Literature Review

The indispensable role of critical thinking in healthcare leadership Forbes, by Dr. Hudson Garret, Jr and the Forbes Business Council; 4/1/24 In the fast-paced and complex landscape of healthcare, where decisions can have life-altering consequences, the value of critical thinking cannot be overstated. Critical thinking is not just a skill; it's a mindset—an essential tool for healthcare leaders to navigate uncertainty, make informed decisions and drive positive outcomes. ... Here are three examples of how I've applied critical thinking in leadership.

How’s Your Soul? JAMA Network, by Daivd Vermette, MD, MBA, MHS; 3/28/24 "Brother David, how’s your soul?” The question took me by surprise. It was time for my first advisement meeting with my residency program director. In medicine, the machine runs on competence and achievement of “milestones.” Yet, as I braced for a meeting to trudge through performance evaluations and in-training exam scores, I awoke to humanity. ... Medical education has numerous models for coaching, advising, and mentoring. While these models helped develop my professional life, they missed the fundamental core of who I am: a human being. Perhaps instead we could embrace a model in medical education built on the tenets of pastoral care. ...

Northwell backs 'emotionally intelligent' AI voice startupBecker's Health IT, by Gile Bruce; 3/28/24The venture capital arm of New Hyde Park, N.Y.-based Northwell Health is backing a startup that is developing a conversational artificial intelligence platform that mimics human speech. Northwell Holdings participated in a $50 million series B funding round March 27 for Hume AI, which was founded by a former Google researcher to provide "near-human-level conversation" with AI. Northwell has already invested several million dollars in the "emotionally intelligent" voice interface.Editor's Note: Is this an April's Fools Day joke? No. Will these replacements of human conversation improve or potentially harm the patient/caregiver experience? What outcomes could be generated if $50 million was invested in making human professionals more emotionally intelligent? For this high-tech oriented hospice and palliative editor/leader, this direction raises patient/caregiver/professional concerns and cautions. 

[UPDATED] CMS 2025 proposed rule signals changes to quality measurement, omits program integrity actionsHospice News, by Jim Parker; 3/29/24In a proposed rule released [Thursday], the U.S. Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% increase in hospice per diems for 2025. The agency also proposed two new quality measures and 2025 implementation of the Hospice Outcome and Patient Evaluation (HOPE) assessment tool to replace the Hospice Item Set.However, stakeholders in the hospice space contend that the increase is insufficient in light of continued inflation, interest rates, staffing shortages and wage hikes.

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. 

Fall prevention for the elderly: 13 strategies to keep them safe U.S. News & World Report, by Claire Wolters, ed. by Christine Comizion, MPH; 3/26/24Falls are the leading cause of injury in adults 65 and older – with reports showing about 14 million adults fall each year, according to the Centers for Disease Control and Prevention. ... According to the CDC, falls are also the leading cause of injury-related death in the 65-and-older population – and the fall death rate is growing.Here's what to know about what increases risk for falls in older adults, and get familiar with fall prevention tips and safety measures that can help reduce the risk.Editor's Note: This U.S. News article primes the pump. Preventing falls matters especially for vulnerable hospice patients as their disease progresses, and as they and/or family want the person to be as mobile as possible. What do your Incident Reports tell you about falls? What falls-specific education do you provide for your interdisciplinary teams? On-call staff? Family caregivers? Volunteers? What QAPI programs have addressed falls? 

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.

Nearly half of health systems are considering dropping Medicare Advantage plans Becker's Hospital CFO Report, by Andrew Cass; 3/22/24 ... "HFMA Health System CFO Pain Points Study 2024" is based on a survey of 135 health system CFOs conducted in January.  According to the report, 16% of health systems are planning to stop accepting one or more Medicare Advantage plans in the next two years. Another 45% said they are considering the same but have not made a final decision. 

The Hospice Special Focus Program: What it is & why it is importantFORV/S, by Angela Huff; 3/25/24 The CMS Hospice Special Focus Program (SFP) aims to shed light on poorly performing hospices. CMS has publicly stated it is looking closely at the hospice industry due to increasing concerns regarding fraud, waste, and abuse. The Hospice Special Focus Program (SFP) is a new CMS program that identifies poor-performing hospices, takes action to inform the public, and engages those hospices to either improve their performance or terminate the hospice from the Medicare program. 

The process of dealing with death is experiencing rebirth in a less-religious Pittsburgh Digital Daily; by Med St-Esprit, PublicSource; 3/24/24 Tanisha Bowman, of the North Side, a palliative care social worker for Butler Health System and a “death walker,” walks amongst the old graves in St. Mary’s Cemetery. ... From green burial to glass orbs containing ashes, the norms of funerals and burials are broadening as religious affiliation declines. ... According to a 2021 survey by Pew Research, 3 in 10 American adults are religiously unaffiliated. Data compiled by Pew Research about the Pittsburgh metro region found that 50% of adults in the region describe religion as “very important” and nearly 20% consider themselves not religious. Shifts in faith and worship mean families as well as businesses related to death and dying have had to alter their approaches.

Improving the Quality Of Quality Metrics Health Affairs; by Aditya Narayan, Bob Kocher, and Nirav R. Shah; 3/19/24... The landscape of health care quality measures is dynamic, reflecting efforts to enhance patient care, safety, and outcomes. These measures are developed and reimbursed by a variety of stakeholders, including government agencies such as the Centers for Medicare and Medicaid Services (CMS), health care organizations, and independent bodies such as the National Quality Forum and the Agency for Healthcare Research and Quality (AHRQ). The development process involves rigorous research, stakeholder engagement, and consensus-building to ensure measures are evidence-based, applicable across different health care settings, and meaningful to patient care.Editor's Note: Read and share this informative, big-picture article about the evolution of healthcare's quality metrics, its tools, and best practices. 

Researchers advocate for more home-based options for end-of-life care McKnights Home Care, by Adam Healy; 3/25/24 As older adults increasingly prefer to receive end-of-life care in their homes, new, community-based options will be critical to help patients achieve a home death, according to a new research review published in Palliative Care and Social Practice. ... The researchers analyzed 28 studies conducted between 2002 and 2023 related to factors that affect patients’ abilities to achieve a home death. One persistent issue, they found, was a lack of available home palliative care services.