Literature Review

Children’s Healing Center opens in Ypsilanti Township in July DBusiness Magazine, Detroit, MI; by R. J. King; 6/24/24 The Children’s Healing Center will open its doors in Ypsilanti Township on July 8, offering children with weakened immune systems and their families a safe and clean place to play. ... The facility is the Children’s Healing Center’s second location after first opening its doors in Grand Rapids in 2015. The new state-of-the-art 11,000-square-foot facility features a hospital-grade environment where families can engage in a diverse range of innovative programming free of charge. “It has always been our goal to open a second location of the Children’s Healing Center,” says Amanda Barbour, founder and CEO of Children’s Healing Center. “The kids, young adults, and families who rely on us have very few options for social interaction, so we provide an invaluable outlet to build friendships and fight the effects of isolation and loneliness. The Children’s Healing Center states it is a first-of-its-kind year-round recreational facility for kids and young adults aged 0-26 with weakened immune systems and their families that provides opportunities for play, programming, education, and socialization. 

Improving advanced care planning for late-stage cancer Medical Xpress; by Melissa Rohman; 6/24/24 Multilevel care interventions improved clinician–documented advanced care planning (ACP) compared with a clinician-level intervention alone for patients with genitourinary cancer, according to findings published in JAMA Oncology. "Clinicians often have limited time to assist patients in fully understanding ACP. This intervention is one approach to improve ACP and care delivery among patients with advanced stages of genitourinary cancer," said Gladys M. Rodriguez, MD, MS, assistant professor of Medicine in the Division of Hematology and Oncology and lead author of the study. For patients diagnosed with late-stage cancer, ACP can help reduce unnecessary acute care, increase palliative care and improve quality of life. However, previous reports have found that less than 20% of patients will engage in ACP with their health care providers. ... The primary outcome was ACP documentation in the electronic health record by the patient's oncology clinician within 12 months. Secondary outcomes included shared decision-making, palliative care use, hospice use, emergency department visits and hospitalizations within 12 months.

Reflections: Three ways to think about death and dyingPost Alley, Seattle, WA; by Anthony B. Robinson; 6/21/24Our book group had a wrap-up session on our “Aging and Mortality” series last night. We invited everyone to share their own take-aways from our six books. What did we learn? What was comforting? Challenging? How might this effect your planning and decision-making? Before I share my own take-aways from the series, I would note one general theme in what we read: the more we isolate death and the dying, the more we fear death. Here my three take-aways from the series and our conversations:

Lawmakers remain committed to passing hospice workforce bill Hospice News; by Jim Parker; 6/24/24 Federal legislators plan to continue to work on passing a bill designed to bolster the hospice and palliative care workforce. The Palliative Care and Hospice Education Training Act (PCHETA) has come before Congress several times but has not yet been passed. The bill’s most recent development occurred in July 2023, when it was reintroduced by Sens. Tammy Baldwin (D-Wisc.) and Shelley Moore Capito (R-W.Va.). Capito has indicated that the senators are not giving up on the legislation as they seek to ensure that hospice and palliative care providers are able to meet growing demand. ... The legislation would establish fellowships through new palliative care and hospice education centers to provide short-term, intensive training, as well as incentivized award programs across all the relevant disciplines. It also would support programs to develop career paths within the field.

Private equity investment in assisted living: Distinct impacts and policy considerationsHealth Affairs; by Kali S. Thomas, John R. Bowblis, Paula Carder, Cassandra Hua, Sean Shenghsiu Huang, Yashaswini Singh, Lindsey Smith, Momotazur Rahman; 6/18/24Numerous academic publications, newspaper articles, and government reports have addressed private equity (PE) investment in health care entities, including nursing homes, hospitals, and physician practices. Proponents argue PE investment brings much-needed financial capital, allowing health care providers to renovate aging facilities, invest in the latest technology, spur innovation, and enhance operational efficiency. However, there are also concerns that PE investment has been associated with higher prices, lower quality, and inadequate staffing levels. Such changes could lead to patient harm, even death. ... However, one significant and continually expanding sector—assisted living—has several distinct features that, compared to other health care entities, may lead to different outcomes from PE investments. Assisted living is paid for differently. In relation to PE investments, the arrangement of assets and operations in assisted living are different from other health care sectors. This distinction creates unique and more nuanced incentives. Crucially, there’s actually no evidence to date on the effect of PE investment on the welfare of the people who reside and work in assisted living communities.

