Literature Review

Impact of prognostic notifications on inpatient advance care planning: A cluster randomized trialJournal of Pain and Symptom Management; by Jessica E Ma, Kayla W Kilpatrick, Clemontina A Davenport, Jonathan Walter, Yvonne Acker, Noppon Setji, Maren K Olsen, Mihir Patel, Michael Gao, Matthew Gardner, Jamie Gollon, Mark Sendak, Suresh Balu, David Casarett;12/25A poor prognosis is an important trigger for advance care planning (ACP) conversations, but clinicians often overestimate prognosis... A pragmatic cluster randomized trial... randomized attending physicians on the inpatient medicine team. An email and page notification was sent to physicians randomized to intervention group for admitted patients at high risk of 30-day and 6-month death based on a machine learning model. The notification recommended to have and document an ACP conversation in the electronic health record (EHR)... Patients of physicians randomized to the intervention group were more likely to have a documented ACP conversation by the randomized physician compared to the control group.

[UK] 'It’s like a weight lifted off your shoulders’: A qualitative study of adult carers taking a breakJournal of Family Issues; by Richard Meade, Debbie Cavers, Neneh Rowa-DewarView; 11/25Unpaid carers play a vital role in supporting individuals with life-limiting conditions, yet without adequate support, they risk poor health and burnout. Ten in-depth interviews were conducted with carers who had used temporary institutional respite services in Scotland. Six key themes emerged: ‘Caring is all-consuming’; ‘Caring changes sense of self’; ‘Relief, recovery, repair’; ‘Breaks give carers their lives back (briefly)’; ‘A break doesn’t solve everything’; and ‘Trust in the respite centre is crucial’. Findings indicate that institutional respite care provides overwhelmingly positive experiences for most carers, offering them essential relief and recovery from the demanding nature of caregiving. However, the benefits were often short-lived, with carers expressing a need for longer and more frequent breaks.

Bereavement service deserts: A 2024 statewide assessment of  bereavement services Death Studies, open access; by Christopher W. Giang, Luisa Kcomt, Joshua Truchan, Kara Dickinson, Rebecca J. Evans-Polce & Sean Esteban McCabe; 12/5/25... This paper introduces the term “bereavement service desert” to describe geographic areas with high mortality and little to no access to bereavement services. Bereavement services deserts are especially concerning where elevated death rates are met with an absence of formal grief supports, trained providers, or community-based resources. As these trends in death have continued to rise over the last decade, the social and economic costs of unresolved grief are becoming more apparent in families, schools, com munities, workplaces, and healthcare systems. ...Editor's Note: Though this research focuses on bereavement agencies across Michigan's 83 counties, its methodologies and outcomes provide data, references, and insights relevant to examining bereavement care in all U.S. states. What are the "bereavement service deserts" in the your state(s)? In the areas you serve?

A legacy of care: How Good Shepherd has served Newton for nearly 50 yearsFig City News, Newton, MA; by Parker Maslowski; 12/15/25 … The story of Good Shepherd began, fittingly, with an act of compassion that crossed an ocean. In the late 1970s, members of the Parish of the Good Shepherd learned about the revolutionary hospice movement emerging in England. … A group of parishioners believed Newton needed something similar. … Newton-Wellesley Hospital donated office space in the Ellison Building. The small program assembled a core team of nurses, a physician, social workers, and volunteers who provided direct patient support, administrative help, and fundraising. And the Hospice of the Good Shepherd opened its doors in the fall of 1979 – the first hospice in Massachusetts. 

The future of the hospice physician: HOPE, staffing & technology Maxwell TEC; podcast by Tom Maxwell with Dr. Andrew Mayo and Dr. Tiffany Richter; 12/15/25... In this episode, Tom sits down with two of the most respected clinical leaders in the country: Dr. Andrew Mayo (Chief Medical Officer, St. Croix Hospice) and Dr. Tiffany Richter (Chief Medical Officer, Agape Care Group). They break down the debate between full-time vs. contracted physicians, the "hybrid" model that is winning, and the heartbreaking regulatory gaps preventing dialysis patients from accessing hospice care. Plus, they share deeply personal stories that remind us why we do this work. 

