Literature Review
Willingness to be present throughout patient death via medical aid in dying in a national sample of interdisciplinary US hospice clinicians: a content analysis of rationales
11/23/24 at 03:25 AMWillingness to be present throughout patient death via medical aid in dying in a national sample of interdisciplinary US hospice clinicians: a content analysis of rationalesPalliative Care and Social Practice; Todd D. Becker, Cindy L. Cain, John G. Cagle, Joan K. Davitt, Nancy Kusmaul, Paul Sacco; 10/24 The United States is one of a growing number of countries across Europe, North America, Oceania, and South America to have legalized what, domestically, is referred to as medical aid in dying (MAID). The objective of the current study was to explore attitudes toward presence throughout a patient’s death via MAID in hospice physicians, nurses, social workers, and chaplains. Participants who were willing to be present (n = 305 [74%]) attributed their willingness to personal support, definitions of quality clinical care, and values from their professional training. Those who were unwilling (n = 63 [15%]) noted personal objections to the concept of MAID, personal objections to MAID participation, and perceptions of MAID’s misalignment with healthcare. Hospice clinicians would benefit from greater professional guidance and support pertaining to MAID.
Suicide deaths among adolescent and young adult patients with cancer
11/23/24 at 03:20 AMSuicide deaths among adolescent and young adult patients with cancerJAMA Network Open; Koji Matsuo, MD, PhD; Christina J. Duval, BA; Briana A. Nanton, BS; Jennifer A. Yao, BA; Erin Yu, BS; Christian Pino, MD; Jason D. Wright, MD; 11/24The overall cancer incidence among adolescent and young adult (AYA) patients is increasing at an alarming rate in the US largely driven by thyroid cancer. Although cancer mortality continues to decrease among AYA patients, those who survive cancer are at elevated risk for emotional distress, mental health problems, and suicide. Together with the population-level increase in the US suicide death rate, the results of this assessment call for attention focused on the increasing suicide death rate among AYA patients with cancer, particularly male individuals. The proportion of AYA patients with cancer of thyroid, testis, or cutaneous melanoma who had a suicide death was greater than 2%, and they most benefit from a psychosocial and mental health evaluation. Because this study noted that many suicide deaths among these AYA patients with cancer occur years after the cancer diagnosis, long-term care and support for cancer survivors is recommended.
Facility- and community-level factors associated with hospice patient experience
11/23/24 at 03:15 AMFacility- and community-level factors associated with hospice patient experiencePalliative and Supportive Care; by Mengying He, Ganisher Davlyatov, Gregory Orewa, Haiyan Qu, Robert Weech-Maldonado; 11/24For-profit and chain-affiliated hospices were negatively associated with CAHPS® scores. Organizational longevity and Medicare payer mix were positively associated with CAHPS® scores. Hospice community factors including competition, per capita income, and the racial/ethnic minorities' percentage were negatively associated with CAHPS® scores.
Economic value of unpaid family caregiver time following hospital discharge and at end of life
11/23/24 at 03:10 AMEconomic value of unpaid family caregiver time following hospital discharge and at end of lifeJournal of Pain and Symptom Management; by Brystana G Kaufman, Wenhan Zhang, Sahar Shibeika, Ro W Huang, Ting Xu, Cory Ingram, Allison M Gustavson, Diane E Holland, Catherine Vanderboom, Courtney H Van Houtven, Joan M Griffin; 12/24Results: Of 282 Family caregivers, 94% were non-Hispanic White, 71% were female, 71% had a college degree, and 51% were in the workforce. Family caregivers of decedents (58%) compared to survivors reported significantly more caregiving hours per person-month (392 vs. 272), resulting in higher estimated economic value per person-month using opportunity ($12,653 vs. $8843), proxy ($5689 vs. $3955), and combined costing methods ($9490 vs. $6443). Conclusion: This study informs more complete economic evaluations of palliative care by estimating the economic value of unpaid caregiving. The high intensity of unpaid caregiving for people with serious illness, especially toward the end of life, should be considered when designing policies and interventions to support family caregivers. Better methods for approximating economic value are needed to address potential inequities in current valuation approaches.