Research uncovers racial disparities in hospice discharge outcomesMcKnight's Clinical Daily News; by Kristen Fischer; 6/20/24When Black patients leave hospice care alive, they have a higher risk for being admitted to a hospital, according to a study published on May 16 in JAMA Network Open. About 15% of patients who enter hospice actually wind up being discharged from it before they die. That can happen for various reasons such as unplanned hospitalization, getting other treatment for a terminal condition, transferring to another hospice service, or if their condition improves. The transition to hospice can be hard, but moving to a different care setting can be challenging as well.

The opportunity for palliative care in ACO Flex Palliative Care NEws; by Audrie Martin; 6/24/24 On Jan. 1, 2025, the Center for Medicare and Medicaid Services (CMS) Innovation Center will begin implementing a payment model for primary care known as the Accountable Care Organizations (ACOs) Primary Care Flex Model under the Medicare Shared Savings Program (MSSP). The ACO Flex Model is a voluntary initiative to improve funding and other resources to support primary care delivery within the MSSP. The model encourages the formation of new, physician-led ACOs, particularly those serving underserved communities and addressing health disparities. This program is not just a test but also seeks to empower participating ACOs and their primary care providers to employ more innovative, team-based, person-centered and proactive approaches to care. [Click on the title's link for more information.]

Column: Hospice offers redirection of care The Andalusia Star News; by Vickie Wacaster; 6/22/24 Watching someone you love grow weaker and weaker with each passing day is challenging. Yet, sadly, many of us experience this. In my own life, when my late husband was diagnosed with a terminal, non-curable, yet treatable disease, I felt we were living on a roller coaster of emotions, appointments, and treatment options. ... Every day was a journey into uncharted territory for both of us. ... It was only during the last few days that we found the strength to say “no more treatments” and asked for hospice. ... Physicians recognize that hospice is not a withdrawal of care but a redirection of care to meet the needs of patients with an advanced terminal illness/disease. ...Editor's Note: The word "redirection" powerfully, easily shifts the course of care. The person remains at the center, with the focus being the person, not the disease. This is not a denial of dying and death, but rather a signpost, a gentle way to open the difficult conversation for providing information and asking "what matters most to you, now?" 

In summer, ice becomes water faster than I can make decisions. - Anonymous

The hospice as a sacred placeThe New Statesman; by Ken Worpole; 6/21/24[UK] The hospice building retains a special place in the modern imagination, a new iteration of Larkin’s “serious building on serious earth”. ... The symbolic power of the hospice building was demonstrated in 2014, when 500 people attended a meeting protesting the proposed closure of Pilgrims Hospice in Canterbury. “It’s only bricks and mortar,” advocates of closure argued, suggesting that hospice care could be provided just as meaningfully at home. John Harries, resident-researcher at St Christopher’s, followed the saga closely. The arguments against closure, he saw, came from families of those who had died within hospice walls, and for whom the building had “achieved the status of a sacred place”: for them, “closure was seen as an act of desecration”. For Harries, “Care is an invisible abstraction, but for many it is symbolised and made concrete by the building.”Publisher's Note: A bit of hospice history woven into this interesting piece.

From C-suite to scrubs, CEO takes a walk in employees' shoes Becker's Hospital Review - Leadership & Management; by Madeline Ashley; 6/20/24 Todd Forkel, CEO of Altru Health System in Grand Forks, N.D., quite literally knows what it's like to walk in his colleagues shoes, and it's all because of a program called "Shadow Me, Todd." Mr. Forkel has been CEO of Altru for more than two years, but has been in healthcare for 32 years with 13 years of CEO experience. A nonprofit health system, Altru comprises around 3,400 employees, including more than 300 providers across 65 care specialties. ... In the program, Mr. Forkel will shadow a different colleague two to four times a month, typically in the morning or afternoon. 

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