Literature Review

My Mother is in Hospice Care Reformed Journal, by Doug Browser; 3/25/24 My 96-year-old mother entered hospice care a few months ago. For a while, it seemed as though she would go on forever, even though we knew that was unlikely. ... [Here’s] the thing, maybe the most striking thing I’ve learned while sitting with my mom over these last few months. Loss of memory can sometimes be a gift. ... I realize that there can be a kind of grace in not remembering a few things. ... We don’t have to go back and revisit any of it. We have this time together. ... And together we are a mom and a son, present in the moment, a moment with a surprising amount of grace. I never expected to get there.

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.

AI scribe saves doctors an hour at the keyboard every dayAMA, by Andis Robeznieks; 3/18/24 When a health system rolls out new technology that it insists will make physicians’ lives easier, the announcement is typically met with skepticism. But the use of augmented intelligence (AI)—often called artificial intelligence—has changed that. The Permanente Medical Group’s rollout of ambient AI scribes to reduce documentation burdens has been deemed a success, saving most of the physicians using it an average of one hour a day at the keyboard. ... Refinement of the tool, however, is ongoing. ... For example, one physician mentioned scheduling a patient’s prostate exam, but the AI scribe recorded that the exam had been performed. 

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.

Physicians often shy away from preparing their patients to dieToday'sHospitalist, by Colleen Poggenburg, MD, MS; 3/22/24 There's beauty in death if we can tolerate looking. ... The beauty in death is the reflections that occur in the weeks, days and minutes prior to it, which together make up a summary of someone’s life. Why then do physicians view this time-honored decline as a series of clustered medical problems, when it really is just someone moving toward death? Are we so concerned about treating just one more condition, and do we actually think it will solve the growing list of medical problems that dying patients have? ... I compared dying to pregnancy to “soften” the description of this decline. Here’s how I see that comparison: ...Editor's Note: The author offers a fascinating, meaningful comparison of physician/patient conversations with someone who is pregant versus someone who is dying. I encourage you to share this article with your clinical leaders (and adapt it for staff), as this model beautifully reframes important conversations that can empower patients and their families.

Amid tense negotiations, Oregon nurses allege patient neglect by PeaceHealth during strike Eugene Register-Guard, by Miranda Cyr; 3/20/24 Tensions between PeaceHealth and Sacred Heart home health and hospice nurses persist, with the Oregon Nurses Association (ONA) claiming last week that PeaceHealth neglected patients during the nurses' two-week strike in February. ... ONA has been negotiating a new contract with PeaceHealth for a full year. The last contract expired in April of 2023. Despite 40 negotiation meetings, no agreement has been reached, according to ONA.

Medi-Cal Update - Hospice Care Program BulletinMedi-Cal, March Bulletin[Topics include:]

Give generative AI another decade to revolutionize healthcare Modern Healthcare - Opinion, by Keith Figoli; 3/15/24... Generative artificial intelligence is poised to transform healthcare by enabling solutions to effectively address [common patient care] challenges. This cutting-edge technology opens new avenues for innovation in diagnosis, treatment planning, operations efficiency and overall healthcare delivery–and industry leaders are taking notice. A recent survey revealed that 25% of healthcare organizations implemented a generative AI solution in 2023, while 58% plan to adopt one this year. However, the generative AI-driven transformation won’t – and shouldn’t – happen overnight.

CMS.gov: ACO Primary Care Flex ModelCMS.gov; 3/19/24The ACO Primary Care Flex Model (ACO PC Flex Model) is a voluntary model that will focus on primary care delivery in the Medicare Shared Savings Program (Shared Savings Program). It will test how prospective payments and increased funding for primary care in Accountable Care Organizations (ACOs) impact health outcomes, quality, and costs of care. The flexible payment design will empower participating ACOs and their primary care providers to use more innovative, team-based, person-centered and proactive approaches to care. The model, which starts January 1, 2025, aims to grow participation in ACOs and the Shared Savings Program and increase the number of people with Medicare in an accountable care relationship.

Giving hospice patients a dignified end-of-life experience Steve Adubato On the Air, with Charles Vialotti, MD; 3/13/24On--location at Villa Marie Claire Residential Hospice, Steve Adubato is joined by medical director, Charles Vialotti, MD to talk about his personal commitment to hospice care and giving residents and their families a dignified end-of-life experience.

Medicare Advantage prior authorization: The impact - increased access to care HHS-OIG; 3/19/24 HHS-OIG’s work on this issue drew national attention to the problem spurring the Centers for Medicare & Medicaid Services, the Industry, and Congress to action.  Editor's Note: You can download the "Impact Brief" from this site. Click on the title's link.

What you should—and shouldn’t—say to a friend going through a major illness MSN, by Jenna Ryu; 3/18/24When a friend receives a life-changing diagnosis, it can be tough to know how to show up for them. ... For instance, you might automatically respond to your buddy's health news with, "I know what you're going through," when really, all you wanted was to be sympathetic. ... So if you’re not sure what, exactly, to say to help them feel better, here are five compassionate and respectful phrases that’ll let them know you’re in their corner.

Navigating difficult conversations with patients with terminal cancer diagnoses Oncology Nursing News, by Darlene Dobkowski, MA; 3/18/24 Although oncology nurses need strong communication skills to help all of their patients navigate their cancer journeys, it is critical to have the ability to have difficult conversations with patients who received a terminal diagnosis, ... Betty Ferrell, Ph.D., M.S.N., CHPN, director and professor in the Division of Nursing Research and Education in the Department of Population Sciences at City of Hope in Duarte, California, said in an interview with Oncology Nursing News. For the past 24 years, her institution has been directing a project called the End-of-Life Nursing Education Consortium (ELNEC), which is a palliative care training program and includes a module focused on communication.  ... “One of the things that we teach nurses is … that your No. 1 job is to listen,” Ferrell said. “Another thing that we say to nurses is, it is not your job to have all the answers. Patients ask very unanswerable questions. ‘Why me?’ is not an answerable question. But when a patient says, ‘Why me,’ then we want nurses to have good communication skills to say, ‘I can imagine why you're asking that question. Because as you've shared with me, you had no idea that you might be diagnosed with cancer, or you're the first person in your family to ever have cancer.’”