[Australia] Components of home-based palliative and supportive care for adults with heart failure: A scoping review
11/23/24 at 03:05 AM[Australia] Components of home-based palliative and supportive care for adults with heart failure: A scoping reviewPalliative Medicine; Madhurangi Perera, Ureni Halahakone, Sameera Senanayake, Sanjeewa Kularatna, William Parsonage, Patsy Yates, Gursharan K. Singh; 10/24Palliative care and supportive care provided in the home for people with heart failure can improve quality of life, caregiver wellbeing and reduce healthcare costs. Ensuring patient and caregiver-centred care supported by a multidisciplinary team is essential to delivering home-based palliative and supportive care for people with heart failure. Further research focussed on the role of digital interventions in home-based palliative and supportive care, the composition of the multidisciplinary team and research which includes individuals across all stages of heart failure is needed.
Artificial intelligence and machine learning in cancer pain: A systematic review
11/23/24 at 03:05 AMArtificial intelligence and machine learning in cancer pain: A systematic reviewJournal of Pain and Symptom Management; by Vivian Salama, Brandon Godinich, Yimin Geng, Laia Humbert-Vidan, Laura Maule, Kareem A Wahid, Mohamed A Naser, Renjie He, Abdallah S R Mohamed, Clifton D Fuller, Amy C Moreno; 12/24Forty four studies from 2006 to 2023 were included. Implementation of AI/ML tools promises significant advances in the classification, risk stratification, and management decisions for cancer pain. Further research focusing on quality improvement, model calibration, rigorous external clinical validation in real healthcare settings is imperative for ensuring its practical and reliable application in clinical practice.
Saturday newsletters
11/23/24 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
Machine learning for targeted advance care planning in cancer patients: A quality improvement study
11/23/24 at 03:00 AMMachine learning for targeted advance care planning in cancer patients: A quality improvement studyJournal of Pain and Symptom Management; by Mihir N Patel, Alexandria Mara, Yvonne Acker, Jamie Gollon, Noppon Setji, Jonathan Walter, Steven Wolf, S Yousuf Zafar, Suresh Balu, Michael Gao, Mark Sendak, David Casarett, Thomas W LeBlanc, Jessica Ma; 12/24Objectives: Examine a quality improvement mortality prediction algorithm intervention's impact on ACP documentation and EOL care. Conclusion: Identifying patients with cancer and high mortality risk via machine learning elicited a substantial increase in documented ACP conversations but did not impact EOL care. Our intervention showed promise in changing clinician behavior. Further integration of this model in clinical practice is ongoing.
[Canada] Feasibility of prospective error reporting in home palliative care: A mixed methods study
11/23/24 at 03:00 AM[Canada] Feasibility of prospective error reporting in home palliative care: A mixed methods studyPalliative Medicine; Allison M Kurahashi, Grace Kim, Natalie Parry, Vivian Hung, Bhadra Lokuge, Russell Goldman, Mark Bernstein; 10/24 Palliative care patients may be particularly vulnerable to experiencing errors due to the complex communication among interdisciplinary team members (including the patient and their caregivers), the use of high-risk medications such as opioids and benzodiazepines, polypharmacy, patient frailty, and patient cognitive decline. Care in patients’ homes presents additional challenges to patient care that are unique from hospital settings: Decreased communication about roles and responsibilities in care can result from involvement of multiple care teams and different electronic records. The collaborative nature of care in a home-based palliative care context may present unique challenges to translating error reporting to improved patient safety. Physicians are amenable to error reporting activities so long as data is used to improve patient safety.
My top 10 list for living with cancer
11/22/24 at 03:10 AMMy top 10 list for living with cancer Cure; by Kelly Irvin; 11/19/24 I’m coming up on the ninth anniversary after my diagnosis of stage 4 ovarian cancer in January 2016. As always, this causes me to ponder my life as someone living with cancer for the rest of my life. I ponder why I’m still here and others are not. Have I used this time well? What have I learned that might be of use for other “lifers,” as well as those just starting on this journey? It’s that last question I’m focused on here. The following is my top 10 list for living with cancer when there’s no likelihood of hearing those magical words “cancer-free.”
