Literature Review
Remote access technologies expose home care firms to cybersecurity vulnerabilities, experts say
04/28/24 at 03:15 AMRemote access technologies expose home care firms to cybersecurity vulnerabilities, experts sayMcKnights Home Care; by Adam Healy; 4/18/24 Some of the most commonly used technologies in home care are also among the easiest for criminals to exploit. ... Remote access systems include any technology that allows users to connect to and access a computer, server or network remotely. Within home care, this could be tools such as remote patient monitoring devices, secure messaging apps, telehealth platforms, cloud-based applications or systems that allow users to remotely access patient data, according to the Department of Health and Human Services. And while these technologies bring efficiency, they can also expose providers and their patients to risk.
CMS increases hours to 3.48 in final staffing rule
04/28/24 at 03:10 AMCMS increases hours to 3.48 in final staffing rule McKnights Long-Term Care News; by Kimberly Marselas; 4/22/24 Nursing homes will be required to deliver 3.48 hours of daily direct care per patient under a final staffing mandate issued this morning. A White House statement on the rule [4/22] said that 3.0 hours must be split between registered nurses at 0.55 hours and 2.45 hours for certified nurse aides. The remaining time was not immediately defined by the White House release, and the full rule text was not available.
Extra: CMS publishes rule outlining final staffing requirements
04/28/24 at 03:05 AMExtra: CMS publishes rule outlining final staffing requirements McKnights Long-Term Care News; by Kimberly Marselas; 4/22/24 The Centers for Medicare & Medicaid Services said it would exempt nursing homes from having registered nurse coverage for up to 8 out of 24 hours a day “under certain circumstances,” unveiling a critical new detail in the second part of today’s staffing rule rollout. A director of nursing also can count toward the rule’s 24/7 RN requirement, CMS said, noting a change that providers will likely appreciate given their persistent challenges hiring RNs across the country. “The RN onsite 24 hours a day, seven days a week requirement ensures that there is an RN available to help mitigate, and ultimately reduce, the likelihood of preventable safety events, particularly during evenings, nights, weekends, and holidays,” CMS said. ...
Examining how improper payments cost taxpayers billions and weaken Medicare and Medicaid
04/28/24 at 03:00 AMExamining how improper payments cost taxpayers billions and weaken Medicare and Medicaid HHS-OIG; by Christi A. Grimm, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services; 4/16/24 HHS Inspector General Christi A. Grimm Testifies Before the U.S. House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations on April 16, 2024. IG Grimm briefs members on HHS-OIG's work to address improper payments in Medicare and Medicaid managed care programs. Click here to watch the testimony.
Sunday newsletters
04/28/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
Today's Encouragement
04/28/24 at 03:00 AMPeople who have come to know the joy of God do not deny the darkness, but they choose not to live in it. They claim that the light that shines in the darkness can be trusted more than the darkness itself and that a little bit of light can dispel a lot of darkness. They point each other to flashes of light here and there, and remind each other that they reveal the hidden but real presence of God. ~Henri Nouwen, The Return of the Prodigal Son.
Time to rethink assisted dying?
04/27/24 at 03:00 AMTime to rethink assisted dying?Bioethics; by Udo Schuklenk; 5/24... But who should be tasked with the provision of such services [assisted suicide and / or voluntary euthanasia], given that it would no longer be the case that only people defined as patients would be eligible for an assisted death. Healthcare professionals might object to providing such services to people who aren't patients. Different societies could decide to introduce permissive assisted dying regimes tasking different professionals with the provision of such services. If doctors are the profession tasked with the provision of such services in a particular jurisdiction, they ought to provide it to those eligible in that society. However, it is worth considering whether a newly created assisted dying profession, that is equally tightly regulated, may be a preferable way forward.
Making end-of-life health disparities in the U.S. visible through family bereavement narratives
04/27/24 at 03:00 AMMaking end-of-life health disparities in the U.S. visible through family bereavement narrativesPEC Innovation; by Cassidy Taladay-Carter; 4/24End-of-life experiences can have important implications for the meaning-making and communication of bereaved family members, particularly due to (in)access to formal healthcare services (i.e., palliative care and hospice). Grounded in Communicated Narrative Sense-Making theory, this study extends knowledge about how the stories told about end-of-life by bereaved family members affect and reflect their sense-making, well-being and importantly, potential disparities in end-of-life care. ... Four themes illustrated the continuum of communication that families engaged in when making sense of end-of-life experiences, including reflections on silence, tempered frustrations, comfort with care, and support from beyond.
Textures of Black sound and affect: Life and death in New Orleans
04/27/24 at 03:00 AMTextures of Black sound and affect: Life and death in New OrleansAmerican Anthropologist; by Matt Sakakeeny; 6/24In a traditional New Orleans jazz funeral, the characteristic shift from mourning to joy is propelled by brass band musicians weaving melodies and rhythms together. This article is about how these thickly layered textures of sound elicit shared sentiments of lament and of joy.
