Literature Review

Patient experiences of specialty palliative care in the perioperative period for cancer surgery Journal of Pain and Symptom Management; by Laura M Holdsworth, Rachel Siden, Anna Sophia Lessios, Mae Verano, Elizabeth Rickerson, Bridget Fahy, Fabian M Johnston, Brittany Waterman, Rebecca Aslakson; 6/19/24 online ahead of print  Context: Though patients undergoing treatment for upper gastrointestinal (GI) cancers frequently experience a range of sequelae and disease recurrence, patients often do not receive specialty palliative care soon after diagnosis and it is unknown in what ways they may benefit.  Results: We found five themes that characterized patient experiences and perceptions of specialty palliative care. Patients typically had limited prior awareness of palliative care (theme 1), but during the study, came to understand it as a "talking" intervention (theme 2). Patients whose concerns aligned with palliative care described it as being impactful on their care (theme 3). However, most patients expressed a focus on cure from their cancer and less perceived relevance for integration of palliative care (theme 4). Integrating specialist palliative care practitioners with surgical teams made it difficult for some patients to identify how palliative care practitioners differed from other members of their care team (theme 5).

The two phases of hospice—Declining Phase and Terminal PhaseJournal of Palliative Medicine; by Roy Zagieboylo, MD; 6/24I propose that hospice care should be identified as Declining Phase or Terminal Phase hospice care. ... In the Declining Phase, patients will usually have a gradual deterioration in function requiring more and more care. ... As many patients progress and their bodies fail, they may enter the Terminal Phase of hospice care. This phase is identified by the patient and family and is that time when the quality of life is so poor, there is no goal to increase the number of days alive. ... If, upon referral to hospice, a doctor was routinely asked “Is this a Declining Phase or Terminal Phase referral?” it would encourage discussion, education, and possibly a better understanding of the full scope of hospice care. If the nomenclature became widespread, it would also help patients and families better understand, appreciate, and accept earlier hospice referrals.

The presence of implantable cardioverter defibrillators is rarely addressed during code status changeAmerican Journal of Hospice and Palliative Medicine; by Namratha Seetharam Meda, MBBS, Watipa Makhumalo, MD, Hunter Groninger, MD, Clint Pettit, MD; 6/24Implantable Cardioverter Defibrillators (ICDs) are used to prevent sudden cardiac death, but they may provide unwanted shocks during end-of-life care. We aimed to study the frequency at which Do Not Resuscitate (DNR) discussions address ICD preferences in high-risk patients. ... ICD discussions were rarely documented in our high-risk population, highlighting a potential need for better in-chart visibility of ICDs and for focused education of clinicians who care for these patients at end of life.

How do enrollees feel about support in Big Hospices? - The caregiver experience of emotional, spiritual, and bereavement support by profit status among large US providersPalliative and Supportive Care; by Jason T Hotchkiss, Emily Ridderman, Brendan T Hotchkiss; 4/24Recent findings narrate profiteering detrimentally impacting hospice care quality. However, no study has examined the caregiver experience of emotional and spiritual support expressed online. The purpose was to evaluate the hospice caregiver's experience of emotional, spiritual, and bereavement support and whether the care was respectful and compassionate to the care unit. ... Compassionate professionals were thanked and praised regardless of profit status. Sadly, anger was expressed toward large, for-profits more fixated on census than emotional, spiritual, and bereavement support; thankfully nonprofits were more supportive.

Saturday newsletters focus on headlines and research - enjoy!

HHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?

Other Business Headlines of Interest, updated 6/27/24 per nasdaq.com

7 of the top tech and IT jobs in demand for the future TechTarget; by David Weldon; 6/24/24 Businesses of the future will rely on workers with IT skills even more than they do today. Find out which jobs might be most in demand and what those roles entail. ... Organizations are having to create new tech roles and redefine existing ones to manage the integration of AI and data into core business functions. Meanwhile, cybersecurity continues to be a top concern, as do digital transformation and cloud computing. These challenges are increasing the demand for job roles that merge technical expertise with strategic business acumen. ... So, what will be some of the hottest IT jobs of the future? ... Roles are listed in alphabetical order. 

Fixing the hospital-to-home health care transition Home Health Care News; by Andrew Donlan; 6/25/24 The transition between hospital discharge and home health care is often fraught with issues. Unfortunately, it also happens to be one of the most crucial parts of a patient’s care journey. With more sick and complex patients coming into home health care than ever, a swift start of home health care is also arguably more important than ever. ... The Discharge to Assess (D2A) Model was a response to this issue in England. The Supporting Older Adults at Risk (SOAR) program, following a similar framework to D2A, was also recently established in the U.S. A study of SOAR’s results within a pilot program in Pennsylvania was recently published in the Journal for Healthcare Quality.

CHAP Pediatric Care CertificationCHAP press release; 6/27/24Join the movement and shape the future of pediatric care. As an independent, nonprofit accrediting body for home and community-based healthcare organizations, CHAP is proud to offer the Pediatric Certification at no extra cost for CHAP-accredited providers. Standards available here.

9 recent hospital, health system CEO moves Becker's Hospital Review; by Kelly Gooch; updated 6/18/24The following hospital and health system CEO moves have recently been reported by Becker's:

Chronic loneliness can raise stroke risk in older adults, findings show McKnights Long-Term Care News; by Kristen Fischer; 6/24/24 A new study links loneliness to stroke risk, showing that those who are regularly lonesome have a 56% higher risk for stroke than those who are more socially connected. Situational loneliness wasn’t linked to a higher risk for stroke, which indicates that the stroke risk stems from chronic loneliness. Investigators led by a team from Harvard T.H. Chan School of Public Health published their report Monday in eClinicalMedicine. Research has already linked loneliness to an increased risk for cardiovascular disease. The new report is one of the first to evaluate the association between loneliness and stroke risk.

Nonprofit hospice to add 12-bed inpatient floor at its Colorado Springs headquarters The Gazette, Colorado Springs, CO; by Debbie Kelley; 6/26/24 Pikes Peak Hospice & Palliative Care — which holds the titles of the region’s only nonprofit hospice and the only inpatient provider of end-of-life services — is adding 12 family suites for inpatient care at its headquarters in Colorado Springs. “The benefit of us being able to design something on our own is it removes that hospital-type setting and makes it a homelike experience,” said Andy Petersen, executive director of the Pikes Peak Hospice Foundation, the organization’s separate fundraising arm. “It’s going to be a great service for the community.” The first floor of the organization’s large two-story building at 2550 Tenderfoot Hill St. off Lake Avenue will undergo an $8.5 million renovation and be transformed into an Inpatient Care Center.