Literature Review
Why not-for-profit health systems need positive margins: Deloitte
03/10/24 at 03:45 AMWhy not-for-profit health systems need positive margins: Deloitte Becker's Hospital CFO, by Andrew Cass; 2/28/24Health system margins are the "lifeblood of a healthy, patient-centered, innovative health care system and community," according to a report from consulting firm Deloitte. "Claims that profits are not important in fact undermine the ability to fund the mission, serve the community, and deliver better, equitable care," Deloitte said in the report. ... "[Systems] should consider a holistic approach that integrates margin drivers to create a balanced transformation portfolio, according to the report. Timing and sequencing are important within each driver and "a full understanding of the dollar impact and priority of each is necessary for margin improvement to be successful."
Maryland: Medical aid-in-dying legislation won’t pass this year
03/10/24 at 03:40 AMMaryland: Medical aid-in-dying legislation won’t pass this yearThe Baltimore Banner, by Pamela Wood; 3/1/24The Maryland General Assembly will not vote this year on a bill that would allow terminally ill residents to be prescribed medication they could take to initiate their own death. Versions of the proposal have been considered, but not passed, in Maryland since 2015.
What is the appropriate response when a colleague is not following an aid-in-dying law?
03/10/24 at 03:35 AMWhat is the appropriate response when a colleague is not following an aid-in-dying law? American Clinicians Academy on Medical Aid in Dying - Ethics Consultation Service; posted by Jean Abbott, MD, MH; originally posted 2/2/24 and emailed 3/4/24 Outline of Ethics Question: A resource practitioner for aid-in-dying care has encountered practitioners who have not followed the requirements of the laws in that state, including eligibility, documentation, and other standard legal or medical elements of aid-in-dying care. The resource practitioner wonders what ethical responsibilities should guide their response to these concerns. Definition of “resource practitioner”: An experienced prescriber who acts as a source of information or a mentor for others prescribing or consulting for patients considering aid in dying. Their role is to advise the provider on aid-in-dying best medical practices and the process required to comply with the law.
Home health disparities: Medicare Advantage patients receive fewer visits, worse outcomes
03/10/24 at 03:30 AMHome health disparities: Medicare Advantage patients receive fewer visits, worse outcomes Home Health Care News, by Patirck Filbin; 3/1/24Home health patients under Medicare Advantage (MA) plans have worse functional outcomes compared to traditional Medicare patients, likely as a result of receiving fewer visits, according to a new study.
Podcast: Dr. Robert Carolla’s reflections on life and mortality
03/10/24 at 03:25 AMPodcast: Dr. Robert Carolla’s reflections on life and mortality Springfield Daily Citizen; 2/28/24 Dr. Carolla, a pioneer in his field, sheds light on the delicate balance between life and mortality that oncologists navigate daily. Through his work with the Hospice Foundation of the Ozarks and national recognition from StoryCorps broadcasts, he and his wife, Peg, have touched countless lives with their compassion and dedication. Dr. Carolla’s journey offers a profound perspective shift on life, death, grief and the human experience.
Contract CNA staffing associated with worse care quality outcomes: study
03/10/24 at 03:20 AMContract CNA staffing associated with worse care quality outcomes: study McKnights Senior Living, by Kathleen Steele Gaivin; 3/1/24Nursing homes that use contract staffing to fill certified nursing assistant position vacancies are more likely to experience worse care quality than those that do not, according to the results of a study by PHI. The proportion of total CNA hours filled by contract CNAs in SNFs increased from 2% in 2017 to 11% in 2022, the study found.
Premier Hospice Phoenix exits Medicare program, impacting local healthcare
03/10/24 at 03:15 AMPremier Hospice Phoenix exits Medicare program, impacting local healthcareBNN, by Mazhar Abbas; 3/4/24Premier Hospice in Phoenix ends its Medicare agreement, sparking concerns among patients and providers. Explore the impact and future of hospice care.
Change Healthcare's temporary funding program 'not even a Band-Aid,' AHA says
03/10/24 at 03:10 AMChange Healthcare's temporary funding program 'not even a Band-Aid,' AHA says Becker's Health IT, by Giles Bruce; 3/4/24 The American Hospital Association called Change Healthcare's temporary funding program for providers affected by the cyberattack on the UnitedHealth Group subsidiary inadequate, while a U.S. Senate leader asked CMS to speed up payments to hospitals. Change Healthcare set up the funding assistance March 1 for providers facing cash-flow issues after losing access to its payer systems, which have been down since the Feb. 21 ransomware attack. However, AHA President and CEO Rick Pollack wrote in a March 4 letter to UnitedHealth Group that the program is "not even a Band-Aid on the payment problems you identify."
