Literature Review
Is caregiver sleep quality an important clinical issue?
03/30/24 at 03:00 AMIs caregiver sleep quality an important clinical issue?Sleep and Biological Rhythms, by Ayfer Durak, Nezahat Muge Catikkas; 3/24Sleep quality is directly related to general health and quality of life. Caregivers' sleep disturbances affect not only their own health, but also the optimal care of their patients, with negative consequences such as neglect and medication errors. This study was conducted prospectively in the palliative care unit. ... The fact that the sleep quality of family group caregivers is worse than that of paid caregivers may prevent healthy medical service delivery.
Consciously choosing unconsciousness
03/30/24 at 03:00 AMConsciously choosing unconsciousnessVoices in Bioethics, by Yuna Lee; 3/24“Because there are no laws barring palliative sedation, the dilemma facing doctors who use it is moral rather than legal.” Dr. Timothy Quill, a professor of psychiatry, bioethics, and palliative care concisely articulates an ethical intricacy in end-of-life care. ... In summary, the ethical considerations surrounding palliative sedation compel clinicians to navigate the nuances of moral responsibility, patient advocacy, and clinical judgment. In the absence of clear legal guidelines, clinicians bear the weight of deciding the appropriateness of palliative sedation, influencing both individual patient experiences and broader palliative care practices.
Physicians, spirituality, and compassionate patient care
03/30/24 at 03:00 AMPhysicians, spirituality, and compassionate patient careNew England Journal of Medicine, by Daniel P Sulmasy; 3/24The past few decades have seen an international revival of interest in the role of spirituality in patient care. ... I believe this trend is salutary for patients and health care professionals alike. Yet the success of a biopsychosocialspiritual approach to 21st-century health care will depend on careful attention to ethical guidelines and boundaries in our increasingly pluralistic world.
Eye donation in palliative and hospice care settings: Patient views and experiences
03/30/24 at 03:00 AMEye donation in palliative and hospice care settings: Patient views and experiencesBMJ Open Ophthalmology, by Tracy Long-Sutehall, Mike Bracher, Banyana Cecile Madi-Segwagwe, Michelle Myall, Adam Hurlow, Professor Christina Faull, Clare Rayment, Jane Wale, Sarah Mollart, Jill Short, Erika Lipscombe, Emma Winstanley; 11/22There is a global shortage of donated eye tissue for use in sight saving and sight restoring operations such as corneal transplantation. ... Patients who die in palliative and hospice care settings could potentially donate eye tissue, however, the option of eye donation is not routinely raised in end-of-life planning discussions. ... It is imperative that patients who would want to be a donor are identified and assessed for eligibility for donation as part of high-quality end of life care.Publisher's note: Organ and tissue donation are interesting topics often overlooked in hospice and palliative care settings. I wrote a brief blog, have presented on, and encourage more discussion of this topic.
Factors associated with hospital admission in the last month: A retrospective single center analysis
03/30/24 at 03:00 AMFactors associated with hospital admission in the last month: A retrospective single center analysisJournal of Pain and Symptom Management, by Jessica E. Ma MD; Maren K. Olsen PhD; Cara L. McDermott PharmD, PhD; C. Barrett Bowling MD; S. Nicole Hastings MD; Tyler White; David Casarett MD, MA; 3/242202 (25.9%) patients had a hospital admission in the last month [of life]. Among the 1282 (15.1%) who died in a health system facility, most (86.0%) were admitted to the hospital in the last month. Among patients with a hospital admission and discharged in the last month, 60.9% were discharged on hospice. Compared to those without these diseases, metastatic cancer, liver disease, or heart failure had the highest odds of admission in the last month. ... As patients with heart or liver disease or metastatic cancer had the highest odds of admission in the last month, collaborative interventions between primary, palliative, and specialty care may improve quality of care at the end of life.
The role and professional standards of the Adult-Gerontology Nurse Practitioner in hospice and palliative care
03/30/24 at 03:00 AMThe role and professional standards of the Adult-Gerontology Nurse Practitioner in hospice and palliative careJournal of Hospice & Palliative Care Nursing, by Coats, Heather PhD, APRN-BC; Henrichs, Kelly DNP, RN, GNP-BC; 3/24The adult/gerontology (gero) nurse practitioner (NP) delivers primary and/or specialty palliative care to persons and their families who live each day with a myriad of serious illnesses. In this role, the adult/gero NP uses their skill set to address the whole person (physical, psychological, social, and spiritual/existential) to improve the quality of life for persons they care for. This article is the fourth in a series of 6 highlighting the different roles of the adult/gero NP and the advanced certified hospice and palliative registered nurse, and how these 2 roles overlap. The purpose of this article was to provide details of education and certification pathways for these NP roles, describe the overlaps in clinical care, and illustrate how the adult/gero NP in palliative and hospice care can contribute to leadership in program development for care of persons and their families who live with serious illness.
