Literature Review

HHS issues new rule to strengthen nondiscrimination protections and advance Civil Rights in health careHHS Press Office; 4/26/24Today, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and the Centers for Medicare & Medicaid Services (CMS) issued a final rule under Section 1557 of the Affordable Care Act (ACA) advancing protections against discrimination in health care. By taking bold action to strengthen protections against discrimination on the basis of race, color, national origin, sex, age, and disability, this rule reduces language access barriers, expands physical and digital accessibility, tackles bias in health technology, and much more.

E-book: "Combating loneliness in senior living residents: A call to action"McKnights Senior Living; 4/24/24Discover in [this] e-book:

45 top healthcare workplaces for mental well-being: Newsweek Becker's Hospital Review; by Alexis Kayer, 4/22/24Newsweek has named 45 hospitals and health systems among its 750 greatest employers for mental well-being. The publication partnered with data researchers Plant-A to rank the top U.S. workplaces "making a positive difference in the mental wellness of their workers," according to a five-stage evaluation. ... Here are the 45 hospitals and health systems included on the list, excluding organizations that exclusively provide long-term, hospice, rehabilitative and medical care, or staffing and management services: [Click on the title's link for the list.]Editor's Note: Is your organization on the list? Or perhaps a colleague's organization? Forward this to them with your congratulations! Invite them to join our newsletter for free at www.HospicePalliativeCareToday.com/registration.

UK survey finds 65% of adults are worried about access to palliative care Medical Xpress; by King's College London; 4/30/24 A survey commissioned by King's College London, and carried out by YouGov, has found that 65% of people across the U.K. are worried about access to palliative and end of life care, and 41% think there is too little NHS resource allocated to palliative care. The survey of 2,164 adults across the U.K. was commissioned by the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King's to explore people's knowledge and experiences of palliative and end of life care. ... Findings from the survey conducted in January 2024 show that nearly a quarter of people (24%) across the U.K. say they don't know much about or have not heard of palliative care, with disparities in knowledge between white and ethnic minority groups.

Saturday newsletters focus on headlines and research - enjoy!

Social Model Hospice: Providing hospice and palliative care for a homeless population in Salt Lake City, UtahJournal of Hospice & Palliative Nursing; by Francine Bench Jensen, PhD, RN; Deborah Thorpe, PhD, APRN; 4/24Abstract:  Health care for the homeless population is a complex challenge and represents a significant gap in care, particularly for those at the end of life. Hospice care may be desired but is rarely an option for people without residences, social support, and payment sources. Social model hospice is a unique paradigm of care delivery that offers a viable solution to make hospice and palliative care possible for this population. ... Recommendations for establishing social model hospices are made: key strategies include identifying stakeholders dedicated to alleviating end-of-life homelessness needs, doing a formal needs assessment to identify community resource deficits, and forming mentoring relationships with established programs.

Substance use disorders in hospice palliative care: A narrative review of challenges and a case for physician interventionCambridge University Press; by Lauren Rudy and Emilie Lacroix; 2/29/24Objectives: Substance use disorders (SUDs) are frequently encountered in hospice palliative care (HPC) and pose substantial quality-of-life issues for patients. However, most HPC physicians do not directly treat their patients’ SUDs due to several institutional and personal barriers. ...Results: ... Recommendations for physicians and training environments to address these challenges include developing familiarity with standardized SUD assessment tools and pain management practice guidelines, creating and disseminating visual campaigns to combat stigma, including SUD assessment and intervention as fellowship competencies, and obtaining additional training in psychosocial interventions.

When a parent dies: A scoping review of protective and risk processes for childhood bereavementDeath Studies; by Rebecca Hoppe, Marcia A. Winter, Chelsea D. William, and Irwin Sandler; 4/15/24Abstract: The death of a parent can have profound effects on child development. ... A scoping review was conducted in samples of parentally bereaved children to identify key processes, synthesize results, and determine research gaps. This scoping review identified 23 studies (mainly from the United States), published between 1990 and 2023, that reported child (ages 3–22 years) individual and/or environmental protective and/or risk processes that contributed to bereavement outcomes. Findings can be used to apprise clinicians, families, and policymakers of the unique nature of childhood bereavement and to identify malleable processes to target in interventions designed to prevent problematic outcomes in bereaved children.Funding: This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development through the Ruth L. Kirschstein National Research Service Award [F31HD110247].

