Literature Review

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.

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. 

[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.

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.

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).

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.

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.

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.

Saturday newsletters focus on headlines and research - enjoy!

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.

Executive Personnel Changes - 8/30/24 

Grief Memoir: ‘It was my turn to do everything for her We Are The Mighty; by Jessica Hall; 8/28/24 ... I joined the phone call with the doctor where he told us all the worst news. The cancer was growing everywhere along the spine. ... He told us that it was time for hospice. ... Even though I had been preparing for this for months, I was truly not ready to go from child to caretaker. ... For my entire life, my mom had cared for me. She had been there when I was sick or hurt. She cleaned my house (sometimes to my chagrin). She cooked my favorite meals and she let me take breaks. Now it was my turn to do everything for her. It hit me like a ton of bricks, but I also just knew that I had to do it. We all had to do everything for her to make her final days easy for her. Hospice came by to get everything set up. ... [Click on the title's link to continue reading this beautiful, personal story.]Editor's Note: Calling all hospice executive leaders who do not have clinical, direct patient care experience--read this article to grasp common family dynamics, decisions, actions, emotions, and life-changing moments for each patient you serve. Multiply this out for the many family members of each patient you serve. How do your hospice services tune into and support these family members?

Awards and Recognitions: August 2024 We congratulate these honorees and celebrate their contributions to our collective hospice and palliative care mission, vision, and compassionate care throughout our world. Do you know any of these leaders? We encourage you to forward this to them or to find another way to celebrate their success. (We are piloting this as a monthly feature in Hospice & Palliative Care Today.)