Literature Review

Examining how improper payments cost taxpayers billions and weaken Medicare and Medicaid HHS-OIG; by Christi A. Grimm, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services; 4/16/24 HHS Inspector General Christi A. Grimm Testifies Before the U.S. House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations on April 16, 2024. IG Grimm briefs members on HHS-OIG's work to address improper payments in Medicare and Medicaid managed care programs. Click here to watch the testimony.

“To prescribe or not to prescribe, that is the question”: Perspectives on opioid prescribingfor chronic, cancer‐related pain from clinicians who treat pain in survivorshipCancer, by Hailey W Bulls, Megan Hamm, Julia Wasilewski, Donna Olejniczak, Sarah G Bell, Jane M Liebschutz; 4/24Opioid pain management in cancer survivorship is a complex and understudied topic. ... Participants suggested that opportunities to improve chronic cancer pain care include developing clear, systematic guidance for chronic cancer pain management, facilitating clinician communication and consultation, creating tailored survivorship care plans in partnership with patients, and developing accessible, evidence-based, complementary pain treatments.

A process evaluation of a palliative care social work intervention for cancer patients in skilled nursing facilitiesJournal of Palliative Medicine, by Sarguni Singh, MD; Ashley Dafoe, MA; Dana Lahoff, LCSW; Laurel Tropeano, LCSW; Bree Owens, LCSW; Erin Nielsen, LCSW; John Cagle, MSW, PhD; Hillary D. Lum, MD, PhD; Brooke Dorsey Holliman, PhD; Stacy Fischer, MD; 4/24Assessing and Listening to Individual Goals and Needs (ALIGN) is a palliative care social work intervention that aims to improve delivery of goal-concordant care for hospitalized older adults with cancer discharged to skilled nursing facilities. ... ALIGN offers support in prognostic understanding, communication, and decision making during a pivotal time when patient and caregivers' goals have not been met and they are reassessing priorities.

Executive Personnel Changes - 4/19/24

LGBTQ+ individuals have higher rates of cancer because of disparities in modifiable risk factors, ACS says ONS Voice [Oncology Nursing Society]; by Magdalen Millman; 4/18/24 About 7% of the U.S. population identifies as LGBTQ+, but understanding cancer in this population is difficult because surveillance data are limited to national surveys on risk factors and screening, the American Cancer Society (ACS) observed in a special section of its Cancer Facts and Figures 2024 report on cancer in the LGBTQ+ community. More than 50% of LGBTQ+ individuals have experienced harassment such as slurs, violence, microaggressions, and sexual harassment, even in healthcare settings. “One in 6 LGBTQ+ adults, and 1 in 5 transgender adults specifically, avoid health care due to previous discrimination,” ACS reported. It’s one factor implicated for the disparities affecting LGBTQ+ individuals’ access to cancer care, including prevention, screening, diagnosis, treatment, and palliative care. Editor's Note: Click here for this site's downloadable pdf, Cancer Facts and Figures 2024, Special Section: Cancer in People Who Identify as Lesbian, Gay, Bisexual, Transgender, Queer, or Gender-nonconforming. Pair this with another article in today's newsletter, "Stillwater Hospice earns SAGECare credential for LGBTQ+ care."

Volunteers make best days possible for 600 people a day at VNA Hospice NWIGreatNews.Life, Valparaiso, IN; 5/19/24VNA Hospice NWI serves over 600 people a day. From Hospice and Palliative Care, Grief Support services for adults and children to the Medical Guardian help button and a Meals on Wheels program, the impact of VNA services around the region is tremendous. The VNA staff work tirelessly to ensure these essential services are available each day – but they can’t do it alone. Their team relies on an army of volunteers, who do everything from stuffing envelopes and labeling meal bags, to working directly with hospice patients and bereaved children, and delivering the meals. Maria Galka, Director of Development for VNA Hospice, said that the organization’s volunteers outnumber its staff by about five to one. Editor's Note: April's Volunteer Appreciation Month is still underway. Learn from this superb article, posted on an online community site. VNA Hospice NWI's astonishing volunteer program bears repeating: "... the organization’s volunteers outnumber its staff by about five to one."