Aspirus Health completes St. Luke's Duluth acquisition
03/10/24 at 03:05 AMAspirus Health completes St. Luke's Duluth acquisitionModern Healthcare, by Alex Kacik; 3/1/24Aspirus Health finalized its acquisition of St. Luke's Duluth, forming a 19-hospital system spanning northeastern Minnesota, northern and central Wisconsin and Michigan’s Upper Peninsula. ... As part of the transaction, Aspirus will invest at least $300 million over eight years in St. Luke’s and will expand its health plan to St. Luke’s service area within two years. In addition, Aspirus will honor all physician, labor and union contracts, the system said in a news release Friday. Editor's Note: Both Aspirus Health and St. Luke's Duluth provide hospice care.
Sunday Newsletters
03/10/24 at 03:00 AMSunday NewslettersTop read stories of the last week (in order) is the focus of Sunday newsletters - enjoy!
Today's Encouragement
03/10/24 at 03:00 AMEverything that irritates us about others can lead us to an understanding of ourselves. ~Carl Jung
Large language models and generative AI in telehealth: A responsible use lens
03/09/24 at 03:50 AMLarge language models and generative AI in telehealth: A responsible use lensJournal of the American Medical Informatics Association, by Javad Pool, PhD, Marta Indulska, PhD, Shazia Sadiq, PhD; 4/24The findings emphasized the potential of LLMs, especially ChatGPT, in telehealth. They provide insights into understanding the use of LLMs, enhancing telehealth services, and taking ethical considerations into account. By proposing three future research directions with a focus on responsible use, this review further contributes to the advancement of this emerging phenomenon of healthcare AI.
Nonprofit behavior altered by monetary donations: evidence from the U.S. hospice industry
03/09/24 at 03:45 AMNonprofit behavior altered by monetary donations: evidence from the U.S. hospice industryThe European Journal of Health Economics; by Miao Guo; Lei Guo; Yang Li; 2/24This study investigates whether reliance on monetary donations alters nonprofit firms’ behaviors. Specifically, in the hospice industry, a shorter patients’ length of stay (LOS) speeds up overall patient turnover, allowing a hospice to serve more patients and expand its donation network.Publisher's note: Correlation does not imply causation...
The realities of work/life balance in palliative care
03/09/24 at 03:40 AMThe realities of work/life balance in palliative careBritish Journal of Community Nursing, by Brian Nyatanga; 3/24The philosophy of palliative care makes the idea of work/life balance a crucial component to providing that care. However, the difficulty of achieving this idealistic work/life split demands another way of looking at the concept.
‘My life is a mess but I cope’: An analysis of the language children and young people use to describe their own life-limiting or life-threatening condition
03/09/24 at 03:35 AM‘My life is a mess but I cope’: An analysis of the language children and young people use to describe their own life-limiting or life-threatening conditionPalliative Medicine, by Katherine Bristowe; Debbie Braybrook; Hannah M Scott; Lucy Coombes; Daney Harðardóttir; Anna Roach; Clare Ellis-Smith; Myra Bluebond-Langner; Lorna Fraser; Julia Downing; Fliss Murtagh; Richard Harding; 3/24Children and young people can provide rich descriptions of their condition. Paying attention to their lexical choices, and converging one's language towards theirs, may enable more child-centred discussions. Expanding discussions about 'what matters most' with consideration of the losses and differences they have experienced may facilitate a fuller assessment of their concerns, preferences and priorities.
Healthcare access dimensions and racial disparities in end-of-life care quality among ovarian cancer patients
03/09/24 at 03:30 AMHealthcare access dimensions and racial disparities in end-of-life care quality among ovarian cancer patientsCancer Research Communications; by Shama Karanth; Oyomoare L Osazuwa-Peters; Lauren E Wilson; Rebecca A. Previs; Fariha Rahman; Bin Huang; Maria Pisu; Margaret Liang; Kevin C Ward; Maria J Schymura; Andrew Berchuck; Tomi F. Akinyemiju; 3/24This study investigated the association between healthcare access (HCA) dimensions and racial disparities in end-of-life care quality among Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Hispanic patients with ovarian cancer (OC). The final sample included 4,646 women. After adjustment for HCA dimensions, NHB patients had lower quality EOL care compared to NHW patients, defined as increased risk of hospitalization in the last 30 days of life (RR 1.16, 95% CI:1.03-1.30), no hospice care (RR 1.23, 95% CI:1.04-1.44), in-hospital death (RR 1.27, 95% CI:1.03-1.57), and higher counts of poor-quality EOL care outcomes (Count Ratio:1.19, 95% CI:1.04-1.36).
