Literature Review

Hospice of the Piedmont CEO: Doubling down on community-based support Hospice News; by Holly Vossel; 7/16/25 Virginia-based Hospice of the Piedmont is sharpening its focus on home-based care services and unfurling several initiatives in this realm. The future of end-of-life care delivery has increasingly shifted into the home, according to Nancy Littlefield, president and CEO at Hospice of the Piedmont. While demand for facility-based hospice care is also rising, sustaining these services has become increasingly difficult, she indicated. Several hospices have shuttered their facility-based programs in recent years, with many citing financial headwinds as a leading reason fueling inpatient center closures. Financial strains were among the challenges that led to the difficult decision to close Hospice of the Piedmont’s Center for Acute Hospice Care, Littlefield said. ... Hospice News recently sat down with Littlefield to learn more about how hospices are sustaining and growing their services in today’s economic and financial climate.

Online reputation management crucial for hospices, home-based care providers Hospice News; by Joyce Famakinwa; 7/18/25 Hospice and home-based care providers cannot put online reputation management on the back burner. That’s a key takeaway from a recent report from Transcend Strategy Group. While all businesses should be concerned about maintaining a good online reputation, this is especially important for home-based hospice care providers due to their unique care delivery setting, according to Tony Kudner, chief strategy officer at Transcend. A hospice provider’s digital presence can give patients and their families greater insight when it comes to the quality and depth of their services, Kudner said. “When you are dealing with the intimacy of someone coming into your home, the personalization and how you feel about the agency that you open the door for matters more,” Kudner told Hospice News.

A great attitude becomes a great mood, which becomes a great day, which becomes a great year, which becomes a great life. ~Zig Ziglar

Regional anesthesia for hip fracture surgery in older adults: A retrospective comparison of outcomes using ACS NSQIP dataGeriatric Orthopaedic Surgery & Rehabilitation; Arissa M. Torrie, MD, MHS; Gerard P. Slobogean, MD, MPH; Rachel Johnson, MD; Ron E. Samet, MD; Samuel M. Galvagno, DO, PhD; Robert V. O’Toole, MD; Nathan N. O’Hara, PhD, MHA; 6/25Surgical fixation of hip fractures in older adults is associated with significant morbidity and mortality. This study found that regional anesthesia, presumably using peripheral nerve block techniques, may offer advantages beyond pain control, with potential protective benefits in high-risk hip fracture patients. Future clinical trials should examine peripheral nerve block benefits beyond pain management, identify mechanisms of action, determine optimal techniques for different risk profiles, and assess long-term outcomes. By combining the insights from this study with carefully designed future research, researchers can work towards developing more effective, patient-centered approaches to anesthesia for older adults undergoing surgical fixation of hip fractures.

Hospital decision-making and adoption of health-related social needs programs in US hospitalsJAMA Network Open; by Dina Zein, Cory E. Cronin, Neeraj Puro, Berkeley Franz, Elizabeth McNeill, Ji E. Chang; 6/25In response to health disparities in the US, the Centers for Medicare & Medicaid Services (CMS) released a Framework for Health Equity recommending increased hospital commitment and leadership engagement around screening for health-related social needs (HRSNs). This cross-sectional study found that hospitals with multiple layers of management engagement tended to adopt multifaceted strategies that address patients’ social needs, which are critical components of health equity frameworks. Interestingly, hospitals where only senior management was involved were more likely to offer specific programs like food insecurity and transportation services, although these associations were generally smaller compared with when both senior and other management were engaged.

Simulating the overall hospital quality Star ratings with random measure weightsJAMA Network Open; Benjamin D. Pollock, PhD, MSPH; Daniel S. Ubl, MPH; Subashnie Devkaran, PhD; Sean C. Dowdy, MD; 7/25We found that only 244 US hospitals achieved reliable excellence in hospital quality in 2024 when defined as 90th percentile performance or better in at least 50.0% of 100,000 simulations using random weights for each measure in the CMS Overall Star Ratings. Our analysis highlights that there is meaningful variation in hospital quality performance across the spectrum of quality measures, even among 5-star hospitals. Future efforts to assess this variation may allow for better identification of reliably excellent hospitals, which could in turn lead to solicitation of evidence regarding the processes or cultures that separate reliable excellence from inconsistent greatness in hospital quality. 