The best portion of a good person's life are the little, nameless, unremembered acts of kindness and of love. ~adapted from William Wordsworth

Lens X: A practical approach to taking care of your peopleThe Journal of Character & Leadership Development, by Daphne DePorres, Matthew Orlowsky, Matthew Horner, David Levy; 4/24Graduates of the United States Air Force Academy (USAFA), as commissioned officers, are charged to “take care of their people.” While this leadership aphorism makes sense, this article describes what it means in practice.  An  interdisciplinary  USAFA  team  explored  the  dynamics  of  leader  development  from  multiple  angles, resulting in a focus on two dimensions (or “lenses”) that help a leader understand what actions can be taken to help an employee achieve subjective well-being at work. The intent is to draw attention to the nature of the interaction with organizational members that foster engagement and need fulfillment. We do that by focusing a leader’s attention on needs, narratives, and micro-exchanges. Those interactions, behav-iors, and micro-exchanges are the foundations of and the most tangible, changeable element of climate and culture. This practical lens equips any leader to seize every opportunity to foster fulfillment of the psychological needs for belonging, agency, and efficacy. This framework can be used by anyone but is particularly relevant to supervisors and USAFA cadets who will be entrusted to lead an all-volunteer military force.Publisher's note: An interesting article on leadership and change management by my friend and colleague Dave Levy, PhD, Professor of Management and Leadership at the US Air Force Academy. He also co-authored three books: The 52nd floor: Thinking deeply about leadership, Attitudes aren't free: Thinking deeply about diversity in the US Armed Forces and Echoes of mind: Thinking deeply about humanship.

Automated electronic health record score to predict mortality risk at the US Department of Veterans AffairsAmerican Journal of Hospice and Palliative Medicine, by Thomas F Osborne, Zachary P Veigulis, Anna Ware, David M Arreola, Catherine Curtin, Marianne Yeung; 4/24A readily available risk score, automatically calculated from EHR data, was able to identify patients at high risk for 30-day mortality in the acute care setting. Next steps will be to assess how the CAN score can be utilized to in improve end of life care for high-risk hospitalized Veterans.

How do people in prison access palliative care? A scoping review of models of palliative care delivery for people in prison in high-income countriesPalliative Medicine, by Emma Gilbert, Nick De Viggiani, Joana de Sousa Martins, Tanuka Palit, Jessica Sears, Daniel Knights, Audrey Roulston, Mary Turner, Lucy E Selman; 4/24We identified a typology of three models of care delivery for people in prison in high-income countries: (1) Embedded hospice model, typified by an interdisciplinary team and volunteer caregivers providing care on-site; (2) Outsourcing Care model, in which end-of-life care is provided outside the prison; (3) Collaborative community model, which involves prisons engagement with other healthcare facilities or practitioners. ... Embedded hospice models in the USA are prevalent and demonstrate promising evidence for enhancing the care experience for recipients and peer caregivers. Chaplains, social workers and peer caregivers provide psychosocial support, yet documented assessment and strategies for managing the distinctive needs of this group and their families are lacking, despite their acknowledged complexity.

We are what we repeatedly do. Excellence, then, is not an act but a habit. ~Aristotle

Value of a multidisciplinary geriatric oncology committee on patient care in a community-based, academic cancer centerJournal of Geriatric Oncology, by Gurbani Singh, Lena Morant, McKenzie Bedra, Jennifer Emel, Kelly Harris, Yudhishtra Markan, Christopher de Borja, Monica Tong, Patrice Downs, Cherif Boutros; 5/24The present study demonstrates the profound impact that the complexities in health status and frailty among older individuals can have during cancer management. The Geriatric Oncology Program at the University of Maryland Baltimore Washington Medical Center maximized treatment outcomes for older adults through the provision of standard oncologic care therapies and optimization services, while also minimizing unnecessary interventions on an individual patient-centric level.

Strategies to enhance the affordability of hospice and palliative care servicesDigital Commons @ University of South Florida - Annual Undergraduate Research Conference, by Jhanav Sabharwali, Roy Chen, Valerie Vargas Ardila (mentor Dr. Irene Hurst); 4/24This research aims to find efficient solutions to aid affordability in vulnerable populations, specifically the hospice and palliative care population.Publisher's note: Interesting topic for an undergraduate research conference!