Keeping life in our patients’ years toward the end of our patients’ lives
04/27/24 at 03:00 AMKeeping life in our patients’ years toward the end of our patients’ livesAnnals of Surgery; by Courtney Collins, Ronnie A Rosenthal; 5/24As surgeons we are trained, some may say indoctrinated, to care about traditional benchmarks like wound infections, the need for critical care, 30-day readmissions, and (of course) mortality. These factors are obsessively collected and analyzed looking for any and all possible opportunities to move the needle of surgical quality by even the tiniest amount (as long as it is statistically significant). To be sure, this approach has yielded vast improvements in how we care for our patients and correspondingly, surgical outcomes have continued to improve over time. This intriguing analysis by Keney et al asks us to consider that in our pursuit of perfection by standard definitions, we may be missing something even more critical: what “good” looks like from the patient’s point of view.
Environmental comfort in promoting sleep in critically ill patients: A scoping review
04/27/24 at 03:00 AMEnvironmental comfort in promoting sleep in critically ill patients: A scoping review[Portugal] Dimensions of Critical Care Nursing; by Derek Braga Moura, Débora de Fátima Sousa Andrade, Carla Rodrigues Silva, Igor Emanuel Soares-Pinto; 5/24It is important to understand the concept of comfort as a whole to build an assistance intervention plan that meets the person's needs. Therefore, it is necessary to monitor and assess the person's sleep by considering the surrounding environment, to provide a comfortable environment that is quiet and provides privacy, especially in contexts of difficult management of environmental factors in the approach to the person in critical condition.Publisher's note:
Saturday newsletters
04/27/24 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
Eleology‐ A modest proposal
04/27/24 at 03:00 AMEleology‐ A modest proposalAmerican Journal of Hospice and Palliative Medicine; by Caleb Knisley, MD, Steven J. Baumrucker, MD; 6/24Words matter. This is a simple but profound truth. ... Since the titles we are known by carry so much weight, misunderstanding and misnomers can be incredibly frustrating. Practitioners of Hospice and Palliative Medicine (HPM) (more on that mouthful in a moment) are uniquely aware of this frustration. ... The name “Hospice and Palliative Medicine” is therefore not an entirely accurate representation of the specialty it represents. ... Eleos is the word for “mercy” in both classical Greek authors and the writings that make up the Greek New Testament of the Christian Bible. ... Eleology, therefore, is a fitting name for the medical specialty uniquely dedicated to relieving suffering through mercy and compassion.
Hospice satisfaction among patients, family, and caregivers: A systematic review of the literature
04/27/24 at 03:00 AMHospice satisfaction among patients, family, and caregivers: A systematic review of the literatureAmerican Journal of Hospice and Palliative Medicine; Timothy Hoff, PhD, Kathryn Trovato, MPH, Aliya Kitsakos, BA; 6/24Thirty-eight studies were included in the review. Key findings were: (a) higher levels of hospice care satisfaction among patients, families, and other caregivers; and (b) correlates of hospice care satisfaction falling into the categories of communication, comfort, and support. The published literature had fewer findings related to demographic correlates of satisfaction such as age or race/ethnicity and was lacking in comparative research examining satisfaction across different types of hospice care settings.
Today's Encouragement
04/27/24 at 03:00 AMA life spent making mistakes is not only more honorable, but more useful than a life spent doing nothing. ~George Bernard Shaw
End-of-life and palliative care for lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity older adults
04/27/24 at 03:00 AMEnd-of-life and palliative care for lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity older adultsClinics in Geriatric Medicine; by Evie Kalmar MD, MS, Jeffrey Mariano MD; 5/24Lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity (LGBTQ+) people are more likely to have alternative family structures. It is important to engage in advance care planning to understand their values, clarify surrogate decision makers, and contribute to goal-concordant care at the end of life. Clinicians can follow recommendations in this article to ensure they are providing LGBTQ-inclusive palliative and hospice care.
"It's a heavy thing to carry": Internal medicine and pediatric resident experiences caring for dying patients
04/27/24 at 03:00 AM"It's a heavy thing to carry": Internal medicine and pediatric resident experiences caring for dying patientsAmerican Journal of Hospice and Palliative Medicine; by Lindsay M Gibbon, Laura Buck, Lauren Schmidt, Jori F Bogetz, Amy Trowbridge; 5/24Our data suggests a model for the process by which residents learn affective skills critical to EOL care: residents (1) notice strong emotion, (2) reflect on the meaning of the emotion, and (3) crystallize this reflection into a new perspective or skill. Educators can use this model to develop educational methods that emphasize normalization of physician emotions and space for processing and professional identity formation.
