Literature Review

Why nurses are protesting AIHealthcare Brew; by Tom McKay; 6/26/24Continuous data collection and analysis is hardly a replacement for knowledge, nursing unions say, and sometimes gets in the way of care. The largest nursing union in the US, National Nurses United (NNU), is sounding the alarm about the use of AI in healthcare. In April, the union’s affiliate California Nurses Association (CNA) protested an AI conference helmed by managed care consortium Kaiser Permanente. Like workers in other sectors who are worried about AI encroachment, the nurses fear that the tech is contributing to the devaluation of their skills amid what they say is already a “chronic” understaffing crisis, nurses reported in an NNU survey of 2,300 registered nurses and members in early 2024. But the NNU, which represents approximately 225,000 nurses across the country, also claims healthcare operators are using AI hype as a pretext to rush half-baked and potentially harmful technologies into service, says Michelle Mahon, NNU’s assistant director of nursing practice.

A little help from your friends... Jennifer Hale, MSN, RN, CHPN, CPHQA little help from your friends is a memorial fund set up for Jennifer Hale's family. If interested, you can read more about it and donate here. Donations accepted 6/30/24 - 7/15/24. ... We recently announced Jennifer Hale unexpectedly died Friday, 6/21/24. Vice President of Quality and Standards at Compassus, former Vice President Clinical Services at Optum Palliative Care and Hospice, and former Executive Director of the Georgia Hospice & Palliative Care Organization, Jennifer was widely known, respected, and loved in the hospice community. We share our condolences with her family, friends, and colleagues. Her obituary is posted here.

Families, volunteers share stories of finding peace through hospice Salina Post; by Cristina Janney, Hays Post; 6/29/24 This is a two-part series on hospice care in northwest Kansas. Dalene Juenemann and her father, Dean, had to make the difficult decision to enter hospice care after he was diagnosed with bladder cancer. “He was just such a social guy and someone was in a couple times a week,” she said. “They were checking in on him and it was that security blanket he had.” ... He didn’t want to go through aggressive chemo and he didn’t qualify for a bladder removal because of his age. “He chose quality of life,” she said. "It was that final decision that we are done with everyone wanting a piece of me. I'm just going to enjoy life," she said. Dalene's father, Dean Shearer, was a patient of NWKareS, Hospice of Northwest Kansas, which serves 16 counties from Interstate 70 to the Nebraska border and Trego County to the Colorado border. ... She said the extra care hospice offered allowed her to just be a daughter to her father as he was dying. [Click on the title's link to continue reading stories from families and volunteers at NWKAreS.]

NPHI Statement: Hospital notifications to patients of hospice referral optionsNPHI press release; 6/17/24Many hospitals are providing discharged patients with a list of all Medicare-certified hospices in the geographic area in which the patient resides, in the mistaken belief that this is a requirement under the Medicare Conditions of Participation (COPs). Hospitals may be understandably confused by existing hospital CoPs that require such lists to be provided for HH, SNF, IRF and LTCHs. Section 482.43(c)(2) clearly states these provider types and excludes hospices. There is no such requirement in the hospice regulations or law that requires a hospital to provide patients with a list of all hospices in a particular geographic area. [See statement for additional information.]

NAHC re-files lawsuit against HHS, CMS over home health cuts Home Health Care News; by Joyce Famakinwa; 6/28/24 The National Association for Home Care & Hospice (NAHC) hasn’t given up on efforts to push back on Medicare home health payment calculations. NAHC has re-filled its lawsuit against the U.S. Department of Health and Human Services (HHS). The lawsuit focuses on the home health PDGM budget neutrality adjustment, which imposed both permanent and temporary calculations with a methodology that NAHC believes is noncompliant with the law. The original lawsuit was filed last summer, and in April the case was dismissed by a federal court in Washington D.C. The case was dismissed on the basis that NAHC did not fully exhaust administrative appeal remedies. ... There are a number of factors that made NAHC decide to re-file the lawsuit, according to [NAHC President, William A.] Dombi. “No. 1, it will be faster,” he said. “No. 2, we are highly likely to get the same judge, as there’s a related litigation standard in an assignment of cases,” he said. One of the biggest factors that heavily contributed to NAHC’s decision was the Supreme Court ruling, which upended the Chevron Doctrine.

