Literature Review

Palliative and hospice care in hospitals and clinics: the good, the bad, and the ugly MedPageToday's KevinMD.com; by Earl Stewart, Jr., MD and Miguel Villagra, MD; 4/1/24 I walk into the patient’s hospital room during evening rounds. He looks pale and tired, having recently completed a round of chemotherapy for his stage IV pancreatic cancer. His wife is at the bedside, scared and concerned about her husband’s rapid decline. I sit down to discuss goals of care when the patient immediately says, “I can’t do this anymore.” His wife responds immediately to the patient: “Of course you can.” ...

“Personhood,” not “Patienthood”:  Tips on dignity-conserving practice in palliative careIAHPC, by Kim Adzich, MD; 4/1/24 One of Dame Cicely Saunders’ foundational tenets of palliative care is embodied in her words, “You matter because you are you, and you matter until the last moment of your life.” Dignity is the inherent worthiness of being human, of mattering until that last breath. But how do we ensure that we reflect that inherent dignity back to those in our care? Dr. Harvey Max Chochinov, having dedicated decades to researching and teaching dignity-conserving care, ... [offers] a few thoughts on how we can foster that sense of dignity and uniqueness in those we care for as they near the end of life. 

Good Sam Center of Caring opens half of new home this week WFIR News Talk Radio and WDBJ 7 TV, Roanoke, VA; by Gene Marrano (text) and Aaron Housch (tv); 4/1/24Perhaps today or sometime in the next few days half of the new Good Sam Hospice Center for Caring on Cove Road northwest will be open for business; a wing dedicated to office staff and volunteers. An update from WFIR’s Gene Marrano: [audio]. See video tour of Center for caring here.

Cancer patients often want ‘one more round.’ Should doctors say no? The Washington Post, by Mikkael A. Sekeres, MD; 3/31/24 My patient was in his early 30s and his leukemia had returned again following yet another round of treatment. He was a poster child for the recently reported rise in cancer rates in the young, and had just asked me what chemotherapy cocktail I could devise for him next, to try to rid him of his cancer. I hesitated before answering. Oncologists are notorious for always being willing to recommend to our patients one more course of treatment, even when the chances of success are negligible.  

Interruptions: Bad for hospitalists and their patientsThe Hospitalist, by Larry Beresford; 4/1/24More than 10 years ago this magazine published an article by Winthrop Whitcomb, MD, MHM, a pioneer of hospital medicine and co-founder of the Society of Hospital Medicine, warning of the hazards of workflow interruptions for hospitalists, which he labeled a career satisfaction issue for clinicians but a safety and quality risk for their patients. A decade later, the problem has surely gotten worse as hospital financial pressures and staff shortfalls push caseloads higher and job stresses drive burnout and premature retirement for doctors who have been pulled in too many directions in their work. 

By failing to prepare, you're preparing to fail. - Benjamin Franklin

Retirement runway lengthens for some CEOsBecker's Hospital Review, by Alexis Kayser; 3/28/24Amid an uptick in abrupt CEO exits, some hospital leaders are drawing out their departures. ... [A] number of CEOs giving retirement notices well in advance. The reasons might seem obvious: Sudden exits, especially from a tenured leader, can disrupt entire systems. A longer transition period gives boards time to identify the right successor and even allows for some overlap in which the outgoing and incoming CEOs can exchange ideas. 

UT Tyler School of Medicine receives $400k gift from anonymous donor [for hospice and palliative medicine fellowship] The Gilmer Mirror; 4/1/24The University of Texas at Tyler School of Medicine received a  $400,000 gift from an anonymous donor to support the hospice and palliative medicine  fellowship. The purpose of the gift is to retain physicians in the East Texas region. 

UCI Health completes acquisition of 4 Tenet hospitals Becker's Hospital Review, by Naomi Diaz; 3/27/24 Orange, CA-based UCI Health has completed its acquisition of Tenet Healthcare's Pacific Coast Network, which includes four hospitals in Southern California and their associated outpatient locations. As part of the agreement, Dallas-based Tenet's medical centers — Fountain Valley Regional Hospital, Lakewood Regional Medical Center, Los Alamitos Medical Center and Placentia-Linda Hospital — will now be part of UCI Health, according to a March 26 news release from UCI Health. The hospitals were sold for $975 million.

North Carolina restaurant fulfills woman’s dying wishABC News WGNO, by Raven Payne; 4/1/24It’s an act of kindness that cleared away a cloud of grief, crossing state lines. A North Carolina restaurant owner drove six hours to deliver what ended up being the last meal for a woman on her death bed. ... On her deathbed, Bowers had one last wish, a pork plate from Outer Banks restaurant Mama Kwans. But Simmons wondered how they could make it happen. After all, they lived six hours away in West Virginia.

Code status discussions; difficult but necessary The Hospitalist, by Mark Menet, MD, MPH; 4/1/24 I thought it was just where I practiced, but it turns out that, in the medical field, we’re really bad about having code discussions, which is a significant issue. When some of my patients revealed that no one had ever asked them about their code status before, I decided to conduct some research on this topic. It turns out that, at most, 41% of patients recall discussions about their code status, however, the 10.3% as documented by another study seems much more accurate.

Integrating palliative care screening in the intensive care unit: A quality improvement projectCritical Care Nurse; by Traci N. Phillips, DNP, APRN, ACNP-BC, CCRN; Denise K. Gormley, PhD, RN; Sherry Donaworth, DNP, APRN, ACNP-BC, FNP-BC; 4/1/24Background: Patients admitted to the intensive care unit have complex medical problems and increased rates of mortality and recurrent hospitalization for the following 10 years ...  Delayed access to palliative care can result in untreated symptoms, lack of understanding of care preferences, and preventable admissions. Conclusion: The screening process can maximize the benefit of palliative care services with early patient identification, improved consultation efficiency, decreased critical care resource use, and reduced readmission rates.

Pediatric Division - National Coalition for Hospice and Palliative Care National Coalition for Hospice and Palliative Care; 3/28/24The National Coalition for Hospice and Palliative Care’s Pediatric Division represents a multi-disciplinary, volunteer team of pediatric palliative care (PPC) leaders. The Division membership is comprised of representatives from all 14 members of the Coalition, three family advocates, as well as representatives from aligned stakeholder organizations including the American Academy of Pediatrics, American Psychological Association, Association for Child Life Professionals, and the State Coalition Network.