Literature Review

Determining the ROI of Change Retail Touch Points; by Allison Torpey; 8/27/24 ... [While] most leaders readily accept that they need to spend money on things like system configurations, vendor contracts and project managers to oversee product rollouts, they’re often hesitant to invest in the change management resources required to accelerate transformation and ensure adoption. And when belts are tightened, change management is often the first thing to go. In many cases, that’s due to a lack of awareness of the return on investment (ROI) of change management and how to measure it. ... Here's how to get started.

Between the hospital and the street: Addressing a crucial gap in care healthleaders.com; by Eric Wisklund; 8/23/24 A unique program in Salt Lake City is managing care for underserved patients who live on the street or in an unsafe location, and helping hospitals reduce ED crowding, improve care coordination and reduce costs in the process. The INN Between is a nine-year-old program that began as a 16-bed Catholic convent and is now an 80-bed “assisted living facility” of sorts, offering everything from hospice care to rehabilitation and care management services. The organization addresses a significant care gap for health systems and hospitals who see these patients in their Emergency Departments and ICUs—and who often discharge them to an uncertain care landscape. ... The INN Between, which operates year-to-year on a budget of $1.6 million (recently cut down from $2 million), exists on a mishmash of charitable donations, grants, and the occasional federal or state subsidy. Editor's Note: Pair this compassionate solution with the scathing article about hospice fraud and abuse of homeless persons, Fraudulent hospices reportedly target homeless people, methadone patients to pad census, by Jim Parker at Hospice News.

‘Lean into your superpowers’: Bayada COO champions women in home health leadership Home Health Care News; by Audrie Martin; 8/20/24 Heather Helle, president and chief operating officer of Bayada Home Health Care, believes that home-based care could benefit from having more women in leadership roles. Founded in 1975 and headquartered in Moorestown, New Jersey, Bayada provides in-home clinical care and support services for children and adults, including hospice, behavioral health, and rehabilitation in 21 states and five countries. ... In 2022, women accounted for approximately 80% of workers in health care occupations, a figure higher than the percentage of women in all other employment sectors, as reported by the Bureau of Labor Statistics. ... However, women are underrepresented in leadership roles, comprising only 25% of health care leadership positions in 2022. ... Gender equity is crucial for developing resilient health systems and gender-transformative health and social care policies, according to The World Health Organization. 

Commentary: Prognostication in Alzheimer's disease and related dementias Journal of the American Geriatrics Society / Early View; by Natalie C. Ernecoff PhD, MPH, Kathryn L. Wessell MPH, Laura C. Hanson MD, MPH; 8/8/24  ... Hospice provides comfort-oriented care, emphasizing patient-tailored elements of quality of life, including time with family, access to nature, and music. In late-stage ADRD, studies show that a majority of families prioritize comfort-oriented treatment, and understanding prognosis may help them align treatments accordingly. Yet, only 15% of people enrolled in hospice with a primary diagnosis of ADRD. This is due to difficulty estimating 6-month prognosis required for hospice eligibility—ADRD carries a prognosis of 12–18 months in the latest stage. While low rates of live discharges from hospice are a regulatory requirement for hospices, people who are increasingly experiencing ADRD progression lose access to those beneficial hospice services. ...

Another healthcare, pharmacy chain files Chapter 11 bankruptcy Idaho Statesman; by Daniel Kline; updated 7/30/24 ... Rite Aid has been in Chapter 11 bankruptcy since October and has closed nearly 700 locations. CVS (CVS) and Walgreens (WBA) have managed to stay solvent, but both companies have been closing stores as well. That's partially something that can be blamed on Covid. The pandemic caused a population shift and that left thousands of pharmacies in locations that lack audience. If you used to pick up your prescription, and maybe a snack, at a pharmacy during your lunch break and you now no longer go into the office most days, that makes it hard for those locations to thrive. Now, another pharmacy chain that also operates an array of services for older Americans is facing financial distress.

Despite past storms’ lessons, LTC residents again left powerless: How a long-term care facility prepares for and handles power outages is one of the first questions potential residents should ask KFF Health News - Rethinking65; by Sandy West; 7/29/24 ... Even after multiple incidents of extreme weather — including a 2021 Texas winter storm that caused widespread blackouts and prompted a U.S. Senate investigation — not much has changed for those living in long-term care facilities when natural disasters strike in Texas or elsewhere. ... [While] nursing homes face such federal oversight, lower-care-level facilities that provide some medical care — known as assisted living — are regulated at the state level, so the rules for emergency preparedness vary widely. ... Editor's Note: While this article is written for the public, its content applies to all hospices that (1) provide hospice facility care, and/or (2) partner with senior care facilities: nursing homes, long-term care, assisted living, senior living communities, and PACE. This can be an important QAPI analysis and gap improvement. 

