Literature Review

Cheers to a new year and another chance for us to get it right. ~Oprah Winfrey

Head and neck cancer mortality in the Appalachian regionJAMA Otolaryngology-Head and Neck Surgery; Todd Burus, MAS; Pamela C. Hull, PhD; Krystle A. Lang Kuhs, PhD, MPH; 12/24In contrast to non-Appalachian US, where HNC [head and neck cancer] mortality rates declined considerably between 1999 and 2020, HNC mortality rates in the Appalachian region have remained stubbornly stable. Moreover, statistically significant increasing rates of HNC mortality in rural Appalachia provide evidence that the lack of rural HNC mortality improvements nationwide are associated with Appalachian disparities. While the exact factors driving these trends are unknown, the Appalachian region has an increased prevalence of multiple risk factors associated with cancer mortality, such as adverse social determinants of health, heightened alcohol and tobacco use, later stage at diagnosis, and limited access to care. Investments in the Appalachian region—such as through the Bipartisan Infrastructure Law or by expanding coverage of the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program among Appalachian states—could help reduce the burden of HNC mortality by improving cancer surveillance and serving the unique needs and experiences of the Appalachian population. These investments could also aid efforts to improve other cancer sites with known disparities in Appalachia, such as lung and colorectal cancers.

Current challenges in neurocritical care: A narrative reviewWorld Neurosurgery; Safa Kaleem, William T. Harris II, Stephanie Oh, Judy H. Ch'ang; 1/25Neurocritical care as a field aims to treat patients who are neurologically critically ill due to a variety of pathologies. As a recently developed subspecialty, the field faces challenges, several of which are outlined in this review ... [including confusion around] brain death testing or the diagnosis of brain death itself ... Given these difficult scenarios encountered in the neuro-ICU, conversations with patients’ decision-makers are often done with the assistance of palliative care services ... the most common reasons for palliative care consultation in the neuro-ICU were discussing prognosis, eliciting patient and family values, understanding medical options, and identifying conflict. Collaboration with hospital chaplains and palliative care services can be helpful, but cultural humility also needs to be a priority for neurocritical care providers to be able to navigate difficult conversations.

Conscience at the end of lifeNursing Reports; Ralph Neil Baergen, James Skidmore; 12/24Caring for patients at the end of life can involve issues that are ethically and legally fraught: withholding or withdrawing artificial nutrition and hydration, pain control that could hasten death, aggressive treatment that is continued when it seems only to be prolonging suffering, patients who request medical assistance in dying, and so forth. Clinicians may find that their deeply held ethical principles conflict with law, institutional policy, or patients' choices. In these situations, they may consider either refusing to participate in procedures that they find morally abhorrent (conscientious refusal) or providing care that they believe to be ethically obligatory despite being contrary to law or policy (conscientious commitment). Healthcare providers who refuse to provide medical services should be expected to explain their reasons, make prompt referrals, and bear some of the resulting costs or burdens.

[China] Family members' experiences of surrogate decision-making in hospice care: A systematic review of qualitative studiesInternational Journal of Nursing Studies; Ting Yu, Yijing Li, Ziyi Hu, Shanshan Liu, Cong Wang, Qian Chen, Yan Jiang; 12/24Determining whether patients receive hospice care at end of life is complex for family members. This process begins with the coexistence of rational and emotional motives for decision-making, involves preparation for decision-making through the acquisition of knowledge and experience about hospice care, and culminates in reflection on the entire decision-making process. These findings underscore the importance of providing sufficient informational and emotional support to family decision-makers, which can improve decision-making and promote more compassionate end-of-life care. Future research should focus on developing effective strategies to strengthen these support systems.

Caregiver reported experiences of not-for-profit hospice agencies with a religious affiliationJournal of the American Geriatrics Society; by Xiao (Joyce) Wang, Joan M. Teno, Momotazur Rahman, Emmanuelle Belanger; 12/24Compared to those without a religious affiliation, the religiously affiliated hospices were smaller in size, newer, had a higher shares of patients with dementia, and also a higher percentage of patients living in nursing homes, and were more likely to be in the Midwest. These hospices also had lower scores across all CAHPS measures, with the magnitude of these differences by religious affiliation being small to medium. Compared to hospices without a religious affiliation, a much lower proportion of hospices with a religious affiliation received four or five stars (66.5% vs. 47.6%).Publisher's note: While for-profit hospices have been grouped into various categories (e.g., private equity owned or publicly traded companies), this is the first article I recall grouping nonprofit hospices into various categories.

