Literature Review

Clinician staffing and quality of care in US health centersJAMA Network Open; Q. Wilton Sun, BA; Howard P. Forman, MD, MBA; Logan Stern, DNP, APRN; et alBenjamin J. Oldfield, MD, MHS; 10/24In this cross-sectional study of 791 US health centers, 5 distinct clinician staffing ratio models were identified, and models emphasizing physicians, advanced practice registered nurses, and physician associates were positively associated with distinct sets of individual quality metrics. Clinician staffing may be associated with certain aspects of care quality, underscoring the importance of strategic, tailored staffing to optimize primary care delivery. In this cross-sectional study of health centers, physician FTE [full time equivalent] ratio was associated with higher performance in cancer screening, infant vaccinations, and HIV testing; APRN FTE ratio was associated with higher performance in preventative health assessments; and PA FTE ratio was associated with higher performance in infant vaccination.

To calm and to commend: Veterans’ musical preferences anticipating end of lifeMilitary Medicine; by Beatrice J Krauss; 11/24Listening to music was the most prevalent of the 20 coping mechanisms for stress in this sample of 30 veterans. Musical preferences were stable across age groups. For calming, music at resting heartbeat rhythms was chosen. Music from early adulthood or from the timelessness of the classics was selected most often. Modern music with lyrics has themes of duty, affirmation, gratitude, and relief. The nearly universal soothing effects of lullabies were recognized. For music for honor ceremonies, desires were often independent of the military branch. Patriotic songs, or songs recognizing multiple service branches, or with themes of peace and affirmation were more often chosen than music from a particular service branch.Publisher's note: Anticipating Veteran's Day on Monday.

Concurrent care and use of advanced cardiac therapies for hospitalized Veterans with heart failureJournal of Pain and Symptom Management; by Tander Simberloff, Laura Godinez, Tiffany Chen, Lan Jiang, Wen-Chih Wu, Jensy Stafford, James L Rudolph, Mitchell Wice; 11/24Veterans with HF receiving concurrent care were few and experienced higher mortality. Rate of burdensome transitions was similar between Veterans receiving concurrent care and those not on hospice. Further research may explore why Veterans infrequently utilize concurrent care at the end of life.

Reps. Van Duyne, Panetta introduce bill to reform hospice Special Focus Program Hospice News; by Jim Parker; 11/6/24 Reps. Beth Van Duyne (R-Texas) and Jimmy Panetta (D-California) have introduced a bill that would reform aspects of the hospice Special Focus Program (SFP). If enacted, the Enhancing Hospice Oversight and Transparency Act also would increase the penalty for hospices that do not report quality measure data to 10% by 2027, up from 4% currently. The SFP has the authority to impose enforcement remedies against hospices with poor performance based on its algorithm. Hospices flagged by the SFP also will be surveyed every six months rather than the current three-year cycle and could face monetary penalties or expulsion from the Medicare program. 

[Global] Palliative care integration into humanitarian settings ten years since the resolution

Nebraska voters approve legalization of medical marijuana. Here's what to know USA Today; by Greta Cross; 11/6/2 Medical marijuana is now legal in the state of Nebraska, approved by voters on Tuesday. Two ballot measures dealing with medical marijuana were on the Nebraska ballot. A total of 70.7% of voters approved Initiative Measure 437 and 66.9% of voters approved Initiative Measure 438. Initiative Measure 437 establishes a new statute that will allow the use, possession and acquisition of up to 5 ounces of cannabis for medical purposes by a qualified patient with a written recommendation from a health care practitioner. The statue will also allow for a caregiver to assist a qualified patient with these activities. Initiative Measure 438 establishes a new statute that makes penalties inapplicable under state law for the possession, manufacture, distribution, delivery and dispensing of cannabis for medical purposes by registered private entities. The statute will also establish a Nebraska Medical Cannabis Commission to regulate such activities.

Fridays are made for catching your breath, expanding your wings, and showing the Universe what you're made of. ~ Anonymous

West Virginia voters narrowly approve state constitutional ban on physician-assisted suicide WVNews - West Virginia's News; by Steven Adams; 11/7/24 An amendment to West Virginia’s constitution to prohibit physician-assisted suicide — already illegal in the state — managed to squeak through after Tuesday’s election with just enough votes, though the vote was a statistical tie. According to unofficial election results posted by the West Virginia Secretary of State’s Office, Amendment 1 passed, with 335,822 votes (50.5%) for and 329,742 against (49.5%) — a difference of 6,080 votes. The West Virginia Legislature adopted House Joint Resolution 28 during the 2024 regular session earlier this year. The joint resolution placed on the November general election ballot a proposed state constitutional amendment that would ban medically-assisted suicide and/or euthanasia.  

