Literature Review

Making end-of-life health disparities in the U.S. visible through family bereavement narrativesPEC Innovation; by Cassidy Taladay-Carter; 4/24End-of-life experiences can have important implications for the meaning-making and communication of bereaved family members, particularly due to (in)access to formal healthcare services (i.e., palliative care and hospice). Grounded in Communicated Narrative Sense-Making theory, this study extends knowledge about how the stories told about end-of-life by bereaved family members affect and reflect their sense-making, well-being and importantly, potential disparities in end-of-life care. ... Four themes illustrated the continuum of communication that families engaged in when making sense of end-of-life experiences, including reflections on silence, tempered frustrations, comfort with care, and support from beyond.

"It's a heavy thing to carry": Internal medicine and pediatric resident experiences caring for dying patientsAmerican Journal of Hospice and Palliative Medicine; by Lindsay M Gibbon, Laura Buck, Lauren Schmidt, Jori F Bogetz, Amy Trowbridge; 5/24Our data suggests a model for the process by which residents learn affective skills critical to EOL care: residents (1) notice strong emotion, (2) reflect on the meaning of the emotion, and (3) crystallize this reflection into a new perspective or skill. Educators can use this model to develop educational methods that emphasize normalization of physician emotions and space for processing and professional identity formation.

Keeping life in our patients’ years toward the end of our patients’ livesAnnals of Surgery; by Courtney Collins, Ronnie A Rosenthal; 5/24As surgeons we are trained, some may say indoctrinated, to care about traditional benchmarks like wound infections, the need for critical care, 30-day readmissions, and (of course) mortality. These factors are obsessively collected and analyzed looking for any and all possible opportunities to move the needle of surgical quality by even the tiniest amount (as long as it is statistically significant). To be sure, this approach has yielded vast improvements in how we care for our patients and correspondingly, surgical outcomes have continued to improve over time. This intriguing analysis by Keney et al asks us to consider that in our pursuit of perfection by standard definitions, we may be missing something even more critical: what “good” looks like from the patient’s point of view.

Saturday newsletters focus on headlines and research - enjoy!

Measuring decision aid effectiveness for end-of-life care: A systematic reviewPEC Innovation; M. Courtney Hughes, Erin Vernon, Chinenye Egwuonwu, Oluwatoyosi Afolabi; 4/24A total of 715 articles were initially identified, with 43 meeting the inclusion criteria. Outcome measures identified included decisional conflict, less aggressive care desired, knowledge improvements, communication improvements, tool satisfaction, patient anxiety and well-being, and less aggressive care action completed. The majority of studies reported positive outcomes especially when the decision aid development included International Patient Decision Aid Standards.

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.

Executive Personnel Changes - 4/26/24

Survey illustrates value of quality onboarding programs at home care firms McKnights Home Care, by Adam Healy; 4/24/24 Investing in a robust, high-quality onboarding and training program can yield big returns for home care firms, especially when workers are in short supply, according to a new survey report by healthcare technology company Viventium. The firm surveyed 175 administrators and 220 caregivers working at post-acute care firms. It found that caregivers are nearly 90% more likely to feel secure in their employment and be more engaged with their work after having a good onboarding experience. These positive results can lead to lower turnover rates and better-trained employees, according to the report.

AI could play role in preventing prescribing of unnecessary drugs in older adults McKnights Senior Living, by Kristen Fischer; 4/22/24 A new study finds that artificial intelligence could encourage doctors to stop prescribing drugs that aren’t necessary — especially in older adults, who tend to be on multiple medications. The report was published 4/18 in the Journal of Medical Systems. More than 40% of older adults are taking five or more prescription medications, a rate that raises their risk for potentially harmful drug interactions. ... AI isn’t a perfect tool compared with having an actual doctor. For instance, it tended not to pay much attention to a person’s pain level, suggesting that the patient stop taking pain medications but not others for clinical ailments such as high cholesterol or high blood pressure, the authors reported.

Hospice groups, AOs speak out on proposed Accreditor Oversight Rule Hospice News; by Jim Parker; 4/22/24Some accreditation organizations (AOs) have balked at the U.S. Centers for Medicare and Medicaid Services’ (CMS) proposed rule designed to strengthen oversight of those institutions. ... Three such organizations currently have deeming authority for hospices, The Joint Commission, the Accreditation Commission for Health Care (ACHC) and Community Health Accreditation Partner (CHAP). These accreditors have joined a host of other stakeholders in making public comments on the proposed rule, with some requesting clarifications and others outright denying that CMS has the authority to establish such requirements.

Eagle Telemedicine announces solution to counter lack of palliative careCision, PRNewswire-PRWeb; by Eagle Telemedicine; 4/25/24 Eagle Telemedicine adds new specialty to increase access to life-saving palliative care in underserved communities. ... Only 71% of U.S. hospitals provide palliative care and metropolitan hospitals are 15% more likely to offer palliative care than rural hospitals (National Institute of Health). Through Eagle's Tele-Palliative Care, hospitals everywhere can offer this next level of care, any day of the year.

Other Business Headlines of Interest, updated 4/25/24 per nasdaq.com

Missoula's first end-of-life center taking shape amid fundraising MissoulaCurrent., by Martin Kidston; 4/24/24 ... Missoula's first dedicated hospice center broke ground last June and is well on its way to opening early next year. The 15,000 square-foot facility has been planned down to the finest detail, from the play of lighting and sound in each room to a reflection center, with end-of-life literature and bereavement support for families. “Missoula has one of the fastest aging and oldest populations in the country. Not only that, we have a vast expanse of area to cover,” said Amanda Melro [Executive Director, Partners of Hope Foundation] . “People live in rural areas and they also live alone. Having a place like this where a family knows they'll be well-taken care of is a huge asset for them. We expect there will be a large demand for the beds.”