Q&A: Prioritizing health equity with Emory Healthcare’s Chief Transformation Officer
11/22/24 at 03:00 AMQ&A: Prioritizing health equity with Emory Healthcare’s Chief Transformation Office CDW Healthcare - Patient-Centered Care; by Teta Alim; 11/19/24 Most healthcare organizations regularly prioritize goals to improve the patient experience and increase clinician satisfaction, aligning with the Quintuple Aim. Atlanta-based Emory Healthcare created the role of chief transformation officer to focus on these areas, and in July 2023, Dr. Amaka Eneanya became the first to fill the role. ... What would you say were the top three lessons you learned during the first year in your new role? ENEANYA: It's been a great year. For lesson one, as someone coming from a different part of the U.S., ingraining yourself and getting to know the people and the culture of the organization that you’re in, that’s important to determine the change readiness of an organization. ... The second lesson is that change is exciting. There's a lot of trepidation with change, and part of being effective with change management and transformation is really garnering excitement. ... The third lesson that continues to be pervasive in my career is that health equity is poorly understood. ... You have to start with the basic foundation and concepts of health equity before you can make initiatives, otherwise people won't understand what you're doing, and they might have a visceral response to what you're doing because of the misinformation around health equity.
Thanksgiving reflections: Gratitude and grieving in hospice care
11/22/24 at 03:00 AMThanksgiving reflections: Gratitude and grieving in hospice care Faith Hope Hospice & Palliative Care, Pasadena, CA; 11/20/24 Thanksgiving is traditionally a time for joy and gratitude, but it can bring mixed emotions for families with a loved one in hospice care. In the diverse communities of Los Angeles, Beverly Hills, and Hollywood, Faith and Hope Hospice provides compassionate guidance on how to balance grief with gratitude, helping families find moments of peace and connection during this reflective time. ... Gratitude can be a healing force, offering comfort to those grappling with loss. In hospice care, where families confront profound challenges, finding space for gratitude can significantly impact emotional and psychological well-being, fostering resilience and a sense of peace.
3 clear signs to quickly identify someone with good leadership skills: Good leadership in the business world extends beyond hitting targets, increasing revenue, and achieving status
11/22/24 at 03:00 AM3 clear signs to quickly identify someone with good leadership skills: Good leadership in the business world extends beyond hitting targets, increasing revenue, and achieving status. Inc., by Marcel Schwantes; 11/20/24 If you’ve ever had the chance to work under a good leader, you’ve probably noticed something important: They actually care about their people. They’re not just focused on hitting targets or climbing the ladder themselves—they genuinely care about helping their team succeed, both in their current roles and in their long-term goals. For many leaders, this doesn’t come naturally. It’s tough to balance caring for others when you’re under pressure to deliver results and meet expectations. But here’s the thing: Research—and countless stories from top leaders I have interviewed on my podcast—shows that focusing on your people is a game-changer for the success of your business. It’s not just a feel-good approach; it’s smart strategy. ... When leaders consistently show they care and foster the right environment, the positive ripple effects are undeniable. Let’s talk about three clear signs that will tell you someone is fit for leadership:
Generations of legacy: The Meyer family returns for 21st Annual Hospice Golf Tournament
11/22/24 at 03:00 AMGenerations of legacy: The Meyer family returns for 21st Annual Hospice Golf Tournament Advent Health Palm Coast; by Michelle Bartlome; 11/21/24 The 21st annual Stuart F. Meyer Hospice House golf tournament on Oct. 23 was a celebration of community support and a touching tribute to the enduring legacy of Stuart F. Meyer. Among the 144 players was one of Meyer’s grandsons, Bryan Ashley, 34, of Fenton, Missouri. He, along with his cousins and brother-in-law, represented his family and honored his grandfather’s memory at the event. ... Stuart F. Meyer, former president of the St. Louis Cardinals and Flagler County resident, spent his final days in the compassionate care of hospice. In his memory, his family supported the construction of a hospice house on the AdventHealth Palm Coast campus more than two decades ago. ... This year’s Stuart F. Meyer Hospice House Golf Tournament raised $56,000, with 36 golf teams signed up.
Nursing homes with more black residents lag in care goal discussions
11/22/24 at 03:00 AMNursing homes with more black residents lag in care goal discussions Medical Xpress; by Columbia University Irving Medical Center; 11/20/24 New research from Columbia University School of Nursing published in the American Journal of Hospice and Palliative Medicine shows that timely goals of care discussions are less likely to take place in nursing homes with a higher percentage of Black residents. These discussions are crucial to ensuring that nursing home residents receive care that aligns with their wishes, postdoctoral research fellow Jung A. "Chloe" Kang, Ph.D. '24, Professor Patricia Stone, Ph.D., and their colleagues note in the report, published online September 15, 2024. But these conversations are often delayed until patients experience life-threatening events, the authors add, which can lead to unwanted therapies and unnecessary hospitalizations. ...
