Literature Review

Q&A: Prioritizing health equity with Emory Healthcare’s Chief Transformation Office CDW Healthcare - Patient-Centered Care; by Teta Alim; 11/19/24 Most healthcare organizations regularly prioritize goals to improve the patient experience and increase clinician satisfaction, aligning with the Quintuple Aim. Atlanta-based Emory Healthcare created the role of chief transformation officer to focus on these areas, and in July 2023, Dr. Amaka Eneanya became the first to fill the role. ... What would you say were the top three lessons you learned during the first year in your new role? ENEANYA: It's been a great year. For lesson one, as someone coming from a different part of the U.S., ingraining yourself and getting to know the people and the culture of the organization that you’re in, that’s important to determine the change readiness of an organization. ... The second lesson is that change is exciting. There's a lot of trepidation with change, and part of being effective with change management and transformation is really garnering excitement. ... The third lesson that continues to be pervasive in my career is that health equity is poorly understood. ... You have to start with the basic foundation and concepts of health equity before you can make initiatives, otherwise people won't understand what you're doing, and they might have a visceral response to what you're doing because of the misinformation around health equity. 

Simmons Nursing and Dix Scholar Alum offers palliative care to Navajo nation Simmons University, Boston, MA; 11/20/24 Susan Perron ’18 came to Simmons as an adult student, pursuing her second bachelor’s degree. “I wanted a job that used both practical and critical thinking skills,” says Perron. “I wanted to do something helpful to humanity.”  ...  “I was a COVID-19 nurse throughout the pandemic, and it burned me out,” she recalls. “If you’re a good nurse, you take time to self-reflect. ... Perron took the opportunity and moved to the Hopi Reservation in Northeastern Arizona. Providing ambulatory care to people on the reservation meant that Perron could work in a clinic and take a break from twelve-hour shifts. That said, the year on the Hopi Reservation presented her with challenges. “I had to drive two hours to Flagstaff to get groceries. We would lose power often, and the water was often shut off for maintenance." ... Perron emphasizes that understanding the Navajo belief system is integral to this kind of work. In addition to Dr. Mohs, Perron works closely with her colleague and mentor, Ida Bradley (Navajo) a nurse who specializes in medical terminology in the Navajo language and has extensive experience with end of life care within the Navajo culture. 

Valley Health's 'hospice in hospital' program expands to another hospital Becker's Hospital Review; by Mariah Taylor; 11/19/24 Hospice in the Hospital, a collaboration between Winchester, Va.-based Valley Health and Winchester-based Blue Ridge Hospice, has expanded to Warren Memorial Hospital in Front Royal, Va. The Hospice in the Hospital program provides hospice care services to hospitalized patients who meet general inpatient hospice criteria, according to a Nov. 18 news release. The patients receive emotional, psychosocial, and spiritual care from a team of social workers, music therapists, chaplains and volunteers. The program originated at Winchester Medical Center in 2020 and expanded to two additional Valley Health hospitals earlier this year. With its launch at Warren Memorial, all of Valley Health System's hospitals in Virginia now incorporate the Hospice in the Hospital program. 

MUSC working to spread awareness about palliative care WCSC 5, Charleston, SC; by Autumn Klein; 11/19/24 The Medical University of South Carolina is prioritizing palliative care education for both MUSC students, faculty and patients. The month of November is recognized as National Hospice and Palliative Care Month. ... Dr. Carrie Cormack is a professor at MUSC and leads the palliative care faculty. She says that treating a patient for the mental and emotional strain that comes with an illness can be just as important as treating the illness itself. ... At MUSC, they are pushing the importance of palliative care education. They are weaving palliative care into the educational curriculum for nursing students while also offering palliative care programs. The palliative care team also works hand in hand with primary care providers. At MUSC, they are even talking with international leaders and traveling internationally to offer palliative care education. Cormack just returned from an international trip offering palliative care education.

Expert advocates for timely palliative care for patients experiencing heart failure during address to URI College of Nursing The University of Rhode Island. Kingston, RI; by Patrick Luce; 11/14/24 While palliative care is common for patients diagnosed with life-threatening conditions like cancer or Alzheimer’s Disease, it is less commonly prescribed to patients suffering from heart failure, a missed opportunity to provide enhanced care for those critical patients, according to Yale University Professor Shelli Feder, who addressed Rhode Island nurses, students and professors during [the URI College of Nursing Distinguished Lecture] on Nov. 13. ... Feder detailed a study ... that shows access to palliative care varies widely among patients suffering from heart failure. Reasons vary from heart failure often being diagnosed late, rendering palliative care irrelevant, to some local hospital systems lacking processes to refer cardiovascular patients to palliative care providers. Feder urges medical facilities to adopt specific policies for referring patients to palliative care to help guide providers’ behavior toward timely referral to palliative experts.

Knowledge of palliative care in men and women diagnosed with metastatic breast cancerAmerican Journal of Hospice and Palliative Medicine; Evelyn Robles-Rodriguez, DNP, APN, AOCN; Ashley Weinmann, MSN, APN-C; Generosa Grana, MD, FACP; Teralyn Carter, MD; Bonnie Jerome-D’Emilia, PhD, MPH, RN; 10/24This sample of men and women diagnosed with metastatic breast cancer and being treated in a Cancer Center had limited knowledge and exposure to Palliative Care services across race and ethnicity. While no specific disparity was noted, the utilization of PC [palliative care] was low. Whether a function of a lack of referrals or patient preference, an effort should be made to increase PC referrals for all patients diagnosed with cancer.

