Literature Review

He who is not everyday conquering some fear has not learned the secret of life. ~Ralph Waldo Emerson

AI can’t worry about patients, and a clinical ethicist says that mattersJAMA; Yulin Hswen, ScD, MPH; Jennifer Abbasi; 11/24This conversation is part of a series of interviews in which JAMA Network editors and expert guests explore issues surrounding the rapidly evolving intersection of artificial intelligence (AI) and medicine. Today, Hull is an associate professor and serves as associate director of the biomedical ethics program at Yale, where her clinical practice focuses on echocardiography and cardiac care of patients with cancer. She spoke about ethical boundaries for using AI in the clinic in a recent conversation with Yulin Hswen, ScD, MPH, an associate editor at JAMA and the newly launched JAMA+ AI and an assistant professor of epidemiology and biostatistics at the University of California, San Francisco. Medicine is, they remind the reader, “as much art as science, as much a moral endeavor as a technical one.”

Resuscitation attempt and outcomes in patients with asystole out-of-hospital cardiac arrestJAMA Network Open; Junki Ishii, Mitsuaki Nishikimi, Kazuya Kikutani, Shingo Ohki, Kohei Ota, Tatsuhiko Anzai, Kunihiko Takahashi, Masashi Okubo, Shinichiro Ohshimo, Taku Iwami, Nobuaki Shime; 11/24This cohort study analyzed data from a nationwide prospective OHCA [out-of-hospital cardiac arrest] registry in Japan ... presenting with asystole, ... the proportion with a favorable neurological outcome at 30 days was substantially low, and no prehospital ALS [advanced life support] procedure was associated with a favorable neurological outcome. These findings suggest that discussions regarding implementation of a termination of resuscitation rule for such patients are warranted.

Donor time to death and kidney transplant outcomes in the setting of a 3-hour minimum wait policyJAMA Network Open; Samuel J. Tingle, MBBS; Nicholas D. H. Chung, MBBS; Abdullah K. Malik, MBBS; Georgios Kourounis, MBBS; Emily Thompson, PhD; Emily K. Glover, MBBS; Jennifer Mehew, PhD; Jennifer Philip, MD; Dale Gardiner, MBBS; Gavin J. Pettigrew, PhD; Chris Callaghan, PhD; Neil S. Sheerin, PhD; Colin H. Wilson, PhD; 11/24Due to concerns regarding organ viability, most organ donation organizations internationally wait no longer than 1 to 2 hours for potential donation after circulatory death (DCD), possibly underutilizing an important organ source; UK policy mandates a minimum 3-hour wait time. In this cohort study of 7,183 DCD kidney transplant recipients, donor time to death was not associated with short-term or long-term kidney transplant outcomes. This study suggests that organ donation organizations can safely extend the minimum wait time to 3 hours to significantly increase the number of kidneys available for transplant internationally.

It gives you a really great feeling, knowing that what you are doing is making somebody's day: Provider perspectives on implementing the individualized positive psychosocial interactionPsychological Services; Cassandra Keiser, Molly Noble, Kimberly VanHaitsma, Katherine M Abbott; 11/24The Individualized Positive Psychosocial Interaction (IPPI) is an evidence-based program that supports engaging people living with dementia and their care partners in the nursing home (NH). IPPIs are brief, one-to-one, preference-based activities to improve well-being and decrease behavioral and psychological symptoms of dementia. Champions voiced that the IPPI program was cost-effective, adaptable to their local contexts, and provided training to staff to support residents experiencing distress. Overall, the IPPI program goals are aligned with nursing home organization goals, supporting staff in providing comfort to residents communicating distress, and can be feasibly implemented.

Always Politically Correct: Supporting Seriously Ill Older Populations and Their FamiliesJournal of Social Work in End-of-Life & Palliative Care; M. Courtney Hughes, Erin Vernon; 8/24We have been researching outcomes related to seriously ill individuals for over a decade, critically examining countless research articles from around the world, and extensively interviewing various stakeholders in this space, including hospital leaders, hospice leaders, lobbyists, nurses, social workers, and informal caregivers... In a world with so many dividing issues, increasing support for these vulnerable groups needing more attention should stand above the fray and become something that all leaders of any political party should support.Publisher's note: Thank you Courtney and Erin, well said.