No One Dies Alone: a movement against isolation and loneliness in the final hours The Optimist Daily; by The Optimist Daily Ediorial Team; 7/27/24 The fear of dying alone is one of the most powerful and agonizing feelings that many harbor, especially during the COVID-19 pandemic. For some, this fear sadly becomes a reality. To address this issue, the No One Dies Alone (NODA) initiative trains and supports volunteers who provide companionship to people in their final hours. ... The NODA concept began in 1986 in Oregon, United States [by] Sandra Clarke, a nurse. ... [Alison] Bunce founded Compassionate Inverclyde (CI) in 2016 as an Ardgowan Hospice-funded project, where she worked as director of care. Starting with 20 volunteers, CI sought to sit with people who were dying alone, initially in hospices and local hospitals before extending to private homes. Today, CI has grown substantially, with over 100 volunteers available to provide companionship at a moment’s notice.

Baptist Health taps 3 vendors to build a population health system that works Healthcare IT News; by Bill Siwicki; 7/26/24With help from Oracle, Innovaccer and Salesforce, the South Florida provider is scoring big population health wins, including a 7% increase in coding gap closure rate and a 17% increase in annual wellness visit completion rates. Baptist Health South Florida operates a network of 11 hospitals covering four counties. It also includes numerous ambulatory facilities, urgent care centers and emergency departments to provide comprehensive healthcare services across the region. ... "One of our primary issues was the fragmented nature of patient data across multiple provider organizations and electronic health record systems," said Milady Cervera, vice president, population health and physician integrated networks, at Baptist Health South Florida. "This lack of interoperability made it difficult to gain a comprehensive view of our patients' health status, care history and ongoing needs. ..."

Millions burdened by the cost of long-term care AHCJ - Association of Health Care Journalists; by Breanna Reeves; 7/18/24 ... [Robert] Ingenito shared the mounting costs of caring for his father, who became really sick in 2023. During the panel, Ingenito shared the estimated total cost of caring for his father for just a few months: $57,000. ... [In the U.S.] 8 million people over age 65 need long-term care services, but 3 million were not receiving them. ... Most people in the U.S. are cared for by unpaid caregivers, which are oftentimes spouses and daughters who have no prior experience in caregiving.

Caregiver charged with abusing dementia patient The Freeman, Waukesha County, WI; by Freeman Staff; 7/9/24 A West Allis woman has been charged after she allegedly struck a dementia patient in her care and put a pillow over the woman’s face out of frustration. Erica Junger, 22, was charged Monday in Waukesha County Circuit Court with a count of intentionally abusing a patient, and faces up to six years in prison if convicted. She made an initial appearance in court Monday, where she was released on a $2,500 signature bond and ordered by Court Commissioner David Herring not to work in any job where she is responsible for the health care and safety of others. ... She said she "snapped" and did things she wasn’t supposed to do, but didn’t mean anything by it. ... The complaint did not identify the facility where the incident took place. But it did identify Junger as an employee of Agrace Hospice, which contracts with the facility.

A professional’s perspective: Ageism within the healthcare system; does it exist? Northern Kentucky Tribune; by Jeff Rubin; 7/6/24 A friend of mine named Dee recently shared with me a particularly unpleasant experience she had with a young hospital discharge planner regarding her 97-year-old mom in California. It appears Dee had a heck of a time trying to get her mom discharged to home health care rather than hospice, even though the particular care she needed could have been better delivered at home. A geriatrician by training, Dee ... recognized the invaluable role of hospice in providing end-of-life care. However, the situation she found herself in was less a question of end-of-life and more of palliative care. ...  A recent study in the US sampling 2,035 individuals between 50 and 80 years of age revealed that 93.4% experienced ageism firsthand. Their perception extended to professionals like doctors, nurses, therapists, social workers, and psychologists whose services included working with older people. [Click on the title's link for significant data, descriptions, and resources.]

Senior care experts detail how to build a coveted ‘destination workplace’ McKnights Home Care; by Josh Henreckson; 6/27/24 Faced with today’s complex array of financial, staffing and regulatory challenges, senior care operators need to rely on a broad range of workplace solutions, a panel of experts said. ... Providers should be actively listening to their employees’ needs and trying to meet the evolving desires of the labor market, they emphasized at McKnight’s “Meeting of the Minds” thought-leader discussion. This must take place whether they’re pursuing recruiting strategies, trying to improve staff retention, integrating new technological advances or investing in new benefits and professional development. “The one area that’s going to undergird everything for your success is paying attention to the most important capital, which is human capital,” said Navin Gupta, CEO at software provider Viventium. “Pay attention to the caregiver experience from recruitment … to retention to recognition and development — the entire journey."

[Four-day workweeks:] A flexibility trend gaining steam in nursing Becker's Clinical Leadership; by Erica Carbajal; 6/26/24 A growing number of health systems are embracing  four-day workweeks for nurse leaders — a strategy that has helped some boost recruitment, retention and staff engagement. Over the past year, the needs and well-being of nurse managers have come into focus, with hospitals and health systems taking a closer look at how to best support them in addition to bedside nurses. Survey findings have indicated nurse managers have a hard time fully disconnecting from work, and they crave much of the same work environment factors that front-line nurses do, such as the ability to take time off when needed and work-life balance support. As such, four-day schedules have increasingly become part of the conversation at many hospitals and health systems.