekend. 

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Share QR code with colleagues to register for our newsletter

08/30/24 at 03:00 AM

Share this QR code with your colleagues to register for our free, national newsletter

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Executive Personnel Changes - 8/30/24

08/30/24 at 03:00 AM

Executive Personnel Changes - 8/30/24 

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Hospice care standards are important. Congress must be careful tinkering with them.

08/30/24 at 03:00 AM

Hospice care standards are important. Congress must be careful tinkering with them. NorthJersey.com, Special to the USA TODAY Network; by Patrick Maron; 8/28/24... As hospice care grows, real attention needs to be paid to the differences between nonprofit and for-profit centers.  [A] staggering  73%  of hospice programs today are for-profit and are driven by financial motives, ... Rep. Earl Blumenauer, D-Oregon, is drafting legislation that, if enacted, would represent the most significant reforms to date for hospice payment and oversight. Though Blumenauer’s bill, the Hospice Care Accountability, Reform, and Enforcement — or Hospice CARE — Act, is still in development, key provisions will likely include a new payment mechanism for high-acuity palliative services, changes to the per-diem payment process and actions to improve quality and combat fraud. The bill would also implement a temporary, national moratorium on the enrollment of new hospices into Medicare, to help stem the tide of fraudulent activities ... However, there are significant challenges for nonprofit freestanding inpatient hospice facilities like Villa Marie Claire in Saddle River. Most important, the proposed five-year moratorium on enrolling new hospice programs into Medicare could limit our ability to expand services, straining resources of the Villa ... What’s more, the legislation mandates more frequent inspections and enhanced oversight, which could lead to operational stress and higher costs. [Click on the title's link to continue reading.]

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