Illinois is newest state to allow medical assistance in dying after Pritzker signs billCBS News, Chicago; by Sara Tenenbaum and Charlie De Mar; 12/12/25, 11:02 am CST Gov. JB Pritzker signed a new law Friday making Illinois the newest state allowing medically assisted dying in terminally ill residents. Known as "Deb's Lawn," allows eligible terminally ill adults with a prognosis to live six months or less to request a prescription from their doctor that would allow them to die on their own terms. The legislation was narrowly approve by the Illinois Senate in October after the Illinois House passed it in May. People on both sides of the debate over the controversial legislation lobbied the governor up until the last minute. Medical aid in dying, also called assisted suicide or dying with dignity, is already legal in 12 states. Eight more are considering similar legislation. Pritzker's signature makes Illinois the first state in the Midwest to allow medically assisted death.Click here for Governor Pritzker's press release; click here for the text of SB1950.

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!   Also, remember our Job Board to find staff for the new year!

A holiday gives one a chance to look backward and forward, to reset oneself by an inner compass.  ~May Sarton

Software as a medical practitioner—Is it time to license artificial intelligence?JAMA Internal Medicine; by Eric Bressman, Carmel Shachar, Ariel D. Stern, Ateev Mehrotra; 11/25The Healthy Technology Act of 2025, a bill being considered by Congress, would permit artificial intelligence (AI) systems to prescribe medications without human sign-off. While allowing AI to practice independently may still be a stretch, large language models are already being used to support diagnosis and treatment. These applications challenge the current regulatory framework for clinical AI, which has focused on software as a medical device (SaMD). The US Food and Drug Administration (FDA) has cleared more than 1000 AI tools using this framework, mostly for narrow, well-defined tasks. However, generative models can be applied across domains, straining the SaMD framework. In this Viewpoint, we explore the application of a licensure paradigm to clinical AI systems, arguing that this offers a more reliable regulatory framework.

Navigating loss: An in-depth exploration of grief and spiritual resilience in Hispanic and Latino culturesUrban Social Work; by Angelica Olivo; 11/25This was a phenomenological study that highlighted how culture, spirituality, and coping mechanisms influenced Hispanic and Latino community grief.  ... [The study] identified themes on death beliefs, traditional grieving practices, cultural taboos, family roles, and religious faith, providing rich data on cultural and spiritual factors in grief. The themes that emerged from the analysis were related to death beliefs, traditional grieving practices, cultural taboos, family roles, and religious faith. Findings supported a second line of evidence that diverse subgroups and the longitudinal grief experience may better inform understandings of, and improve cultural competency in, bereavement support.

Home Health Aides caring for adults with heart failure-A pilot randomized clinical trialJAMA Network Open; by Madeline R. Sterling, Cisco G. Espinosa, Sasha Vergez, Margaret V. McDonald, Joanna Ringel, Jonathan N. Tobin, Samprit Banerjee, Nicola Dell, Lisa M. Kern, Monika M. Safford; 11/25Objective: To examine the effectiveness of an education- and communication-based intervention among HHAs caring for patients with HF.  In this pilot randomized clinical trial including 102 agency-employed HHAs randomized to training alone or in addition to an application that allowed HHAs to exchange text messages with nurse supervisors, training improved HHAs’ HF knowledge and HF caregiving self-efficacy. The addition of the application did not improve these primary outcomes, but it significantly reduced HHAs’ self-reported preventable 911 calls, a secondary outcome.

[South Korea] Factors influencing burnout among hospice and palliative care ward nursesJournal of Hospice & Palliative Nursing; by Young-Mi Kim, Chieun Song, Jeoungmin Park; 11/25This study aimed to identify the factors influencing burnout among nurses in hospice and palliative care units. This descriptive correlational study investigated the effects of nursing practice environment, resilience, and nurses' character on burnout among hospice and palliative care ward nurses. The participants were 217 nurses working in hospice wards of 20 institutions selected from the 88 inpatient hospice and palliative care institutions designated by the Ministry of Health and Welfare in South Korea, as of 2021. The results showed that a better nursing practice environment and higher resilience were positively associated with lower burnout. Among hospice and palliative care nurses, being in their 30s and having fewer than 5 years of total clinical experience were associated with higher burnout.