Karen Bullock honored for Outstanding Contributions to Diversity in Palliative Medicine
03/30/24 at 03:00 AMKaren Bullock honored for Outstanding Contributions to Diversity in Palliative MedicineWomen in Academia Report; 3/24As an endowed professor at Boston College and scholar at the Dana Farber Cancer Institute, Dr. Bullock’s new award honors her dedication to improving care for underrepresented patient populations in hospice and palliative medicine.
Hospice providers serving assisted living residents: Association of higher volume with lower quality
03/30/24 at 03:00 AMHospice providers serving assisted living residents: Association of higher volume with lower qualityJournal of the American Geriatric Society, by Wenhan Guo, Helena Temkin-Greener, Brian E McGarry; 3/24Hospice providers serving higher volumes of AL patient days had lower quality scores.
Connecticut Appellate Court rules employer could discharge medical marijuana user impaired on the job
03/29/24 at 03:15 AMConnecticut Appellate Court rules employer could discharge medical marijuana user impaired on the job The National Law Review; by John G. Stretton, Nicole S. Mulé, Zachary V. Zagger of Ogletree, Deakins, Nash, Smoak & Stewart, P.C.; 3/27/24 On March 19, 2024, the Connecticut Appellate Court upheld an employer’s right to discharge an employee for being impaired on the job from medical marijuana under a state law that provides employment protections for qualified medical marijuana users.
4 ways to drive transformational change in sustainability
03/29/24 at 03:15 AM4 ways to drive transformational change in sustainabilityAmerican Hospital Association; 3/26/24Like a growing number of health care organizations, New Jersey’s Hackensack Meridian Health (HMH) system has been on a journey for some time now to reduce its environmental impact and boost sustainability practices. Recent achievements include:
5 C-suite roles talent leaders are watching
03/29/24 at 03:15 AM5 C-suite roles talent leaders are watchingBecker's Hospital Review, by Alexis Kayser; 3/21/24Becker's recently connected with HR and talent executives to learn how their health systems are strengthening leadership pipelines. When asked which leadership roles they expect to focus hiring efforts on in the coming years, these C-suite titles emerged.
Disruptions to endure even as Change Healthcare fixes systems
03/29/24 at 03:15 AMDisruptions to endure even as Change Healthcare fixes systems Modern Healthcare, by Lauren Berryman; 3/28/24 Providers and health insurance companies see a long road ahead that stretches past whenever UnitedHealth Group declares Change Healthcare is fixed. Full restoration of claims, billing and other processes won't mark the end of the mess that began with a cyberattack last month, which forced UnitedHealth Group to take Change Healthcare systems offline and plunged the healthcare sector into disarray. Healthcare organizations anticipate operational and financial effects even when Change Healthcare is up and running again.
From doctor to family: Witnessing both sides of end-of-life care
03/29/24 at 03:00 AMFrom doctor to family: Witnessing both sides of end-of-life care MedPage Today's KevinMD.com, by Jessica Bloom, MD; 3/27/24We all have those moments in medicine when we know that care has become more futile. Then we do everything in our power to educate, support, gently guide, and give permission to patients and families. There are moments that treating for a cure goes against our tenet to “first do no harm.” ... Specialists and his regular physicians sat with us, listened to my family’s questions, and offered kindness along with medical advice. They gently helped my siblings let go of futile searching for treatments. ...
UnitedHealth urges Change customers to reconnect to restored systems
03/29/24 at 03:00 AMUnitedHealth urges Change customers to reconnect to restored systems Modern Healthcare, by Lauren Berryman; 3/28/24 UnitedHealth group is calling on more health insurance companies to utilize the Change Healthcare systems it has already restored and bring the healthcare system closer to normalcy. The company, which operates Change Healthcare through its Optum subsidiary, is processing claims through its restored Assurance software and has reactivated its Relay Exchange clearinghouse, for example. But UnitedHealth Group needs more insurers to reconnect, it said in a notice on its website Wednesday.
Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition
03/29/24 at 03:00 AMHospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner
Steward to sell 'highly desired' physician group to Optum
03/29/24 at 03:00 AMSteward to sell 'highly desired' physician group to Optum Becker's Hospital CFO Report, by Alan Condon; 3/27/24 Dallas-based Steward Health Care plans to sell its physician group to UnitedHealth Group's subsidiary Optum, The Boston Globe reported March 26. The proposed sale of Stewardship Health is part of the 33-hospital system's plan to shore up its finances amid ongoing challenges, including falling behind in paying bills and rents. If approved, physicians who work at Steward facilities across nine states would be employed by Optum, the largest employer of physicians in the U.S.
