Literature Review

Reducing central nervous system–active medications to prevent falls and injuries among older adults-A cluster randomized clinical trialJAMA Open Network; Elizabeth A. Phelan, MD, MS; Brian D. Williamson, PhD; Benjamin H. Balderson, PhD; Andrea J. Cook, PhD; Annalisa V. Piccorelli, PhD; Monica M. Fujii, MPH; Kanichi G. Nakata, PhD; Vina F. Graham, BS; Mary Kay Theis, MA, MS; Justin P. Turner, PhD; Cara Tannenbaum, MD, MSc; Shelly L. Gray, PharmD, MS; 7/24This cluster randomized clinical trial found that a health system–embedded deprescribing intervention was no more effective than usual care in reducing medically treated falls among community-dwelling older adults prescribed CNS-active medications. For health systems that attend to deprescribing as part of routine clinical practice, additional interventions may confer modest benefits on prescribing without a measurable effect on clinical outcomes.

Fairness in predicting cancer mortality across racial subgroupsJAMA Open Network; Teja Ganta, MD; Arash Kia, MD; Prathamesh Parchure, MSc; Min-heng Wang, MA; Melanie Besculides, DrPH; Madhu Mazumdar, PhD; Cardinale B. Smith, MD; 7/24In this cohort study, a machine learning [ML] model to predict cancer mortality for patients aged 21 years or older diagnosed with cancer ... was developed. ... The lack of significant variation in performance or fairness metrics indicated an absence of racial bias, suggesting that the model fairly identified cancer mortality risk across racial groups. The findings suggest that assessment for racial bias is feasible and should be a routine part of predictive ML model development and continue through the implementation process.

Saturday newsletters focus on headlines and research - enjoy!

Updated Care Compare for Hospice ReleasedCMS website; 8/28/24Publisher's note: See link above to access updated Care Compare for Hospice publicly reported quality measures.

Rounds with Leadership: Focusing on the outcomes of NP practice American Association of Colleges of Nursing - The Voice of Academic Nursing; by American Colleges of Nursing (AACN); 8/28/24 ... In a synopsis of more than 50 research studies, the American Association of Nurse Practitioners found that patients under the care of NPs have fewer unnecessary hospital readmissions, higher patient satisfaction scores, and fewer unnecessary emergency room visits than patients under the care of physicians only. Recent studies have shown that ... NPs engaging in end-of-life care had fewer hospitalizations and higher hospice use; ... Despite such compelling evidence, challenges to NP education and practice continue. More than 20 states have yet to grant full scope of practice authority to NPs, denying these expert clinicians the opportunity to exercise the full range of their clinical expertise.

This was the year advanced practice nurses thought they’d get full practice authority in NC. They were wrong.NC Health News - NC Board of Nursing; by TwumasiD-Mensah; 8/29/24 Every so often, Megan Conner, a nurse anesthetist in Greenville said she sees a patient who’s driven for hours to come for a screening colonoscopy but who instead has to be sent to the emergency department. ... It frustrates Conner that so many patients, who have to travel sometimes hours for care in eastern North Carolina, end up not getting it because of common ailments they can’t get treated closer to home.That’s why Conner is a big believer in the Safe, Accessible, Value-directed and Excellent Health Care Act (SAVE Act), which would give advanced practice registered nurses (APRNs) like her full practice authority. She argues the data show that more nurse practitioners would provide primary care in rural North Carolina if the state would give them autonomy to practice, bringing care to small burgs that often go without. And now, the demands for care are being driven by hundreds of thousands of patients newly eligible for care because of Medicaid expansion. Along with a growing number of lawmakers who believe the legislation is overdue, advanced practice nurses thought this would be the year that the SAVE Act finally passed. They were wrong. [Click on the title's link to continue reading.]

