Literature Review

Q&A: Prioritizing health equity with Emory Healthcare’s Chief Transformation Office CDW Healthcare - Patient-Centered Care; by Teta Alim; 11/19/24 Most healthcare organizations regularly prioritize goals to improve the patient experience and increase clinician satisfaction, aligning with the Quintuple Aim. Atlanta-based Emory Healthcare created the role of chief transformation officer to focus on these areas, and in July 2023, Dr. Amaka Eneanya became the first to fill the role. ... What would you say were the top three lessons you learned during the first year in your new role? ENEANYA: It's been a great year. For lesson one, as someone coming from a different part of the U.S., ingraining yourself and getting to know the people and the culture of the organization that you’re in, that’s important to determine the change readiness of an organization. ... The second lesson is that change is exciting. There's a lot of trepidation with change, and part of being effective with change management and transformation is really garnering excitement. ... The third lesson that continues to be pervasive in my career is that health equity is poorly understood. ... You have to start with the basic foundation and concepts of health equity before you can make initiatives, otherwise people won't understand what you're doing, and they might have a visceral response to what you're doing because of the misinformation around health equity. 

Hospice of Northwest Ohio will operate ProMedica's palliative care services CBS WTOL 11, Toledo, OH; by Karmann Ludwig; 11/18/24 Hospice of Northwest Ohio will operate ProMedica's palliative care services at the start of next year, according to a press release from Hospice released Monday. The company said ProMedica's patients who remain in palliative care will be transferred to Sincera Supportive Care and Symptom Relief, one of Hospice of Northwest Ohio's services. Sincera will also take over responsibility for ProMedica's palliative care outpatient clinics, Hospice of Northwest Ohio said. 

New report for 2024: Rural-urban disparities in health care in Medicare Centers for Medicare & Medicaid Services (CMS); 11/14/24 Advancing Health Equity in Rural, Tribal, and Geographically Isolated Communities. FY2023 Year in Review, November 2023. From the Co-Chairs: ... This year’s annual report demonstrates CMS’ ongoing commitment to advancing health equity for individuals living and working across diverse geographies. These actions span a wide breadth of the agency’s authorities and roles, including regulation, payment, coverage, tools and publications, partner engagement, health system innovations, quality of care, and regional coordination. Across these actions, CMS maintains a focus on the goal of improving the lives of our enrollees and those who care for them. We eagerly anticipate our continued collaboration and partnership with all those CMS serves to advance health care in rural, tribal, and geographically isolated communities.

LECOM Health opens Erie County's first specialty hospice unit Erie Times-News, Erie, PA; by David Bruce; 11/15/24 Erie County will soon have its first specifically designed medical unit for end-of-life care when LECOM Nursing and Rehabilitation Center opens its Visiting Nurses Association Specialty Hospice Unit later this month. Until now, local hospice patients who require a higher level of medical care than what can be provided at home usually lived their final days at a nursing home or hospital. The reluctance to open a dedicated hospice unit in Erie County is due to operating costs, Lin said. State laws require each unit to have a medical director and registered nurses, and the reimbursement for hospice care makes it difficult to cover those costs if there are fewer than four or five patients at a time. "Since this unit is part of the Nursing and Rehabilitation Center, we can share the medical director and registered nurses," Lin said.

New Health Equity Guide from Center to Advance Palliative Care provides a roadmap to transform care for black patients with serious illness Cision PRWeb; by Center to Advance Palliative Care; 11/13/24 Having medical concerns dismissed, not being believed when reporting pain, and facing multiple barriers to care are just three of the experiences reported to Center to Advance Palliative Care (CAPC) in a focus group of Black patients with serious illness. In fact, when Black people in the United States are living with a serious illness like cancer, heart failure, or dementia, they experience disproportionately high suffering compared to white patients—often due to poor pain management, low-quality communication from their care teams, and high family caregiver burden. To address these inequities, CAPC has released a new, comprehensive guide, Advancing Equity for Black Patients with Serious Illness, to equip palliative care leaders and health equity change agents with practical tools to implement meaningful change. Drawn from research, examples of health equity initiatives from across the country, and the wisdom of health equity leaders, the guide provides a practical roadmap for transforming care for Black patients, and their families and caregivers.