Timing of palliative care, end-of-life quality indicators, and health resource utilizationJAMA Network Open; Sarah J. Mah, MD, MSc; Daniel M. Carter Ramirez, MD, PhD; Kara Schnarr, MD, PhD; Lua R. Eiriksson, MD, MPH; Anastasia Gayowsky, MSc; Hsien Seow, PhD; 10/24In this cohort study of 8,297 individuals with ovarian cancer decedents, initiating palliative care earlier than 3 months before death was associated with lower rates of death in the hospital, late chemotherapy, intensive care unit admission, and aggressive care at the end-of-life. Implementation strategies for early palliative care initiation are needed to optimize care quality and health resource utilization at the end of life.

Meals on Wheels substantially reduces risk of senior hospitalizations: report McKnights Home Care; by Adam Healy; 11/8/24 Home-delivered nutritious foods programs can help keep seniors out of the hospital and reduce their feelings of social isolation, according to a new report by Meals on Wheels and home care technology firm WellSky. The report examined how Meals on Wheels programs helped seniors recover after being discharged from a hospital stay. Each meal delivery also involved a social determinants of health assessment, which allowed Meals on Wheels staff to engage with participants and gauge their wellness and safety. After 30 days of the program, the researchers observed an 85% decrease in hospitalizations among participants. Approximately 98% of meal recipients said that Meals on Wheels helped their recovery, and 61% said it lowered their feelings of social isolation.Editor's note: While we know hospice patients experience a significant decline in appetite, the person's changing needs for nutrition continue. Pair this data with several recent articles we've posted regarding seniors' struggles compounded by living alone, isolation, and depression. We invite you to explore this educational/support video for caregivers/families of persons experiencing serious illness, palliative, or hospice care: Small Words - Big Meanings: EAT. Disclosure: Composing Life Out of Loss is a sponsor of our newsletter.

How health system palliative providers can leverage data to gain more resources Hospice News; by Jim Parker; 11/12/24 Palliative care clinicians in health systems can apply research to lobby administrators for additional resources. In doing so, they may get a profile boost due to the COVID-19 pandemic. Palliative care’s reputation grew during the pandemic, with more patients and health care organizations recognizing its benefits and value. Stakeholders can leverage this in discussions with organization leaders, according to Dr. Tamara Vesel, chief of the Palliative Care Division at Tufts Medical Center and associate professor of medicine and pediatrics, Tufts University School of Medicine. ... When approaching organization leaders to advocate for palliative care, the importance of data cannot be overstated, according to study co-author Dr. Bernice Burkarth, chief medical officer of Tufts Medicine Care at Home and assistant professor of medicine at Tufts University School of Medicine.Editor's note: Reminder, our newsletter's Saturday edition always compiles relevant, timely research articles for you. To me, the word "research" means to "re-search," as in to search again--now--for the best information and appliciations available, today. We do alot of the work for you, re-searching and re-searching topics, pairing timely hospice and palliative challenges with formal research's background needs, research methods, data, references, conclusions, applications, and needs for further examination. 

Palliative care, ACO collaborations fuel ‘historical savings’ in MSSP Program Hospice News; by Holly Vossel; 11/11/24 Palliative care providers that form collaborative partnerships with Accountable Care Organizations (ACOs) may be lending to a landmark downward trend in health care spending in the value-based payment landscape. The U.S. Centers for Medicare & Medicaid Services (CMS) recently announced that its Medicare Shared Savings Program (MSSP) yielded more than $2.1 billion net savings in 2023 — the largest amount in the program’s inception more than a decade ago, according to the agency. ACOs participating in MSSP earned an estimated $3.1 billion in shared savings payments during the program’s 2022 to 2023 performance year, the highest dollar amount thus far, CMS reported. [Click on the title's link to continue reading.]

Most heart failure patients miss out on guideline-recommended palliative care Cardiovascular Business; by Dave Fornell; 11/6/24 Over the past decade, the American Heart Association (AHA) and European Society of Cardiology have recommended integrating palliative care into heart failure management. Despite these recommendations, the use of palliative care for heart failure remains low in the United States. Racial and geographic variations in access and use of palliative care are also pronounced, highlighting health disparities. These were the findings of a recent study in the Journal of the American Heart Association. Researchers at Saint Louis University led the study and said only one in eight patients with heart failure in the United States receive palliative care consultations within five years of diagnosis. Their study highlights the alarmingly low uptake of palliative care among adults with heart failure in the U.S., especially compared to patients with cancers that have the same mortality rates. The study also pointed out significant racial and geographic disparities. Black patients were 15% less likely to receive palliative care compared to their white counterparts. They said this disparity is particularly concerning given the higher cardiovascular risk and mortality rates in the Black population.

Early palliative care may curb aggressive end-of-life care Medscape; by Marilynn Larkin; 11/6/24 Increasing the uptake of palliative care may decrease the aggressiveness of end-of-life care, an analysis of ovarian cancer decedents suggested. Palliative care initiated earlier than 3 months before death was associated with lower rates of emergency department (ED) visits, hospital admissions, and intensive care unit (ICU) admissions in the last 3 months of life. It was also associated with a lower rate of death in the hospital. “When patients with advanced or incurable cancers experience aggressive end-of-life care, spending their final weeks of life in and out of the ED or admitted to acute care hospital wards or the ICU, where they undergo invasive tests or procedures that may not meaningfully prolong life or address symptoms or suffering, this can be very distressing for patients and their caregivers,” lead author Sarah J. Mah, MD, of McMaster University in Hamilton, Ontario, Canada, told Medscape Medical News.