Certified Child Life Specialists in hospice and palliative care organizations: A state of the professionAmerican Journal of Hospice and Palliative Medicine; by Jennifer Mangers-Deans, Alyssa Friedberg, Kimberly Downing, Lisa C. Lindley; 8/25Certified Child Life Specialists (CCLSs) provide developmentally appropriate psychosocial care to children to promote positive coping. However, little is known about the current professional landscape and opportunities for professional growth, especially in hospice and palliative care. Key insights into the profession, along with challenges and opportunities of working within the hospice and palliative care setting were identified. The findings highlighted the unique need for professional development among CCLSs.

[China] Machine learning models to predict 6-month mortality risk in home-based hospice patients with advanced cancerAsia-Pacific Journal of Oncology Nursing; by Wan Cheng, Jianwei Zheng,Yuanfeng Lu, Guojuan Chen, Zheng Zhu, Hong Wu, Yitao Wei, Huimin Xiao; 12/25This study aimed to construct predictive models using five different machine learning algorithms for predicting 6-month mortality risk among home-based hospice patients with advanced cancer. Our study demonstrated that routinely collected healthcare data on the first home visit have the potential to help screen high-risk patients, which may provide evidence for targeted hospice care.

Healthy days at home and prognosis of older adults with cancer and non-cancer serious life-limiting illnessesBMC Geriatrics; Oluwaseun J. Adeyemi, Nina Siman, Allison M. Cuthel, Keith S. Goldfeld, Corita R. Grudzen; 7/25Approximately 75% of U.S. older adults with serious life limiting illnesses visit the emergency department (ED) in the last six months of life, with three quarters of these individuals being admitted to the hospital. In this context, Healthy Days at Home (HDaH) and prognosis have emerged as important concepts for assessing and guiding care among older adults with serious life-limiting illnesses. HDaH is a patient-centered outcome measure that captures the number of days individuals spend at home without hospitalizations or ED visits. Among US older adults with serious life-limiting illnesses, worse prognosis is associated with fewer HDaH. Increasing age is associated with fewer HDaH, with substantial variability by race/ethnicity. In contrast, cancer is associated with more HDaH.Assistant Editor's note: "Healthy Days at Home (HDaH)" is such a fabulous concept, and so in keeping with the intent and goals of palliative care. Perhaps a HDaH is a quality measure that palliative care providers might consider using. 

Local hospice offers new grief support option The Reporter, Vacaville, CA; by Robin Miller; 7/24/25 ... Solano Care Hospice [in Vallejo, CA] is taking the reins of a beloved bereavement program that was previously operated by NorthBay Health Hospice and Bereavement. NorthBay, which had offered end-of-life care and support services for years, recently made the decision to close its hospice program. One of the cornerstone offerings of that program was a 10-week bereavement support group, designed to help individuals navigate the emotional journey of grief and healing. Rather than let that service disappear, Solano Care Hospice has embraced the opportunity to carry on the tradition. They’ve reintroduced the program under a new name — “Circle of Comfort” — and are expressing a deep sense of honor in continuing to help people through the bereavement process. 

[Finland] Moral psychological exploration of the asymmetry effect in AI-assisted euthanasia decisionsCognition; by Michael Laakasuo, Anton Kunnari, Kathryn Francis, Michaela Jirout Košová, Robin Kopecký, Paolo Buttazzoni, Mika Koverola, Jussi Palomäki, Marianna Drosinou, Ivar Hannikainen; 9/25A recurring discrepancy in attitudes toward decisions made by human versus artificial agents, termed the Human-Robot moral judgment asymmetry, has been documented in moral psychology of AI. Our studies documented reduced approval of an AI doctor's decision to withdraw life support relative to a human doctor. This effect persisted regardless of whether the AI assumed a recommender role or made the final medical decision, but, importantly, disappeared under two conditions: when doctors kept on rather than withdraw life support, and when they carried out active euthanasia (e.g., providing a lethal injection or removing a respirator on the patient's demand) rather than passive euthanasia. These findings highlight two contextual factors–the level of automation and the patient's autonomy–that influence the presence of the asymmetry effect, neither of which is not predicted by existing theories. Finally, we found that the asymmetry effect was partly explained by perceptions of AI incompetence and limited explainability. As the role of AI in medicine continues to expand, our findings help to outline the conditions under which stakeholders disfavor AI over human doctors in clinical settings.Publisher's note: I find this study simultaneously interesting and unsettling...