Older Americans living alone often rely on neighbors or others willing to help California Healthline; by Judith Graham; 11/12/24Donald Hammen, 80, and his longtime next-door neighbor in south Minneapolis, Julie McMahon, have an understanding. Every morning, she checks to see whether he’s raised the blinds in his dining room window. If not, she’ll call Hammen or let herself into his house to see what’s going on. Should McMahon find Hammen in a bad way, she plans to contact his sister-in-law, who lives in a suburb of Des Moines. That’s his closest relative. Hammen never married or had children, and his younger brother died in 2022. Although Hammen lives alone, a web of relationships binds him to his city and his community — neighbors, friends, former co-workers, fellow volunteers with an advocacy group for seniors, and fellow members of a group of solo agers. ... American society rests on an assumption that families take care of their own. But 15 million Americans 50 and older didn’t have any close family — spouses, partners, or children — in 2015, the latest year for which reliable estimates are available. Most lived alone. By 2060, that number is expected to swell to 21 million. ... [Click on the title's link to continue reading.]Editor's note: This important article includes "a noteworthy study published by researchers at Emory University

Location of pediatric deaths in the US JAMA Network - JAMA Pediatrics; by Sarah H. Cross, PhD, MSW, MPH; Khaliah A. Johnson, MD; Maura A. Savage, MSW; Dio Kavalieratos, PhD; 11/11/24Historically, most seriously ill children in the US have died in hospitals despite a presumed preference for home death. Among the general population, home and hospice facility deaths have increased in the past 2 decades, whereas hospital and nursing facility deaths have decreased; however, recent patterns in location of pediatric deaths are unknown.

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.

UP Health System Hospice coming to Dickinson County The Daily News, Iron Mountain, MI; 11/5/24U.P. Health System Hospice will begin bringing its hospice care to Dickinson County. UPHS’s goal is to improve the quality of life for patients and their families by providing compassionate and comprehensive care during the final stages of life. U.P. Health System Hospice has made it the mission of its agency to change end of life care in the U.P. and its most rural communities by bringing awareness to hospice services, advocating for patient rights, and working hand-in-hand with the medical community to help more people receive support in their health care. 

Why home health deserts are spreading across rural states Modern Healthcare; by Diane Eastabrook; 11/1/24 Home health deserts are increasing at an alarming rate across some rural states as home health companies close or reduce services due to financial challenges. Home health companies in Maine, Nebraska and Minnesota say a proposed Medicare rate cut, low Medicare Advantage reimbursements and workforce shortages are forcing them to make difficult business decisions — leaving many communities with limited access or no access to post-acute care in the home. ...  Approximately 800 home health providers have closed over the past five years, according to the National Alliance for Care at Home, a trade group that represents the industry. Alliance CEO Dr. Steve Landers mostly blames a Medicare home health payment model that went into effect in 2020 for reducing Medicare reimbursements and causing financial stress for providers. “While closures are significant, we are also getting reports that providers are restricting the territory they serve as a first step to addressing their financial stresses,” Landers said in an email. “This appears to be especially concerning in rural areas where no other provider is available to step in.”

PACE elderly care center opens in Murrieta [California] Patch, Murrieta, CA; by Kat Schuster; 11/1/24 Neighborhood Healthcare opened the doors to a new 20,000-square-foot medical and care center for older adults in Murrieta on Friday. It is the second Program of All-Inclusive Care for the Elderly (PACE) to open in town. The new facility offers a medical team specializing in aging and chronic conditions. PACE touts itself as an alternative to nursing homes and a program for older adults to get social and medical services in their own homes and communities. Neighborhood Healthcare also offers a bilingual medical team that works with therapists, dieticians, social workers, and home care nurses "to create a customized care plan" for each patient. 

‘Stop Requested’: To Lakeview, Oregon’s ‘Mile High City’ OPB (Oregon Public Broadcasting); by Lillian Karabaic; 10/27/24 Lakeview isn‘t close to much, but locals figure out how to get ’er done. ... OPB “Weekend Edition” host Lillian Karabaic and producer Prakruti Bhatt experience the joys and difficulties of rural transit and talk to many people along the way. ... To reach Lakeview, we turn to the Lake County Cloud, a transit service run by the Lakeview Senior Center. Lake County Cloud doesn‘t have any fixed route services. Its crew of eight part-time drivers mostly do by-reservation trips to medical appointments and a few shopping trips. This became even more important after Lakeview’s only specialty clinic and hospice closed in 2023. ... Because the nearest city is Klamath Falls, more than 90 miles away, Lake County Transit puts in a lot of miles. It also goes up to Medford, down to California, and even all the way to Portland for chemotherapy. “We do about 30,000 [or] 40,000 miles a month … it’s a lot for a little town and little crew," says Linda Mickle, transportation coordinator for Lake County Transit.

80-year-old 'Mom' cares for homeless men in Philadelphia ABC News 7, New York, NY; by Matteo Iadonisi; 10/30/24 Cecelia Robinson has earned the nickname 'Mom' during her two decades of showing motherly love to homeless residents at St. John's Hospice. Her work in environmental services and housekeeping ranges from taking out the trash to developing relationships with clients and making sure their needs are met. Specifically, she works in the Good Shepherd residence at St. John's Hospice, which cares for men who are considered medically fragile. Robinson has helped men like Craig Freeman, who utilized the Good Shepherd for transitional housing and has since moved into his own apartment. Watch the video [here] to see Robinson's story in action.Editor's note: Do you need inspiration? Click here to view this beautiful story about Cecelia Robinson's care for homeless residents at St. John's Hospice.