Grief Memoir: ‘It was my turn to do everything for her We Are The Mighty; by Jessica Hall; 8/28/24 ... I joined the phone call with the doctor where he told us all the worst news. The cancer was growing everywhere along the spine. ... He told us that it was time for hospice. ... Even though I had been preparing for this for months, I was truly not ready to go from child to caretaker. ... For my entire life, my mom had cared for me. She had been there when I was sick or hurt. She cleaned my house (sometimes to my chagrin). She cooked my favorite meals and she let me take breaks. Now it was my turn to do everything for her. It hit me like a ton of bricks, but I also just knew that I had to do it. We all had to do everything for her to make her final days easy for her. Hospice came by to get everything set up. ... [Click on the title's link to continue reading this beautiful, personal story.]Editor's Note: Calling all hospice executive leaders who do not have clinical, direct patient care experience--read this article to grasp common family dynamics, decisions, actions, emotions, and life-changing moments for each patient you serve. Multiply this out for the many family members of each patient you serve. How do your hospice services tune into and support these family members?

Bon Secours Mercy Health partners with private equity-owned provider[VA] VPM; by Adrienne Hoar McGibbon; 8/27/24There is a growing demand for hospice care in Virginia. 40,000 people received hospice care in the state in 2023, according to the U.S. Centers for Medicare and Medicaid Services. The joint venture with Compassus plans for expanded hospice and home health care. Bon Secours Mercy Health’s home health and hospice care division is teaming up with national home health care provider Compassus as part of a newly minted partnership. The home health and hospice program will now be called Bon Secours Home Care and Hospice by Compassus... The merger will also impact BSMH locations in Florida, Illinois, Kentucky, Ohio and South Carolina.

Year-over-year health spending growth highest ‘by far’ for home healthcare McKnights Senior Living; by Lois A. Bowers; 7/28/24 Year-over-year growth in national health spending in June was highest “by far” for home healthcare, at 20.9%, compared with other major healthcare categories, according to a brief issued late Tuesday by Altarum. Most of the growth, 18.5 percentage points, was due to changes in utilization rather than price, George Miller, PhD, Altarum fellow and research team leader, told the McKnight’s Business Daily. “Nursing home care spending was a distant second, at 10.0% year-over-year growth,” Miller said. By comparison, year-over-year spending growth was 8.3% for prescription drugs, 8.2% for hospital care, 7.3% for dental services and 6.6% for physician and clinical services, according to the report. Overall, spending on healthcare goods and services grew by 8.1% between June 2023 and June 2024, with utilization growth continuing to outpace price growth.

Awards and Recognitions: August 2024 We congratulate these honorees and celebrate their contributions to our collective hospice and palliative care mission, vision, and compassionate care throughout our world. Do you know any of these leaders? We encourage you to forward this to them or to find another way to celebrate their success. (We are piloting this as a monthly feature in Hospice & Palliative Care Today.)

$83M fraud case against nursing home group may proceed, with no defendants excusedMcKnight's Long-Term Care News; by Jessica R. Towhey; 8/27/24A New York Supreme Court judge threw out all arguments from lawyers for an embattled group of nursing homes that sought to have charges dismissed in a case accusing the owners and operators of $83 million in Medicare and Medicaid fraud. Judge Melissa Crane ruled that the owners of Centers Health Care, along with numerous other individuals, did not make sufficient arguments for dropping charges of fraud, “saddling” nursing homes with “excessive debts,” colluding to pay “sham vendors,” and paying themselves “inflated” salaries.

Hospice patient publishes first poetry book BBC News, Derby, United Kingdom; by Jude Winter; 8/26/24 A woman receiving end-of-life care has fulfilled an ambition by publishing a book of poems. Sarah Colina started writing the poems more than 40 years ago but never got round to getting her work published despite encouragement from friends and family. The 60-year-old has been receiving care at Ashgate Hospice since being admitted to its Inpatient Unit in Old Brampton, Chesterfield. ... he added staff at the hospice had been "so supportive" and is selling 50 of her books to raise money to support their work. "I’m hoping it will be nicely received and people will enjoy reading my poems", said Ms Colina. She added: "Some of the poems are very dark, but some make you laugh. "I'm hoping it gives people an insight into their inner person."