Literature Review

Clinician- and patient-directed communication strategies for patients with cancer at high mortality risk JAMA Network Open - Oncology; by Samuel U. Takvorian, MD, MSHP; Peter Gabriel, MD, MSE; E. Paul Wileyto, PhD; Daniel Blumenthal, BA; Sharon Tejada, MS; Alicia B. W. Clifton, MDP; David A. Asch, MD, MBA; Alison M. Buttenheim, PhD, MBA; Katharine A. Rendle, PhD, MSW, MPH; Rachel C. Shelton, ScD, MPH; Krisda H. Chaiyachati, MD, MPH, MSHP; Oluwadamilola M. Fayanju, MD, MA, MPHS; Susan Ware, BS; Lynn M. Schuchter, MD; Pallavi Kumar, MD, MPH; Tasnim Salam, MBE, MPH; Adina Lieberman, MPH; Daniel Ragusano, MPH; Anna-Marika Bauer, MRA; Callie A. Scott, MSc; Lawrence N. Shulman, MD; Robert Schnoll, PhD; Rinad S. Beidas, PhD; Justin E. Bekelman, MD; Ravi B. Parikh, MD, MPP; 7/1/24 Serious illness conversations (SICs) that elicit patients’ values, goals, and care preferences reduce anxiety and depression and improve quality of life, but occur infrequently for patients with cancer. Behavioral economic implementation strategies (nudges) directed at clinicians and/or patients may increase SIC completion. ... In this cluster randomized trial, nudges combining clinician peer comparisons with patient priming questionnaires were associated with a marginal increase in documented SICs compared with an active control. Combining clinician- and patient-directed nudges may help to promote SICs in routine cancer care.

[Certificate of Need] Diagnosis for 6.26.24: Checking the pulse of Florida health care news and policy Florida Politics, scroll down to "Death and Dying"; 6/26/24 Florida health care regulators this week announced they tentatively denied 21 Certificate of Need (CON) applications for new hospice programs and approved 9 others. Heavily populated Broward and Hillsborough counties drew the most interest, with seven providers wanting to establish new hospice programs in each area. [For details, click on the title's link and scroll down to "Death and Dying."]

Pasadena Hindu Temple offers health planning series for seniors: Interactive session to cover advance care, palliative care, and hospice services Pasadena Now; 7/2/24 The Pasadena Hindu Temple is hosting a health and wellbeing series for seniors, focusing on future healthcare planning. ... Doctors Alka and Pradeep Kapoor, both board-certified in internal medicine, hospice, and palliative medicine, will present on topics including advance care planning, palliative care, and hospice care. The doctors, who have over 45 years of medical experience, are also certified in Post Acute and Long-term care medicine. ... Established in 2002, the Pasadena Hindu Temple has evolved into a hub for Indian heritage and Hindu worship in Southern California. Now operating as the Hindu Temple and Heritage Foundation (HTHF), the nonprofit organization offers various community services. Editor's Note: What cultures and faith communities are in your service areas? Do you reach out to all? Does your staffing reflect your community? Click here for U.S. Census information and search for your geographical areas. 

Empowering ‘deeply undervalued’ caregivers would improve ‘lifeline for older adults’ McKnights Senior Living; by Kimberly Bonvissuto; 6/28/24 Direct care workers and family caregivers remain “deeply undervalued” and often overlooked despite calls for investment in the care economy, according to the authors of a new report. “These caregivers provide a lifeline for older adults, people with disabilities, and people living with chronic conditions,” PHI and the National Alliance for Caregiving said in an issue brief released Wednesday. “Empowering them in their roles will help to ensure high quality, responsive care to meet the needs and preferences of millions of Americans now and in the future.” The organizations called on providers, Congress, the Department of Labor, the Centers for Medicare & Medicaid Services, the federal Health Resources and Services Administration, states, managed care plans and advocates to invest in the “essential partnership” between direct care workers and family caregivers. The new brief includes insights from a variety of stakeholders ...  The result is a list of recommendations that prioritize improvements to direct care jobs.Editor's Note: Our sponsor, Composing Life Out of Loss, equips hospice and palliative care organizations with caregiver education and support video libraries to strengthen relationships between the direct care professional and the family caregiver, with timely information for the entire family. Contents are written to CMS CoPs, CAHPS, and contemporary grief research; English and Spanish.

Evaluating palliative care impact: Insights from Tennessee Oncology's OCM participation The American Journal of Managed Care (AJMC); by Mary Caffrey and Pearl Steinzor; 6/27/24 A study finds limited changes in hospice utilization, highlighting challenges in real-world implementation. In an interview at the 2024 American Society of Clinical Oncology annual meeting, Ravi Parikh, MD, MPP, assistant professor of medicine and health policy, Perelman School of Medicine, University of Pennsylvania, discussed the outcomes of a palliative care study at Tennessee Oncology, providing insights into the challenges and limitations of evaluating hospice utilization and quality-of-life improvements in the real-world setting. 

HHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?