Guidelines for the prevention, diagnosis, and management of urinary tract infections in pediatrics and adults-A WikiGuidelines group consensus statementJAMA Network Open; Zachary Nelson, PharmD, MPH; Abdullah Tarık Aslan, MD; Nathan P. Beahm, PharmD; Michelle Blyth, MD, MSPH; Matthew Cappiello, MD; Danielle Casaus, PharmD; Fernando Dominguez, MD; Susan Egbert, PharmD; Alexandra Hanretty, PharmD; Tina Khadem, PharmD; Katie Olney, PharmD; Ahmed Abdul-Azim, MD; Gloria Aggrey, MD; Daniel T. Anderson, PharmD; Mariana Barosa, MD, MSc; Michael Bosco, PharmD; Elias B. Chahine, PharmD; Souradeep Chowdhury, MBBS; Alyssa Christensen, PharmD; Daniela de Lima Corvino, MD; Margaret Fitzpatrick, MD, MS; Molly Fleece, MD; Brent Footer, PharmD; Emily Fox, PharmD; Bassam Ghanem, PharmD, MS; Fergus Hamilton, MRCP, PhD; Justin Hayes, MD, MPH; Boris Jegorovic, MD, PhD; Philipp Jent, MD; Rodolfo Norberto Jimenez-Juarez, MD; Annie Joseph, MBBS; Minji Kang, MD; Geena Kludjian, PharmD; Sarah Kurz, MD; Rachael A. Lee, MD, MSPH; Todd C. Lee, MD, MPH; Timothy Li, MBChB; Alberto Enrico Maraolo, MD, MSc; Mira Maximos, PharmD, MSc, ACPR; Emily G. McDonald, MD, MSc; Dhara Mehta, PharmD; Justin William Moore, PharmD, MS; Cynthia T. Nguyen, PharmD; Cihan Papan, MD; Akshatha Ravindra, MD; Brad Spellberg, MD; Robert Taylor, PhD; Alexis Thumann, PharmD; Steven Y. C. Tong, MBBS (Hons), PhD; Michael Veve, PharmD, MPH; James Wilson, DO; Arsheena Yassin, PharmD; Veronica Zafonte, PharmD; Alfredo J. Mena Lora, MD; 11/24Urinary tract infections (UTIs) are among the most common infections globally, notably impacting patient quality of life and posing substantial clinical and economic challenges. In this third WikiGuidelines consensus statement, we provide an evidence-based approach to UTI management developed by a global network of experts for practical use across diverse clinical settings. This guideline fills a critical gap by providing pragmatic, broadly applicable recommendations tailored for generalist care and systems-based practice. Our guidance is rooted in the best available evidence and is designed for clinicians from various backgrounds and health care environments. It emphasizes a patient-centered approach to the diagnosis, prevention and treatment of UTIs and related genitourinary infections.

Saturday newsletters focus on headlines and research - enjoy!

NUMC partners with Hospice of New York to offer hospice servicesLong Island Press; 11/27/24 The Nassau Health Care Corporation, which represents Nassau University Medical Center, and the A. Holly Patterson Extended Care Facility have announced a partnership with Hospice of New York to offer hospice services for the first time for patients, regardless of their ability to pay. ... Megan C. Ryan, NHCC interim president and CEO [said,] “Hospice of New York’s proven expertise ensures that this initiative will provide the highest standard of care to patients and their families, including those from low-income and at-risk populations. Bringing this kind of care to those at their most vulnerable is why NUMC exists and why this partnership is so groundbreaking for both our institution and Hospice. We welcome the Hospice team to the NUMC family.” Ryan announced the appointment of Simon Ulubabov to the recently-created position of executive vice president for Hospital and Palliative Care Services at NUMC. 

TCN Podcast: Industry Trends Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux, with Maria Warren; 11/27/24Join us for an insightful conversation with Maria Warren, Vice President of McBee, part of NetSmart, as she demystifies the challenges of hospice care audits. Maria shares her journey from entry-level consultant to a leader in compliance, highlighting how audits, designed to combat fraud, can unintentionally burden resources and detract from patient care. Her thoughtful perspective sheds light on balancing regulatory demands with compassionate care. We also dive into the transformative role of technology in hospice care with insights from Betsy Hansen. Discover how electronic medical records (EMRs) go beyond digital documentation to improve patient outcomes and streamline operations. Learn about the potential of EMRs to enhance compliance and care quality while tackling the challenges of implementing innovative, user-friendly systems. This segment emphasizes the importance of creativity and high standards in overcoming staffing hurdles and fostering a supportive care environment.

Hospice Oversight: 2024’s most impactful regulatory action Hospice News; by Jim Parker; 11/27/24 The past year has seen a slew of regulatory developments aimed at improving quality and combatting fraud in the hospice industry. The drive by regulators and members of Congress to strengthen oversight is fueled by two main factors. The first was two July 2019 reports on hospice quality from the Office of the Inspector General (OIG) in the U.S. Department of Health and Human Services (HHS). These spurred passage of the Helping Our Senior Population in Comfort Environments (HOSPICE) Act, which mandated the establishment of a hospice Special Focus Program (SFP), among other actions. The second driving force was the emergence of fraudulent actors in the space in relatively large numbers, particularly concentrated in California, Nevada, Arizona and Texas. [Click on the title's link to continue reading this important information.]

Liberty Hospice provides Thanksgiving for 7 families Lake Gaston Gazette-Observer, Gaston, NC; by Mark Mathews; 11/27/24 Liberty Hospice volunteers recently traveled to the Pleasant Hill Christian Church kitchen in Gasburg to prepare Thanksgiving meals for seven families. “The families were selected as those who would benefit the most by our wonderful Liberty Hospice Health Care team,” Liberty Hospice Regional Volunteer Coordinator Esther Harris said. “As it turned out, two of the families preferred to have us bring all the fixings to them and they were going to the cooking themselves for Thanksgiving.” ...  Harris approached DrugCo Discount Pharmacy Chief Financial Officer Neal White about helping her group with the Thanksgiving meals. She received a better-than-expected response. “I was looking for help to buy some turkey and maybe some ham,” Harris said. “Mr. White asked me how much I thought it would cost to do the entire meal for each of the seven families. I gave him a number and they donated the entire amount. So we thank DrugCo who is just a wonderful community partner.”

Holiday tradition: Hospice of Health First volunteers deliver Thanksgiving meals to patients and families Space Coast Daily, Brevard County, FL; 11/27/24  A Brevard County holiday tradition dating back to 2004 continued this week as Hospice of Health First volunteers gathered to box and deliver Thanksgiving holiday meals to hospice patients and their families. Nearly three dozen Health First volunteers met at the Hospice of Health First office in West Melbourne to sort and load more than 100 Publix Thanksgiving meal boxes for delivery. Juanita Yarber of Melbourne was one of the first recipients of the holiday meal. She said the Thanksgiving meal delivery was special but just one of the many special touches she receives from the Hospice team and Sharon Berrier, a hospice volunteer.