[UK] Hospice to run Christmas tree removal fundraiser BBC News, United Kingdom; by Jacob Panons; 1/1/25 A hospice in Kent is once again offering Christmas tree removals to help raise funds. In 2023, Heart of Kent Hospice raised more than £9,000 by receiving donations to recycle Christmas trees. Between 3-5 January, the Aylesford-based charity will run the service for the third time, collecting in and around Chatham, Maidstone, Staplehurst, Paddock Wood, Borough Green and the surrounding areas. A donation of £15 for each tree is suggested and people are urged to book a slot online before the new year. 

Memorial Health Systems puts visitor restrictions in place due to respiratory illness surge The Marietta Times, Marietta, OH; 12/31/24 Visitor restrictions have been put in place at all Memorial Health Systems facilities because of a surge in patients with respiratory illnesses, the the health care system announced Tuesday [12/24/24]. The restrictions are two visitors per patient, visitors must be 18 or older and show no signs of illness and all minors must be accompanied by an adult, Memorial Health said. Exceptions may be permitted for:

Nearly 5,000 Providence Oregon workers issue strike notice Becker's Hospital Review; by Kristin Kuchno; 12/30/24 Nearly 5,000 front-line healthcare workers from Providence Oregon hospitals plan to begin an open-ended strike Jan. 10. The Oregon Nurses Association issued a 10-day notice following intensive bargaining, according to a Dec. 30 news release from the union. The striking workers include physicians, nurses and other healthcare staff from all eight Providence Oregon hospitals and six clinics. The union is urging Providence to invest in patient safety and provide competitive wages and benefits to support recruitment and retention efforts. ... Providence Oregon has secured replacement workers and identified other strategies to maintain patient care, Chief Executive Jennifer Burrows, RN, said in a message to caregivers shared with Becker's. She said the system has communicated to union leaders that bargaining stops during a work stoppage to prioritize patient care.

CDC weekly US map: Influenza summary update U.S. Centers for Disease Control and Prevention (CDC) - HHS.gov; retrieved from the internet 1/2/25, with most current data from 12/21/24 A Weekly Influenza Surveillance Report Prepared by the Influenza Division: Outpatient Respiratory Illness Activity Map Determined by Data Reported to ILINet. This system monitors visits for respiratory illness that includes fever plus a cough or sore throat, also referred to as ILI, not laboratory confirmed influenza and may capture patient visits due to other respiratory pathogens that cause similar symptoms. Editor's note: Click here for the map and bookmark it to regularly monitor your service areas through this flu season.

[Hospice] Volunteer coordinator whose husband unexpectedly died gets touching surprise from a Secret SantaEast Idaho News; by Nate Eaton; 12/31/24A local Secret Santa is giving [money] to deserving people in eastern Idaho this holiday season and the East Idaho News elves are helping out. Every day since Nov. 1, we’ve posted a Secret Santa surprise, and today have our last video with a wonderful woman named Gwen. Gwen currently works as the volunteer coordinator for a home health and hospice agency in Rexburg. Having her own mother on hospice, Gwen understands the grief and hardship people experience with anticipating death. Gwen is passionate about service, and cares very deeply about every resident that she sees. 

Top Modern Healthcare stories of 2024 Modern Healthcare; by Mary Ellen Podmolik; 12/31/24 Ups and downs in healthcare kept Modern Healthcare reporters plenty busy in 2024, and 2025 is shaping up as a critical year for the industry, particularly as a new administration takes over in Washington, D.C. Our reporters this year did what Modern Healthcare excels at — bringing readers the news along with the context and analysis our audience needs to stay ahead. Get ready for 2025 by catching up on some hot topics during 2024.

MA Special Needs Beneficiaries more likely to receive lower quality hospice care Hospice News; by Jim Parker; 1/2/25 Medicare Advantage special needs plan (SNP) beneficiaries were more likely to use lower-quality hospices than those enrolled in fee-for-service Medicare. Researchers from the Perelman School of Medicine at University of Pennsylvania in Philadelphia examined Medicare enrollment and claims data for 4.2 million decedents and 2.2 million hospice enrollees from Jan 1, 2018 to Dec. 31, 2019. Among other findings, results indicated that MA SNP beneficiaries were more likely to receive care from hospices with lower Hospice Quality Reporting Program (HQRP) scores. “These results suggest that policymakers should consider incentivizing referrals to high-quality hospices and approaches to educating beneficiaries on identifying high-quality hospice care,” researchers wrote in the study, published in JAMA Network Open. Editor's note: Click here for the CMS.gov Special Needs Plans webpage.