The Program of All-Inclusive Care for the Elderly will begin in July at Jordan Valley Community Health Center KSMU Ozarks Public Radio; by Michele Skalicky; 6/24/24 A new program at Jordan Valley Community Health Center in Springfield will allow those 55 and older to age in their own homes. The Program of All-Inclusive Care for the Elderly is the first PACE program in southwest Missouri. "We'll do home assessments to make improvements that will allow them to live in their homes safely so we don't have potentials for trips and falls or if somebody has a need to have a built, we'll take care of all of that through our home assessment and allow them to have the safest possible home," said Ryan Kruger, vice-president of operations for PACE and pharmacy at the health center. The PACE model uses an interdisciplinary team of professionals that provide coordinated care. PACE care includes medical and personal care, rehabilitation, social interaction, medications, transportation and more.

Dementia decisions: Making tough choices about hospice, palliative care Being Patient; by Katy Koop; 6/25/24 In the later stages of Alzheimer's, palliative and hospice care can be necessary. But how do you find a facility designed for dementia patients? ... Dr. Maribeth Gallagher, director of Arizona’s Hospice of the Valley dementia program, joins Being Patient video reporter Mark Niu to discuss how to make these difficult decisions and what makes a palliative or hospice care program “dementia-capable.” Gallagher’s work directing the Hospice of the Valley’s dementia program has received national and international awards for its innovative approaches. Her focus on dementia care was initially inspired by her personal experiences as a family caregiver, sharing the journey with her loved one from diagnosis to death. [Click on the title's link for the full conversation, in both audio and text.]

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.

Anatomy of hospice grief camps for children Hospice News; by Holly Vossel; 6/20/24 Training staff and volunteers to provide developmentally-appropriate grief support is among the key parts of operating summer camp programs for children and adolescents suffering a recent loss. Whether rolling out summer grief camps for the first time or innovating these programs throughout the course of several decades, hospices need a firm grasp around the different emotional and cognitive needs of pediatric populations coping with the death of a loved one, according to Alissa Drescher, senior director of mission-based services at Alive Hospice. With a greater understanding of how children process death, hospices can ensure staff and volunteers are well-equipped to support their evolving needs as they grow, Drescher said. [Click on the title's link to continue reading, particularly "Common threads among children's grief programs."]

Strong palliative care presence at this year’s World Health Assembly Worldwide Hospice Palliative Care Alliance - WHPCA; by Stephen Connor, Executive Director, WHPCA; 6/18/24 Palliative care was well represented at the World Health Assembly (WHA) this year! All together there were twelve delegates from the organisations attending in official relations with WHO (6 from WHPCA and 6 from IAHPC). All attendees covered their expenses. This year is the 10th anniversary of the passage of the Palliative Care Resolution (67.19) “Strengthening of Palliative Care as a Component of Comprehensive Care Throughout the Life Course.” ... To use this fact as an opportunity WHPCA organised a side event on the margins of this year’s WHA titled: Ten Years Since the WHA Resolution on Palliative Care: Access is Increasing Slowly in LMICs, How Can We Expedite it? The event was co-sponsored by four countries (Australia, Belgium, Chile, and Panama) along with nine NGOs (UICC, ICPCN, IAHPC, NCDA, C/Can, APCA, APHN, UNTF NCDs, and Team Humanity). ... WHPCA is working to create a coalition of countries to advocate for palliative care at upcoming UN meetings.

The efficacy of Hospice-In-Place Care versus Traditional Inpatient CareAmerican Journal of Hospice and Palliative Care; by Emily Butler, Claire Hanson, Taaseen Khan, Tuzo Mwarumba, Derek Daniels, Maxim Turchan, Kemberlee Bonnet, David Schlundt, Kelly Harper, Marc Bennett, David Charles; 8/24The hospice-in-place program at Vanderbilt University Medical Center (VUMC) is available to patients and families who elect for hospice benefits and are too unstable to be transported for hospice care. The goal of this study was to assess the satisfaction of family members of patients who died while hospitalized at VUMC and received hospice-in-place compared to the families of patients who did not receive hospice care. ... Quantitative findings of this study showed improved satisfaction but were unable to show a significant difference in satisfaction with hospice-in-place compared to traditional care. Questionnaire results suggest that both types of care yield high satisfaction scores and are successfully supporting patients and families. The conceptual framework also adds to the understanding of end-of-life experiences at VUMC.

Circle of Life Hospice opens guest house ABC KOLO 8 NewsNow, Reno, Nevada; by Emily Benito; 6/19/24The Circle of Life Hospice Foundation has just opened their first hospice care guest house for those that cannot afford room or board or end of life care. President of The Circle of Life Hospice Foundation Michelle Cagle says that if they had 10 to 15 beds in the house, they could help around 271 patients a year. The guest house currently has three beds for patients but with more land to build on, there are plans to build a second guest house on the property. “Whether they are homeless or just elderly or their wife can’t take care of them or they’re just not able to afford it or they don’t have any family or children, that’s what we do and opened this house to care for those people.”