Literature Review

Integrating palliative care screening in the intensive care unit: A quality improvement projectCritical Care Nurse; by Traci N. Phillips, DNP, APRN, ACNP-BC, CCRN; Denise K. Gormley, PhD, RN; Sherry Donaworth, DNP, APRN, ACNP-BC, FNP-BC; 4/1/24Background: Patients admitted to the intensive care unit have complex medical problems and increased rates of mortality and recurrent hospitalization for the following 10 years ...  Delayed access to palliative care can result in untreated symptoms, lack of understanding of care preferences, and preventable admissions. Conclusion: The screening process can maximize the benefit of palliative care services with early patient identification, improved consultation efficiency, decreased critical care resource use, and reduced readmission rates.

I'm 34 and terminally ill, but I'm not scared of death anymore Metro / Microsoft Start, by Jyoti Smith; 3/31/24 I’ve spent the last nine years living with the idea of dying. In 2015, aged 25, I received my terminal diagnosis. ... My prognosis: three-to-five years. But here I am, almost 10 years on, at 34, and I’m living life to the fullest – if on the edge – and it’s largely down to one thing. Embracing hospice care. ... Editor's Note: Jyoti describes her journey and the care she now received from Marie Curie (hospice), in the United Kingdom.

[Rural Hospitals] A popular healthcare myth debunked Becker's Hospital CFO Report, by Laura Dyrda; 3/28/24Many in the healthcare industry assume rural hospitals are inherently worse off financially than urban hospitals. It's easy to see why. ... But a February Kaufman Hall report refutes the financial divide between rural and urban hospitals. When comparing rural and urban hospitals as a collective, the firm found no statistically significant difference in average operating margin. Rural and urban hospitals on average have similar operating margins and financial performance. So why do we often associate more dire financial struggles with rural hospitals over urban ones?

A multicentre survey on the perception of palliative care among health professionals working in haematology Multicenter Study / PubMed; by Sara Di Lorenzo, Lisa Mozzi, Flavia Salmaso, Claudia Silvagni, Silvia Soffientini, Vanessa Valenti, Vittorina Zagonel; 3/27/24Purpose: Patients with haematologic malignancies have less access to palliative care and are referred later than patients with solid tumours. We developed a survey to investigate this phenomenon, with the intention of analysing palliative care perceptions among health professionals who treat haematology patients and identifying barriers and facilitators to referrals to palliative care services.

How sales and marketing compensation can get hospices into hot waterHospice News, by Holly Vossel; 3/27/24Regulators are taking a closer look at how hospices pay their marketing and outreach workforces to curb fraudulent activity tied to referral streams. Federal and state regulatory agencies have systems in place to detect fraud, waste and abuse in hospice, and some are honing on oversight of sales, marketing and outreach staff payment arrangements, according to Ellen Persons, shareholder at Polsinelli Law Firm. 

Hospitalists more likely to recommend hospice than specialists: Study Becker's Hospital Review, by Mariah Taylor; 3/27/24 A New Haven, CT-based Yale School of Medicine study [published in the American Cancer Society Journals] suggests oncology hospitalists have better hospice utilization and reduce hospital stays for cancer patients compared to oncologists. Researchers compared referrals for hospice settings from hospitalist-led services and oncologist-led services. Hospitalist-led services referred 11.8% of patients to inpatient hospice settings, nearly double the referral rate of oncologist-led services (5.8%). The adjusted average length of stay before inpatient hospice care was 6.83 days for hospitalist-led care and 16.29 days for oncologist-led care. 

How home-based care providers are leveraging palliative care in hospital partnerships Home Health Care News, by Patrick Filbin; 3/26/24 Oftentimes, talks between home health providers and their many referral partners are an exercise in education. For providers offering palliative care, that education usually starts at a 101-level. Part of that conversation with hospital and health system partners includes convincing case managers that patients will be better suited at home. Editor's Note: Features Choice Health at Home CEO David Jackson; Kaiser Permanente Senior Director of Care Hospice and Palliative Care Gina Andres

Why California doesn't know how many people are dying while homelessKQED, by Vanessa Rancano; 3/25/24 The grants manager and his team at Alameda County Health Care for the Homeless knew people were dying on the streets, but they wanted more than anecdotal evidence; they wanted data that could show them the big picture and help them hone their strategies. ... Alameda County’s latest homeless mortality report is now prompting the team to focus on how to extend palliative care services to unhoused people with terminal illnesses. Garlin estimates almost one-fifth of those who died in 2022 would likely have been eligible for hospice care.

Medicaid Health Plan will reimburse Health Equity Certification HealthPayerIntelligence, by Kelsey Waddill; 3/22/24 Meridian Health Plan of Illinois, Inc.—a wholly-owned subsidiary of Centene Corporation that offers Medicaid coverage—announced that it will cover part of the fee hospitals must pay to undergo health equity certification through the Joint Commission. ... The health plan’s goal in offering this aid is to support providers’ efforts to reduce local care disparities.

Massachusetts makes paid family leave more accessible, offering services in Spanish, Portuguese New England Public Media, by Elizabeth Roman; 3/22/24... The state passed a law in 2018 which provides paid family and medical leave (PFML) for serious injury or illness whether personal or a family member, as well as time for parental leave, but found that people whose primary language is not English were unaware of, or hesitant, to apply for the services. ... While the state portal for applying for PFML services now has options in various languages, some people are still overwhelmed by filling paperwork out online. ... There are representatives who speak Spanish and Portuguese and the state also works with an interpretation service for many other languages.

HHS Secretary Becerra: We’re with you on telehealth flexibilities Hospice News, by Jim Parker; 3/21/24 Telehealth flexibilities must become permanent U.S. Health and Human Services (HHS) Secretary Xavier Becerra indicated in a congressional hearing [Wed]. At the end of this year, telehealth flexibilities implemented during the pandemic are slated to expire. In a hearing before the U.S. House Ways and Means Committee Becerra said that HHS was willing to make them permanent. However, he said this would require closer collaboration with state governments. “We’re with you. We can’t allow those flexibilities to expire, and we need to work closer with our state partners, because much of the flexibility that comes from telehealth means being able to go over state lines,” Becerra said.

5 myths about dying that too many people believeThe Hearty Soul, by Maria Sykes; 3/21/24 Myth# 1: I should always stay positive for the sake of my loved one.Myth #2: I should make sure my loved one eats, drinks, and sleeps as normal.Myth #3: I need to prolong my loved one's life as much as possible.Myth #4: It's important to limit the use of painkillers to keep my loved one healthy.Myth #5: If I seek help to care for my loved one, I'm a failure. 

Home-based care employment exceeding pre-pandemic levels Hospice News, by Jim Parker; 3/19/24 Employment in the home-based care sector rose above pre-pandemic levels in 2023, according to the Medicare Payment Advisory Commission (MedPAC). The U.S. Department of Commerce defines this sector to include hospices, home health agencies, private duty, pediatric agencies and other providers of care in the home. ... Nevertheless, workforce pressures and associated costs are overwhelmingly the industry’s most damaging headwind, including the associated wage hikes, enhanced benefits and bonus programs. The shortages also have reduced clinical capacity, which has contributed to drops in patient census and length of stay for many providers.