Trends in end-of-life care and satisfaction among Veterans undergoing surgery
03/09/24 at 03:25 AMTrends in end-of-life care and satisfaction among Veterans undergoing surgeryAnnals of Surgery; by Dualeh, Shukri H.A. MD; Anderson, Maia S. MD MS; Abrahamse, Paul MA; Kamdar, Neil MA; Evans, Emily MS; Suwanabol, Pasithorn A. MD; 2/24To examine trends in end-of-life care services and satisfaction among Veterans undergoing any inpatient surgery.
Illness trajectories of incurable solid cancers
03/09/24 at 03:20 AMIllness trajectories of incurable solid cancersBMJ, by Eric C T Geijteman, Evelien J M Kuip, Jannie Oskam, Diana Lees, Eduardo Bruera; 3/24[See article for] updated treatment illness trajectories for patients with incurable solid cancer include major temporary improvement, long term ongoing response, and rapid decline. Supportive and palliative care should be provided in conjunction with newer anticancer therapies to address patients’ physical, psychological, social, and spiritual challenges.
Public health and palliative care
03/09/24 at 03:15 AMPublic health and palliative careClinics in Geriatric Medicine, by Sarah H. Cross PhD, MSW, MPH; Dio Kavalieratos PhD; 8/23Meeting the needs of people at the end of life (EOL) is a public health (PH) concern, yet a PH approach has not been widely applied to EOL care. The design of hospice in the United States, with its focus on cost containment, has resulted in disparities in EOL care use and quality. Individuals with non-cancer diagnoses, minoritized individuals, individuals of lower socioeconomic status, and those who do not yet qualify for hospice are particularly disadvantaged by the existing hospice policy. New models of palliative care (both hospice and non-hospice) are needed to equitably address the burden of suffering from a serious illness.
Aging is not an illness: Exploring geriatricians' resistance to serious illness conversations
03/09/24 at 03:10 AMAging is not an illness: Exploring geriatricians' resistance to serious illness conversationsJournal of Pain and Symptom Management, by Alexis Drutchas MD; Deborah S. Lee MD; Sharon Levine MD; Jeffrey L. Greenwald MD; Juliet Jacobsen MD, MPH; 9/23Three key themes emerged that help explain the reluctance of clinicians caring for older patients to have or document serious illness conversations: 1) aging in itself is not a serious illness; 2) geriatricians often focus on positive adaptation and social determinants of health and in this context, the label of “serious illness conversations” is perceived as limiting; and 3) because aging is not synonymous with illness, important goals-of-care conversations are not necessarily documented as serious illness conversations until an acute illness presents itself.
First person profile: Betty Ferrell, PhD, RN
03/09/24 at 03:05 AMFirst person profile: Betty Ferrell, PhD, RNCancer, by Mary Beth Nierengarten; 2/24Dr Ferrell has built her career on the belief that palliative care should be offered from the time of cancer diagnosis rather than just as end-of-life care.Publisher's note: Honoring our heros...
Saturday Newsletters
03/09/24 at 03:00 AMSaturday Newsletters: Research literature is the focus of Saturday newsletters - enjoy!
Today's Encouragement
03/09/24 at 03:00 AMHalf the world is composed of people who have something to say and can't, and the other half who have nothing to say and keep on saying it. ~Robert Frost
Tour a room at Quiet Oaks Hospice House video
03/08/24 at 03:45 AMTour a room at Quiet Oaks Hospice House video WJON News, St. Cloud, MN; 3/6/24 Even though Quiet Oaks Hospice House has been in our community for over 15 years now, many of us have never actually visited the home. They have eight rooms with all suites similar in size and layout. Executive Director Linda Allen says they have a large-sized hospital bed so loved ones can sleep together. Other room amenities include a TV, radio, and wifi. ... The rooms are equipped with a call button for help and have a camera monitoring system.Editor's Note: This simple, warm, practical video can help allay fears of hospice patients, caregivers, and family members. This type of visual information can be especially supportive to long distance family members who might be grappling with the news of moving their loved one to a hospice facility.
Mother and daughter brave Sahara trek in memory of beloved Grace for hospice fundraiser
03/08/24 at 03:30 AMMother and daughter brave Sahara trek in memory of beloved Grace for hospice fundraiser BNN, by Wojciech Zyim; 3/7/24Rebecca Gaskell and her daughter, Imogen, from Chalfont St Peter, are embarking on a moving journey across the Sahara Desert this March to honor the memory of their daughter and sister, Grace, while raising funds for Helen & Douglas House, the hospice that provided care for Grace during her battle with a brain tumor. Diagnosed at just 12, Grace’s brave fight ended two years later, leaving her family seeking ways to give back to the hospice that offered them comfort in their darkest times.Editor's Note: The Helen & Douglas House for terminally ill children is located at Oxford, United Kingdom.