What's in the Black Box of a successful nurse and social worker team palliative telecare intervention (ADAPT)? (RP317)Journal of Pain and Symptom Management; by Lyndsay DeGroot, PhD, RN, CNE; Kevin Wells; Brianne Morgan, BSN; Michelle Upham, MSW, LICSW; David B. Bekelman, MD, MPH; 5/24Key Message: A nurse and social worker palliative telecare team provided structured symptom management, psychosocial care, and individualized medical changes to improve quality of life, depression, and anxiety for patients with COPD, HF, and ILD. Impact: A nurse and social work palliative telecare team used collaborative care to tailor recommendations to the unique needs and symptoms of each patient, thereby improving quality of life.

Home care clinicians' perspectives on Advance Care Planning for patients at risk for becoming incapacitated with no evident advance directives or surrogates Journal of Hospice & Palliative Nursing; by Landau, Aviv Y. PhD, MSW; Venkatram, Chinmayi BA; Song, Jiyoun PhD, AGACNP-BC, APRN; Topaz, Maxim PhD; Klitzman, Robert MD; Shang, Jingjing PhD; Stone, Patricia PhD; McDonald, Margaret MSW; Cohen, Bevin PhD; 4/24 Abstract: ... This qualitative descriptive study elicited perspectives of home health nurses and social workers regarding barriers and facilitators to creating advance care plans in home health settings, with particular attention to patients with few familial or social contacts who can serve as surrogate decision-makers. ...  Participants reported a multitude of barriers to supporting patients with advance care planning at the provider level ... Participants noted that greater socialization and connection to existing educational resources regarding the intended purpose, scope, and applicability of advance directives could benefit home care patients.

Shocked at end-of-life: An educational video for hospice workers about Implantable Cardioverter-Defibrillators Journal of Pain and Symptom Management; by Sarah Godfrey, MD, MPH; Christine L. Chen, MD; Melanie S. Sulistio, MD; Sharika Kumar, MD; and Kelley Newcomer, MD; 2/24 Introduction: Hundreds of thousands of patients with implantable cardioverter-defibrillators (ICDs) die yearly. Though ICD shocks can be lifesaving, they can also be severely painful. One third of ICD patients are shocked in the last day of life irrespective of DNR status. Over 97% of hospice programs admit patients with ICDs, yet only 10% have deactivation policies and less than 50% of hospice patients have their ICD deactivated. ...  Conclusion: Hospice personnel have limited knowledge about ICDs, prohibiting best care of patients with these devices at EOL. A short educational video increased knowledge and may serve as a helpful tool. Improving ICD knowledge amongst hospice personnel is essential to ensuring the unique needs of hospice patients with ICDs are met.

Prioritizing patient care: Medical technology innovations on the horizon MedCityNews; by Dhaval Shah; 5/1/24 The MedTech industry is poised for breakthroughs, owing to the rapid integration of digital ecosystems and technologies like AI and cloud. 2023 was a banner year for MedTech, especially in terms of technological innovations. Incidentally, it also witnessed the largest ever number of FDA approvals on novel medical devices in a single year. This list included a number of AI-enabled MedTech products, among others. ... Three key areas are continuing to shape the industry: 

MultiPlan, insurance giants sued over out-of-network rates Modern Healthcare; by Nona Tepper; 4/29/24 A rural health system sued technology company MultiPlan and eight of the country's largest insurance companies over alleged schemes to strongarm providers into accepting low out-of-network rates. At issue in the proposed class-action suit are MultiPlan's repricing tools, which allegedly rely on insurers' data to deflate their out-of-network reimbursement payments.