NAHC-NHPCO Alliance Transition Board met for 1st time last weekNAHC press release; 7/1/24Today, July 1, 2024, is the first day of the NAHC-NHPCO Alliance. While the two organizations will continue to operate separately in some areas until the end of the year, they are now governed by a single body, the Transition Board, which held its inaugural meeting last week. “This is an important step in the process of transitioning from our fiduciary duties as governing bodies of NAHC and NHPCO respectively, to a singular focus on our duties of care, obedience and loyalty to what is now the merged entity,” said Alliance Transition Board Chair Ken Albert. “From July 1 on, we are NAHC-NHPCO Alliance (soon to be named)..." Until the Alliance hires a new CEO, Bill Dombi and Ben Marcantonio will be acting as co-CEOs of the organization, and will be closely consulting with each other on all important matters. Below is a full list of attendees at the Transition Board meeting.

Amedisys to divest certain home health locations to VitalCaring, clearing path for UnitedHealth Group deal Home Health Care News; by Andrew Donlan; 6/28/24 Amedisys Inc. filed paperwork Friday with the U.S. Securities and Exchange Commission saying it has agreed to divest “certain” locations to an affiliate of home health and hospice company VitalCaring. The divestiture was a way for Amedisys to avoid further antitrust concerns from regulators prior to it joining UnitedHealth Group. UnitedHealth Group’s Optum agreed to purchase Amedisys last June for a purchase price of $3.3 billion. Optum already owns LHC Group, another one of the largest home health companies in the country.

In a 1st at ChristianaCare, physicians vote to unionize Becker's Hospital Review; by Kelly Gooch; 7/1/24 Physicians at ChristianaCare locations in Delaware and Maryland voted to join the Doctors Council, an affiliate of the Service Employees International Union. ... The decision marks the first attending physician union in Delaware, the first union at ChristianaCare, and the largest union of private sector physicians in the U.S., according to the Doctors Council. Union representatives said the physicians' decision is a response to ongoing concerns about corporatization and their professional autonomy.

Factors affecting palliative care collaboration with pain medicine specialists Clinical Pain Advisor; by James Maitlall, MD; 6/27/24 Structured collaboration between physicians working in palliative care (PC) and pain medicine (PM) may increase PC physician referral of seriously ill patients to PM specialists and potentially optimize their care, according to study results published in the Journal of Pain and Symptom Management. ... In a survey study, a multicenter team of investigators explored attitudes and beliefs among US PC physicians regarding PM specialists, as well as factors potentially impacting collaboration between physicians in these 2 areas of practice. ... The American Academy of Hospice and Palliative Medicine (AAHPM) approved the survey for distribution to 1000 of its physician members, who were selected at random. ... The investigators concluded, “Although we found that PC physicians have highly positive attitudes about the value of PM specialists, referral rates remain low, even for IDDS implantation, which has perhaps the largest body of evidence for patients with complex cancer-associated pain.”  

[American Heart Association] Palliative care beneficial to manage symptoms, improve quality of life for people with CVD [cardiovascular disease] American Heart Association; by NewMediaWire; 7/1/24 Implementing patient-centered palliative care therapies, including prescribing, adjusting or discontinuing medications as needed, may help control symptoms and improve quality of life for people with heart disease, according to “Palliative Pharmacotherapy for Cardiovascular Disease,” a new scientific statement from the American Heart Association, published today in the Association’s journal, Circulation: Cardiovascular Quality and Outcomes. The new scientific statement reviews current evidence on the benefits and risks of cardiovascular and essential palliative medications. The statement provides guidance for health care professionals to incorporate palliative methods as part of holistic medication management at all stages of a patient’s health conditions, emphasizing the importance of shared decision-making and goal-oriented care.

[Four-day workweeks:] A flexibility trend gaining steam in nursing Becker's Clinical Leadership; by Erica Carbajal; 6/26/24 A growing number of health systems are embracing  four-day workweeks for nurse leaders — a strategy that has helped some boost recruitment, retention and staff engagement. Over the past year, the needs and well-being of nurse managers have come into focus, with hospitals and health systems taking a closer look at how to best support them in addition to bedside nurses. Survey findings have indicated nurse managers have a hard time fully disconnecting from work, and they crave much of the same work environment factors that front-line nurses do, such as the ability to take time off when needed and work-life balance support. As such, four-day schedules have increasingly become part of the conversation at many hospitals and health systems. 

Evaluating palliative care impact: Insights from Tennessee Oncology's OCM participation The American Journal of Managed Care (AJMC); by Mary Caffrey and Pearl Steinzor; 6/27/24 A study finds limited changes in hospice utilization, highlighting challenges in real-world implementation. In an interview at the 2024 American Society of Clinical Oncology annual meeting, Ravi Parikh, MD, MPP, assistant professor of medicine and health policy, Perelman School of Medicine, University of Pennsylvania, discussed the outcomes of a palliative care study at Tennessee Oncology, providing insights into the challenges and limitations of evaluating hospice utilization and quality-of-life improvements in the real-world setting.