Literature Review

[Canada] Feasibility of prospective error reporting in home palliative care: A mixed methods studyPalliative Medicine; Allison M Kurahashi, Grace Kim, Natalie Parry, Vivian Hung, Bhadra Lokuge, Russell Goldman, Mark Bernstein; 10/24 Palliative care patients may be particularly vulnerable to experiencing errors due to the complex communication among interdisciplinary team members (including the patient and their caregivers), the use of high-risk medications such as opioids and benzodiazepines, polypharmacy, patient frailty, and patient cognitive decline. Care in patients’ homes presents additional challenges to patient care that are unique from hospital settings: Decreased communication about roles and responsibilities in care can result from involvement of multiple care teams and different electronic records. The collaborative nature of care in a home-based palliative care context may present unique challenges to translating error reporting to improved patient safety. Physicians are amenable to error reporting activities so long as data is used to improve patient safety.

[UK] Multiple points of system failure underpin continuous subcutaneous infusion safety incidents in palliative care: A mixed methods analysisPalliative Medicine; Amy Brown, Sarah Yardley, Ben Bowers, Sally-Anne Francis, Lucy Bemand-Qureshi, Stuart Hellard, Antony Chuter, Andrew Carson-Stevens; 10/24 About 25% of palliative medication incidents involve continuous subcutaneous infusions. Complex structural and human factor issues make these risk-prone interventions. Primary incidents (most proximal to patient outcomes) leading to inappropriate medication use (including not using medication when it was needed) were underpinned by breakdowns in three major medication processes: monitoring and supply ... administration ... and prescribing ... Recurring contributory factors included discontinuity of care within and between settings, inadequate time, inadequate staffing and unfamiliarity with protocols. Psychological harms for patients and families were identified. System infrastructure is needed to enable timely supply of medication and equipment, effective coordinated use of continuous subcutaneous infusions, communication and continuity of care.

In 2023, the majority of home health aides and personal care aides were women U.S. Bureau of Labor Statistics - TED: The Economics Daily; 11/13/24 In honor of National Home Care and Hospice Month, we are highlighting data about two of the most common occupations that provide care to people with illnesses or disabilities in a home or community-based setting—home health aides and personal care aides. In 2023, women accounted for 87 percent of all home health aides and 80 percent of personal care aides. Workers in these two occupations assist people with activities of daily living (such as feeding or bathing), though home health aides generally focus more on their patients’ health and safety, while personal care aides often assist with other tasks (such as errands and housekeeping). Across all occupations, 47 percent of workers were women. Home health aides and personal care aides were more likely to be Black or African American (30 percent and 25 percent, respectively) than were workers overall (13 percent). Forty-two percent of home health aides and 27 percent of personal care aides were foreign born, higher than the average of 19 percent for workers overall. ... [Click on the title's link to continue reading.]

National program helped 27 states develop background check processes for long-term care McKnights Senior Living; by Kimberly Bonvissuto; 11/11/24 A national background check program was so successful in helping states develop or enhance systems for conducting background checks of prospective long-term care employees that more than a quarter million prospective employees were disqualified from working in the sector, even after funding for the program ran out, according to a final report on the program. The US Department of Health and Human Services Office of Inspector General released a final analysis on Thursday of the National Background Check Program for long-term care providers. The agency reported that 29 states participated in the program between 2010 and 2024 and that the program helped 27 of them develop programs to identify efficient, effective and economical procedures for conducting background checks on prospective long-term care employees. During the National Background Check Program, states disqualified at least 106,000 individuals with criminal convictions from employment. Disqualifying criminal convictions included offenses of murder, assault, battery, robbery, theft, fraud and forgery. 

Nurse burnout the root of decreased resident safety, medication errors, study shows McKnights Long-Term Care News; by Zahara Johnson; 11/6/24 A new study has found a direct link between nurse burnout and unfavorable patient and facility outcomes, including medication errors and a degraded safety culture. The meta-analysis of 85 studies and 288,581 nurses, compiling more than 30 years of research, concluded that nurses who suffer from burnout – emotional exhaustion, depersonalization and a low sense of personal accomplishment – have a negative impact on patients.

Why Judy Faulkner believes in 'yin-yang' leadership Becker's Health IT; by Giles Bruce; 11/4/24 Epic founder and CEO Judy Faulkner says effective leadership teams typically consist of people who balance each other out. She pointed to the definition of "yin and yang" as "complementary and at the same time opposing forces that interact to form a dynamic system in which the whole is greater than the assembled parts and the parts are important for cohesion of the whole," she wrote in a Nov. 4 blog post. Ms. Faulkner has often noticed that two people in leadership roles have great success together because they're so different.