Measuring decision aid effectiveness for end-of-life care: A systematic review
04/27/24 at 02:00 AMMeasuring decision aid effectiveness for end-of-life care: A systematic reviewPEC Innovation; M. Courtney Hughes, Erin Vernon, Chinenye Egwuonwu, Oluwatoyosi Afolabi; 4/24A total of 715 articles were initially identified, with 43 meeting the inclusion criteria. Outcome measures identified included decisional conflict, less aggressive care desired, knowledge improvements, communication improvements, tool satisfaction, patient anxiety and well-being, and less aggressive care action completed. The majority of studies reported positive outcomes especially when the decision aid development included International Patient Decision Aid Standards.
Quality in Motion: Acting on the CMS National Quality Strategy
04/26/24 at 03:30 AMQuality in Motion: Acting on the CMS National Quality Strategy CMS - Centers for Medicare & Medicaid Services; 4/22/24In 2022, the Centers for Medicare & Medicaid Services (CMS) launched the CMS National Quality Strategy (NQS), a plan aimed at improving the quality and safety of health care for everyone, with a special focus on people from underserved and under-resourced communities. ... The CMS National Quality Strategy has four priority areas, each with two goals. This action plan provides details on how CMS is putting these eight goals into action.
45 top healthcare workplaces for mental well-being: Newsweek
04/26/24 at 03:15 AM45 top healthcare workplaces for mental well-being: Newsweek Becker's Hospital Review, by Alexis Kayer, 4/22/24Newsweek has named 45 hospitals and health systems among its 750 greatest employers for mental well-being. The publication partnered with data researchers Plant-A to rank the top U.S. workplaces "making a positive difference in the mental wellness of their workers," according to a five-stage evaluation. ... Here are the 45 hospitals and health systems included on the list, excluding organizations that exclusively provide long-term, hospice, rehabilitative and medical care, or staffing and management services: [Click on the title's link for the list.]Editor's Note: Is your organization on the list? Or perhaps a colleague's organization? Forward this to them with your congratulations! Invite them to join our newsletter for free at www.HospicePalliativeCareToday.com/registration.
PE-Backed Legacy Hospice acquires HomeCare Hospice
04/26/24 at 03:00 AMPE-Backed Legacy Hospice acquires HomeCare HospiceLevin Associates; by Avery Swett; 4/19/24 Legacy Hospice, backed by the Chicago-based private equity firm Prairie Capital, announced this week its acquisition of HomeCare Hospice ... HomeCare Hospice is a leading provider of hospice and palliative care services throughout the state of Mississippi. The company operates four locations across the state.
Executive Personnel Changes - 4/26/24
04/26/24 at 03:00 AMExecutive Personnel Changes - 4/26/24
PeaceHealth's home nurses authorize a potential second strike
04/26/24 at 03:00 AMPeaceHealth's home nurses authorize a potential second strike The Lund Report, by Nathan Wilk; 4/23/24Homecare and hospice nurses at PeaceHealth Sacred Heart in Springfield [OR] have authorized a second strike that could last indefinitely. The nurses are seeking a contract with same wage increases as their in-hospital counterparts. They previously went on strike for two weeks in February. ...During the previous strike, nurses accused PeaceHealth of providing poor replacement care to patients. If this strike goes through, Waltasti said it would continue to provide uninterrupted services, but he also pointed to other options for patients.
Missoula's first end-of-life center taking shape amid fundraising
04/26/24 at 03:00 AMMissoula's first end-of-life center taking shape amid fundraising MissoulaCurrent., by Martin Kidston; 4/24/24 ... Missoula's first dedicated hospice center broke ground last June and is well on its way to opening early next year. The 15,000 square-foot facility has been planned down to the finest detail, from the play of lighting and sound in each room to a reflection center, with end-of-life literature and bereavement support for families. “Missoula has one of the fastest aging and oldest populations in the country. Not only that, we have a vast expanse of area to cover,” said Amanda Melro [Executive Director, Partners of Hope Foundation] . “People live in rural areas and they also live alone. Having a place like this where a family knows they'll be well-taken care of is a huge asset for them. We expect there will be a large demand for the beds.”
Cardinal Health, OptumRx break up
04/26/24 at 03:00 AMCardinal Health, OptumRx break up Becker's Hospital Review, by Paige Twenter; 4/22/24Cardinal Health's pharmaceutical distribution contracts with OptumRx, a subsidiary of UnitedHealth Group, will not be renewed, the medical distributor said April 22. The contracts, which mainly included non-specialty bulk shipments to Optum's mail dispensing sites, will expire in late June. In 2023, sales to OptumRx generated 16% of Cardinal Health's consolidated revenue. "Total sales to OptumRx generate a meaningfully lower operating margin than the overall pharmaceutical and specialty solutions segment," Cardinal said. McKesson Corp. won the contract, according to Bloomberg, which cited Evercore ISI.