Expanding the use of continuous sedation until death and physician-assisted suicide
03/29/24 at 03:00 AMExpanding the use of continuous sedation until death and physician-assisted suicide The Journal of Medicine & Philosophy: A Forum for Bioethics and Philosophy of Medicine; by Samuel H Lipuma and Joesph P Demarco; 3/27/24 The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD.
Today's Encouragement: The absolute heart of loyalty ...
03/29/24 at 03:00 AMThe absolute heart of loyalty is to value those people who tell you the truth, not just those people who tell you what you want to hear. In fact, you should value them most. Because they have paid you the compliment of leveling with you and assuming you can handle it. - Pat Summitt, Head Coach, University of Tennessee Lady Volunteers (1974-2012)
Home care providers’ creative benefit packages are paying off
03/29/24 at 03:00 AMHome care providers’ creative benefit packages are paying off Home Health Care News, by Joyce Famakinwa; 3/26/24 ... Amid a persistently challenging labor market, home care companies are still constantly working on configuring the best possible employee benefits package for caregivers. Companies like Right at Home San Gabriel Valley, Devoted Guardians and Family Tree Private Care have emerged as standouts when it comes to crafting impressive benefits packages. ...
Antibiotics in end-of-life care
03/29/24 at 03:00 AMAntibiotics in end-of-life care NEJM Journal Watch, by Abigail Zuger, MD; 3/27/24Antibiotics often are considered to be among the gentler and more comfort-oriented interventions in end-of-life care, certainly far less aggressive than intubation or last-ditch surgery. ... Still, antibiotics do entail their own costs in the form of toxicities and need for intravenous access, and liberal antibiotic use reliably worsens institutional and community drug-resistance profiles. ... A new review was written for infectious disease consultants but contains specific suggestions that should interest both generalists and other subspecialists caring for dying patients.
20 states facing acute nursing shortages
03/29/24 at 03:00 AM20 states facing acute nursing shortages Becker's Hospital Review, by Kelly Gooch; 3/25/24 ... On March 1, Medical Solutions, a healthcare staffing company, released the 20 states where nurses are needed the most based on the most current nurse-to-state population ratios and projected need by 2030. Ratios in the report were from Census and Bureau of Labor Statistics data published in NurseJournal. Projected need by 2030 is from Projections Central, a site sponsored by the Labor Department. Here are the 20 states where nurses are needed the most, per the Medical Solutions article: ...
Medicare, Medicaid made $100B in improper payments in 2023
03/29/24 at 03:00 AMMedicare, Medicaid made $100B in improper payments in 2023 Becker's Hospital Review - Legal & Regulatory Issues, by Andrew Cass; 3/27/24 The federal government reported an estimated $235.8 billion in improper payments in fiscal year 2023, with more than $100 billion coming from Medicare and Medicaid, according to a March 26 report from the U.S. Government Accountability Office. The $235.8 billion in improper payments reported by 14 agencies across 71 programs is a decrease from the $247 billion reported in 2022, but the figure remains higher than pre-pandemic levels, according to the report.
Enhancing interoperability in home health and hospice care
03/29/24 at 03:00 AMEnhancing interoperability in home health and hospice careMcKnights Home Care, by Tim Smokoff; 3/26/24In the dynamic realm of home health and hospice care, the seamless flow of information across care settings stands as a crucial element for ensuring quality patient outcomes and efficient workflows. Recent advancements in electronic health record (EHR) solutions within this sector have not only fostered enhanced care-team collaboration, but have also addressed challenges posed by evolving reimbursement models and workforce shortages.
Other Business Headlines of Interest, updated 3/28/24 per nasdaq.com
03/29/24 at 03:00 AMOther Business Headlines of Interest, updated 3/28/24 per nasdaq.com
How healthcare AI is regulated by the FDA, HHS, state laws
03/29/24 at 03:00 AMHow healthcare AI is regulated by the FDA, HHS, state laws Modern Healthcare, by Gabriel Perna; 3/26/24 Widespread oversight of artificial intelligence in healthcare is still a work in progress but that doesn’t mean the technology is completely unregulated. ... There are areas where developers, providers and insurers are regulated in how they use AI. Federal agencies like the Food and Drug Administration and Health and Human Services Department have some oversight authority. Also, a few states have enacted laws governing use of AI within clinical care.