Rise in pancreatic cancer tied to better detection, study suggests
11/22/24 at 03:00 AMRise in pancreatic cancer tied to better detection, study suggests Becker's Hospital Review; by Elizabeth Gregerson; 11/19/24 The rise in pancreatic cancer diagnoses can be attributed to previously undetected disease and not a rise in cancer occurrence, according to a study published Nov. 19 in the Annals of Internal Medicine. Researchers from Boston-based Brigham and Woman's Hospital and Austin, Texas-based Dell Medical School analyzed U.S. Cancer Statistics and National Vital Statistics System data of adults aged 15-39 from between 2001 and 2019 for the study. Here are five notes from their findings:
Empassion achieves $34 million in savings in novel Medicare program serving high needs patients
11/22/24 at 03:00 AMEmpassion achieves $34 million in savings in novel Medicare program serving high needs patients Globe Newswire, New York City; 11/21/24 Empassion Health, Inc., the nation’s largest managed care provider of high-quality end-of-life care for adults living with serious illness so that they can have more good days, today reported near-record results for four Medicare Accountable Care Organizations (ACOs) serving Original Medicare lives in 35 states. Specifically, Empassion achieved total gross savings of $34.1m in the High Needs Population Track of ACO REACH for Performance Year 2023 while managing a record number of lives – nearly 9,000 across 35 states – in total cost-of care arrangements. This includes a 50-percent reduction of unnecessary hospital stays. Empassion also earned the highest quality scores for provider communication and care coordination. “While we are enormously proud of the $34 million in Medicare savings, more important is that Empassion provided high-quality end-of-life care for adults living with serious illness so that they had more good days,” said Robin Heffernan, the CEO of Empassion. “These outcomes are specific to Empassion and its unique model. ..."
Executive Personnel Changes - 11/22/24
11/22/24 at 03:00 AMExecutive Personnel Changes - 11/22/24
This New York Times bestselling author cracked the code on transformative leadership
11/22/24 at 03:00 AMThis New York Times bestselling author cracked the code on transformative leadership Forbes Talks; by Brittany Lewis with Keith Ferrazzi; 11/19/24 Keith Ferrazzi and Forbes reporter Brittany Lewis discuss his new book Never Lead Alone: 10 Shifts from Leadership to Teamship on 'Forbes Talks.' Keith Ferrazzi, a #1 New York Times Bestselling Author of Never Eat Alone, Leading Without Authority, Competing in the New World of Work, and his newest book, Never Lead Alone: 10 Shifts from Leadership to Teamship. Keith is an acclaimed global executive team coach, who stands at the forefront of transformative leadership having coached the transformation of Fortune 500 corporations, the World Bank, fast growth Unicorns and even governments of entire countries. The founder of Ferrazzi Greenlight, Keith spearheads behavioral shifts in leadership and high impact teams, empowering organizations to thrive in the ever-evolving landscape of business. Keith's research can be found in prestigious publications including Harvard Business Review, Forbes, The Wall Street Journal, Fortune, Fast Company, and Inc. Magazine, where his columns serve as valuable insights for business leaders.
Today's Encouragement: We must find time to stop and thank the people who ...
11/22/24 at 03:00 AMWe must find time to stop and thank the people who make a difference in our lives. ~ John F. Kennedy Editor's note: Today marks the 61st anniversary of his death, November 22, 1963. As we know too well in our end-of-life roles, death's timing often does not give us time to voice what matters most to those persons who matter most. May we all "find time to stop and thank" persons who "make a difference in our lives"--whether over the course of a lifetime or in a simple spontaneous moment.
YoloCares: The case for independence
11/22/24 at 03:00 AMYoloCares: The case for independenceThe Davis Enterprise; by Craig Dresang; 11/17/24I recently received an email from an individual in Temple Terrace, Fla., informing me that two Northern California nonprofit hospices — with close historical ties to YoloCares — have decided, via affiliation, to turn their keys over to a Florida-based health system that has had no previous presence in California.Publisher's note: Craig Dresang, CEO of YoloCares, goes on to discuss questions and concerns with Chapters Health System's (Tampa, FL) acquisition of Hospice of East Bay (Pleasant Hill, CA), Hospice of Santa Cruz County (Scotts Valley, CA), Nathan Adelson Hospice (Las Vegas, NV), and Willamette Vital Health (Salem, OR). The original story - Chapters Health System launches new Chapters Health West Division - was announced 10/30/24.