Future-proofing healthcare: Upskilling the workforce to meet tomorrow’s challenges Healthcare Business Today; by Chris Trout; 11/4/24 A surgical technician recently told me, “We’re constantly helping people.” This simple yet powerful sentiment captures the essence of what healthcare workers ... focus on every day. However, the healthcare industry is undergoing profound changes that will shape its future over the next decade and beyond. These changes, driven by workforce shortages, AI and technological advancements, and shifting skill demands, have the potential to either enhance or burden healthcare systems. ... One of the most significant forces driving change is the shortage of healthcare workers, especially in critical areas like nursing. ...  The replacement cost for a nurse is estimated to be between $40,000 and $60,000, covering recruitment, temporary staffing and lost productivity. But these numbers don’t account for the consequences of staffing shortages: diminished patient care, declining morale and increasing mental health challenges among overworked staff. Despite these challenges, healthcare organizations have a remarkable opportunity to develop talent, especially in entry-level and middle-skill roles. [Click on the title's link to continue reading.]

15 things to know about Gen Z workers Becker's Hospital Review; by Kristin Kuchno; 10/29/24 Each new generation entering the workforce tends to puzzle management, and members of Generation Z are no exception. Here are 15 things healthcare leaders should know about Gen Z:

Less activity, more sitting linked with higher death risks: study McKnights Long-Term Care News; by Kristen Fischer; 10/28/24 Low physical activity is associated with a higher risk of dying from all causes as well as from cardiovascular disease, diabetes, and kidney disease. In addition, the combination of reduced activity and longer sitting time every day is linked with a higher risk of death from any cause, a new study finds. Staying active and reducing sitting time may lower the risks, authors of the report wrote. The report was published Oct. 26 in BMC Geriatrics.Editor's note: Calling all leaders who have desk-bound employees, and who sit too long (yourselves) ... What creative ways do you encourage healthy work habits, movement, and more? Do you provide ergonomic sit/stand desks? Healthy chairs? More? Read this and remember that as we will age, today's habits impact tomorrow's health.

The case for stronger caregiver vetting in home care Home Health Care News; by Audrie Martin; 10/24/24 Direct care workers are, in many ways, the collective face of home-based care organizations. They are who clients and patients interact with. Therefore, regulators and providers are increasingly taking a closer look at who they’re hiring in the first place. While it is shocking to see caregivers commit crimes against clients, it does happen. About one in six people aged 60 and older experienced some form of abuse during 2023, according to the World Health Organization. Rates of abuse against older people have increased since the COVID-19 pandemic and are predicted to continue rising as many countries experience rapidly aging populations. To combat this trend, increased vetting is essential when hiring individuals to care for seniors in their homes. Editor's note: Related, disturbing articles we posted recently include ...

Diagnosed with disease he studied, Stanford doctor puts his personal story at center of new class. NBC Bay Area; 10/24/24 Stanford Medicine physician Dr. Bryant Lin is the perfect professor to teach the course “From Diagnosis to Dialogue: A Doctor's Real-Time Battle with Cancer” at Stanford. And that’s not necessarily a good thing. The class focuses on the cancer journey of a non-smoking patient diagnosed with lung cancer. Dr. Lin is that patient. “I want to take something that is obviously very negative to me personally and get some benefit out of it for at least for other people,” Dr. Lin said. 20 years ago, Dr. Lin chose a career in medicine for a simple reason. “I wanted that personal connection and that satisfaction from helping people on a day-to-day basis,” Dr, Lin said. This same motivation led Dr. Lin to co-found Stanford’s Center for Asian Health Research and Education in 2018, with a particular focus on lung cancer in non-smokers. This is why Dr. Lin was (and in a way was not) surprised when earlier this year he found himself part of the 20% of lung cancer patients who have never smoked. ...  [Click on the title's link to continue reading this inspirational story.]

Kaiser Permanente mental health workers go on strike in Southern California Fox 5 - KUSI, San Diego, CA; by Danielle Dawson; 10/21/24 Thousands of mental health workers at Kaiser Permanente locations across Southern California hit the picket lines on Monday for the first day of an open-ended strike, calling for measures to reduce employee turnover and better patient care. ... The unionized mental health professionals — encompassing therapists, psychologists, social workers and psychiatric nurses — have been demanding Kaiser address issues in their next contract that have contributed to “substandard” care in Southern California. ... Last year, California behavioral health regulators flagged several of these problems when it hit Kaiser with a $50 million fine — the largest-ever penalty issued by the department — for failing to provide timely care to its patients as part of a wider $200 million settlement agreement. “Our agency could lose its Medicare license because we have five days to see our patients and, because our unsustainable caseloads, patient care is being delayed,” Elizabeth Meza, a San Diego-area hospice worker, told KUSI Monday morning. “We are only able to provide the minimum amount of care that they need.”

Music therapist helps patients navigate end-of-life journey on Long Island CBS New York / YouTube; by Jenna DeAngelis; 10/15/24 Music therapy helps with emotional and physical health, and now the healing power of music is being brought to hospice patients on Long Island.