Literature Review

Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner

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. 

Top 10 patient safety threats of 2024: Helping new clinicians, maternal care barriers, AI, and more Chief Healthcare Executive, by Ron Southwick; 3/21/24 When ECRI unveiled its list of the leading threats to patient safety for 2024, some items are likely to be expected, such as physician burnout, delays in care due to drug shortages or falls in the hospital. However, ECRI, a nonprofit group focused on patient safety, placed one item atop all others: the challenges in helping new clinicians move from training to caring for patients. ... ECRI’s top 10 threats to patient safety for 2024: 

Preventing adverse drug events in hospice care Hospice News, by Holly Vossel; 3/15/24 Documentation errors and a fragmented health system pose the greatest risks for adverse drug events among hospices. ... Evaluating these risks involves having solid medication reconciliation processes in place — both at the time of a patient’s admission and throughout their end-of life care experience, according to Mary Lynn McPherson, professor and executive program director of advanced post-graduate education in palliative care at the University of Maryland’s School of Pharmacy. McPherson also serves on the board of the American Academy of Hospice and Palliative Medicine (AAHPM).

Contract CNA staffing associated with worse care quality outcomes: study McKnights Senior Living, by Kathleen Steele Gaivin; 3/1/24Nursing homes that use contract staffing to fill certified nursing assistant position vacancies are more likely to experience worse care quality than those that do not, according to the results of a study by PHI. The proportion of total CNA hours filled by contract CNAs in SNFs increased from 2% in 2017 to 11% in 2022, the study found.

Essentia Health-Fosston Home Care and Hospice team recognized for excellenceEssentia Health Newsroom, by Caitlin Pallai; 2/14/24The Essentia Health-Fosston Home Care and Hospice Team has been recognized for providing exceptional patient experiences. The team was named a 2023 Human Experience Guardian of Excellence Award winner by Press Ganey, which works with more than 41,000 health care facilities — including Essentia — to solicit patient feedback and create meaningful change. To receive a Guardian of Excellence Award, a team must rank in the top 5% of health care providers on patient surveys conducted by Press Ganey. 

Using patient narratives to evaluate a hospice serviceNursing Times - Patient Experience, by Val Stangoe and Steve Mee; 2/12/24Questionnaire surveys at a hospice proved ineffective as a tool to identify areas for service improvement, but narrative inquiry with patients and their families identified important deficits that offered clear guidance for service development. This method needed a careful, respectful approach, as well as significant time and resources, but proved to be invaluable. Many of the patients enjoyed having an opportunity to tell their stories, while nursing staff could be involved in the project, thereby enhancing their skills and raising their ambitions.

Mom enters hospice in final days of cancer and releases viral song for 7-year-old sonPeople, by Jordan Greene; 1/25/24Cat Janis shared her final wish – for her song 'Dance You Outta My Head' which she wrote for her 7-year-old son — to go viral. 

Role matters in understanding 'quality' in palliative care: a qualitative analysis of patient, caregiver and practitioner perspectivesBMJ Open, by Laura M Holdsworth, Karleen Giannitrapani, Raziel C Gamboa, Claire O'Hanlon, Nainwant Singh, Anne Walling, Charlotta Lindvall, Karl Lorenz; 1/17/24Objectives: To compare the discussions from two panels on the concept of palliative care quality for patients with advanced cancer, exploring the priorities reflected in each group's perspectives.

Quality of data on profit status reported Care CompareJournal of Pain & Symptom Management, by Joan M. Teno, Emmanuelle Belanger, Gulmeena Khan; 11/23.For-profit hospice providers differ in both key processes of care and bereaved family member perceptions of the quality of care. Recent rapid growth of hospices, formation of national for-profit hospice chains, and acquisition of hospice by private equity firms has raised concerns regarding the quality of hospice care. In response, starting in April 2023 the Center for Medicare and Medicaid Services made hospice ownership data public on the Care Compare website to help consumers make informed choices in hospice programs. On the Care Compare website, hospice are listed as for-profit, nonprofit, and other category, based on hospices’ self-reported ownership status. In this study, we examined the accuracy of this information.

Mercy medical record transition heats up in bankruptcy courtThe Gazette (Cedar Rapids, IA)December 22, 2023Iowa City, IA—Among the complexities of a Mercy Iowa City bankruptcy sale to the University of Iowa is the transition of its electronic medical system—with any gap or abrupt termination of system operations posing “significant” threat to Mercy and its patients. 

2023’s Most Impactful Hospice Regulatory MovesHospice NewsDecember 12, 2023Program integrity issues that have heated up in the hospice space during the past five years reached a boiling point in 2023. Hospice providers have seen an array of increased regulatory oversight in 2023. That momentum has been fueled by two main concerns among regulators—risks of patient safety and evidence of malfeasance in the space. Hospice News sat down with providers, advocacy groups, legal experts and other stakeholders to uncover the most significant hospice regulatory trends from this year and their anticipated impacts heading into 2024 and beyond. ...Editor's Note: Quoted in the article, Jason Wallace, partner in health care, Barnes & Thornburg LLP; Ben Marcantonio, COO and interim CEO, NHPCO; Carrie Uebel, senior vice president and chief ethics and compliance officer, Compassus

Hospitals Think Some Dead Patients Are AliveBloombergDecember 7, 2023Neil Wenger, a professor of medicine at UCLA, was researching different ways of encouraging patients to make end-of-life care plans when he discovered something troubling—hundreds of patients who were seriously ill, according to the health system’s records, were actually dead. This is a well-known but little-studied phenomenon, according to Wenger—until now. Wenger and his colleagues wrote up their findings in a short paper that was published Monday in JAMA Internal Medicine. They identified 676 patients from UCLA’s health system that were recorded as alive, but were actually dead, according to state data. At face value, it sounds absurd. But there are many reasons why it might happen, Wenger says. While patients who die in the hospital are automatically recorded as deceased in that system’s database, patients who die at home are not. Same goes for patients who die at another health system with a different electronic records database. “The health system continues to act as if they’re alive,” Wenger says. “If we don’t know they’re dead, we can’t do the right thing.” ... “We think this is a really important finding that needs to be corrected,” Wenger says.