The work of hospicing
11/22/24 at 03:00 AMThe work of hospicing Stanford Social Innovation Review; by Vanessa Andreotti and Habib Nabatu; Winter 2025 issue, 11/20/24As we stand at the precipice of endings—of species, ecosystems, organizations, and systems themselves—the work of hospicing is to move beyond fear and embrace the deep transitions ahead with wisdom. To be stewards of this time, we must develop the practices and capacities to tend to these endings, not with urgency or control, but with a kind of stillness that invites the birth of new ways of being. Endings are not failures; they are part of a cycle that requires presence, reverence, and humility. Our hyperfocus on growth and expansion has left us ill-prepared to sit with death—whether it be the death of industries or the biosphere—and this discomfort with grief prevents us from being fully alive in the present. How might we allow the crumbling of outdated structures without rushing to rebuild too quickly? How might we hold space for what is irreversibly changing, without rushing to save or fix it? ...
Hospice a cornerstone of New Day’s 3-pronged growth strategy
11/22/24 at 03:00 AMHospice a cornerstone of New Day’s 3-pronged growth strategy Hospice News; Holly Vossel; 11/20/24 New Day Healthcare LLC is prioritizing hospice growth in its strategic plans as the home-based care company focuses on improving quality for patients across the care continuum. Texas-based New Day launched in 2020 by a group of former hospice and home health professionals. The organization offers hospice, home health and personal care through several brands. New Day’s three-pronged merger and acquisition approach hinges on culture, quality and clinical excellence, according to CEO and Founder G. Scott Herman. Quality is perhaps the most important driver in a transaction consideration, Herman stated. ... To date, New Day has integrated 11 acquisitions into its pipeline, four of which have involved hospice assets.
A guiding light: hospice care social workers provide support for dealing with the idea of death
11/22/24 at 02:00 AMA guiding light: hospice care social workers provide support for dealing with the idea of death Scot Scoop - Carlmont High School's Student News Site; by Rei Baxter; 11/20/24 Death is a natural part of life, yet it is also terrifying. Being young and dying is especially difficult to accept. Regina Tong, a hospice social worker, has to deal with difficult cases. "The hardest parts for me are the young patients, like the moms with children, or younger people who are just not ready to die, but they get this terminal illness, and their parents are grieving. Those are really hard for me,” Tong said. ... Before starting in hospice, Tong worked in nursing homes and palliative care patients, who are people that aren’t quite hospice level but have chronic illnesses. However, when her mom died, she realized that she needed to stretch her boundaries and learn more about something she was uncomfortable with: death. “That’s why I’m here. The more I work in hospice, the more I realize how important inner peace is. I see a lot of patients who are at the end of their lives, and they really struggle with the idea of death, even though it’s a natural process of everything that has a life. So people who resisted end up suffering so much towards the end,” Tong said. Tong’s work doesn’t just help her patients and their families; it helps her connect more with herself. ...Editor's note: Rei Baxter--this article's author--is a high school senior. This beautiful article gifts us with a prelude into Thanksgiving week, as we gather with intergenerational families and tune into what matters most.
Walking pneumonia is booming − and targeting the young and the poor
11/21/24 at 03:10 AMWalking pneumonia is booming − and targeting the young and the poor USA Today, Arlington, VA; by John Bacon; 11/20/24 Infections of the bacteria that cause walking pneumonia, a lesser evil of the more serious illness of pneumonia, is seeing a dramatic jump after a lengthy decline that came with the start of the COVID-19 pandemic, health officials say. Most alarming is the sharp increase in children infected with the disease. And, as with COVID-19, the impact of the disease can hit low-income Americans the hardest. The Centers for Disease Control and Prevention said infections from the bacteria that can cause walking pneumonia are common: An estimated 2 million infections occur each year in the United States. However, the true number isn't known, in part because so many people get it without seeking medical help and in part because there is no nationwide reporting system. The infections dropped off during the COVID pandemic but are now booming. Hospital emergency department discharge data from April to October showed an increase in infections of the bacteria among all age groups, according to the CDC.