Pennsylvania signs home care, hospice efficiency bills into law McKnights Home Care; by Adam Healy; 11/5/24 Pennsylvania Gov. Josh Shapiro (D) signed into law two bills that will reduce operational challenges and improve recruitment efforts for home care and hospice agencies. House Bill 155 allows healthcare providers, including home care and hospice agencies, to use remote video technology for interviews with direct care workers. Meanwhile, Senate Bill 1080 allows licensed practical nurses (LPNs) to pronounce death in home-based hospice settings. These two new laws will make direct care worker recruiting processes more accessible and efficient, while improving end-of-life care for both patients and providers, according to the Pennsylvania Homecare Association. “The signing into law of HB 155 and SB 1080 helps create efficiencies in how we deliver home-based care,” Mia Haney, chief executive officer of PHA, said Friday in a statement. “With a growing demand for these services, efforts such as these allow providers to use their time effectively and focus on what’s most important — quality of care.”

Specialized hospice care program honors and supports veterans facing terminal illness NBC 10 News - WSLS, Southwest and Centeral Virginia; by Kelly Marsh; updated 11/7/24 In Southwest Virginia, a quarter of people with a terminal illness is a veteran, a statistic that highlights the unique challenges many former service members face in their final days. In response to this, several specialized hospice programs in the region have been developed to offer care that specifically addresses the needs of veterans as they navigate the end-of-life journey. For many veterans, the experience of facing terminal illness is compounded by the physical and emotional toll of their military service, particularly conditions like Post-Traumatic Stress Disorder (PTSD), depression, and anxiety. ... The We Honor Veterans program, created through a partnership between the National Hospice and Palliative Care Organization and the U.S. Department of Veterans Affairs, encourages hospice centers to offer a heightened level of care for veterans. Across Southwest Virginia, multiple hospice programs have achieved the highest level of recognition—Level 5—demonstrating their commitment to providing veterans with the best possible care. One such program is based in Franklin County. Despite its size, Carilion Hospice in Franklin County has earned a five-star status for its exceptional veteran services ...Editor's note: We thank and recognize all hospice organizations that find meaningful ways to support and honor your veterans. Click here for more information about NHPCO/The Alliance for Care at Home's We Honor Veterans program.

Most heart failure patients miss out on guideline-recommended palliative care Cardiovascular Business; by Dave Fornell; 11/6/24 Over the past decade, the American Heart Association (AHA) and European Society of Cardiology have recommended integrating palliative care into heart failure management. Despite these recommendations, the use of palliative care for heart failure remains low in the United States. Racial and geographic variations in access and use of palliative care are also pronounced, highlighting health disparities. These were the findings of a recent study in the Journal of the American Heart Association. Researchers at Saint Louis University led the study and said only one in eight patients with heart failure in the United States receive palliative care consultations within five years of diagnosis. Their study highlights the alarmingly low uptake of palliative care among adults with heart failure in the U.S., especially compared to patients with cancers that have the same mortality rates. The study also pointed out significant racial and geographic disparities. Black patients were 15% less likely to receive palliative care compared to their white counterparts. They said this disparity is particularly concerning given the higher cardiovascular risk and mortality rates in the Black population.

[Nebraska Department of Correctional Services] NDCS launches hospice care volunteer program News 2 North Platte, NE; 11/4/24 A new program is aiming to bring transformative change to end-of-life care in Nebraska correctional facilities. The Nebraska Department of Correctional Services recently launched a hospice care volunteer program to ensure terminally ill patients are not alone in their final moments. The first cohort of 16 volunteers selected from the Reception and Treatment Center completed 10 weekly trainings, delivered by healthcare professionals. The trainings covered various aspects of hospice care, including communication skills with patients and families, confidentiality, end-of-life care and stress management. In the program, volunteers work with NDCS team members and healthcare providers a few hours each day to addresses the physical, emotional and spiritual needs of incarcerated individuals who have a terminal diagnosis. This will allow them to maintain employment within the facility and participate in programming, NDCS said.

Veterans Day 2024 Events (parades, celebrations, concerts) – listed by state VeteranOwnedBusiness.com; retrieved from the internet 11/6/24Here is a list of events being held in each state (also virtual) for Veterans Day 2024. Some of these events (parades, speeches, tributes and more) take place before, on and after Veterans Day (Monday, November 11, 2024).Editor's note: Veterans Day is Monday, November 11th. What are you doing for the patients you serve who are veterans? For your employees and volunteers who are veterans? For hospice-specific resources, click here for NHPCO/The Alliance's "News and Information from We Honor Veterans." For more generic location-specific event and resources click here for this list (by state) of Veterans Weekend events in your area.