Literature Review

Bill introduced to increase access to advanced wheelchairs HomeCare, Nashville, TN; 10/24/24 U.S. Senators Marsha Blackburn (R-Tenn) and Tammy Duckworth (D-Ill.) introduced the Choices for Increased Mobility Act (S 5154) to increase access to wheelchairs made with advanced materials by allowing Medicare beneficiaries to upgrade to lighter, more functional wheelchairs without bearing the entire upfront cost. These manual wheelchairs help prevent shoulder injuries, enhance maneuverability and reduce overall pain and fatigue for users. ... When the Medicare billing code for ultra-lightweight manual wheelchairs was established in 1993, materials like titanium and carbon fiber were not considered, as they were not yet in use for wheelchairs. As a result, ... providers have struggled to supply wheelchairs with these advanced materials at the fee schedule amounts set by Medicare.

Michigan HHS to pay $13M after unannounced shooter drill at psych hospital Becker's Hospital Review; by Mariah Taylor; 10/18/24The Michigan Department of Health and Human Services agreed to pay $13 million to settle allegations that it caused psychological damage after conducting a surprise active shooter drill at a children's psychiatric hospital, The Washington Post reported Oct. 17. The Hawthorn Center, based in Northville Township, Mich., is a state-run psychiatric hospital for children with emotional, mood and thought disorders. On Dec. 21, two laborers were instructed by their supervisor to act as armed intruders in an unannounced drill. The two were told to walk around the facility and ensure every room was locked and the people inside were hidden. The receptionist was instructed to announce that there were active shooters in the building and that shots were fired. Neither the staff nor the police were notified a drill was occurring. 911 calls reported the active shooter and 22 police officers rushed to the scene. The two laborers exited the building and were detained while the police sorted out the situation. Employees filed a class action lawsuit in April 2023 against the health department-run facility alleging that the unannounced drill gave them post-traumatic stress and emotional harm. According to the lawsuit, patients acted aggressively toward themselves and others in the subsequent weeks, and staff members experienced increased anxiety and sleep struggles, and some quit their jobs.

Safety first: How to ward off health care facility violence SmartBrief; by Julia M. Johnson; 10/23/24Panelists on an American Hospital Association webinar highlight ways in which hospitals and practices can protect their patients and themselves. ... The American Hospital Association recently hosted a webinar about what hospitals and practices need to know to protect themselves, staff members and patients. “Understanding Origins of Violence in Health Care Facilities” featured Jason Grellner of Evolv Technology and Drew Neckar of Cosecure. Both panelists spoke candidly about technology, terminology and steps that can be taken to dial down the danger at health care facilities.  

Research suggests AI could enhance patient safety, but raises questions The American Journal of Managed Care (AJMC); by Hayden E. Klein; 9/26/24 A new study from Boston University highlighted the potential of generative artificial intelligence (AI) to improve patient safety in health care. Published in The Joint Commission Journal on Quality and Patient Safety, the study tested the widely used AI model GPT-4 on the Certified Professional in Patient Safety (CPPS) exam, where it answered 88% of questions correctly. Researchers believe AI could help reduce medical errors, estimated to cause 400,000 deaths annually, by assisting clinicians in identifying and addressing safety risks in hospitals and clinics. ... The study authors suggested that AI has promise in helping doctors better recognize, address, and prevent mistakes or accidental harm in hospitals and clinics. ... However, the study also highlighted critical limitations of current AI technologies, including the risk of bias, fabricated data, and false confidence in responses. 

Man accused of choking terminally ill wife accepts plea deal KSL.com; by Pat Reavy; 9/27/24 A man who prosecutors say attempted to end his terminally ill wife's life by choking her has accepted a plea deal. DeWayne McCulla, 46, pleaded guilty on Thursday in 5th District Court to an amended charge of attempted manslaughter, a third-degree felony. The charge comes with a domestic violence sentencing enhancement. Arenda Lee McCulla, 47, died on Dec. 21, 2021, following her battle with breast cancer. The night before, however, as a small group of family members were by her side in La Verkin, DeWayne McCulla "choked the victim in an attempt to kill her to ease her suffering while they were with her during her terminal cancer and being on hospice," according to charging documents. Other family members pulled McCulla off of his wife.Editor's note: Crucial information that is not reported in this article: Where was the hospice team in managing this patient's pain? In educating and supporting the caregiver (the husband?) and family about contacting the hospice? In making required visits when the patient is actively dying? In assessing the caregiver's ability to provide care, especially any history or risks of domestic violence, neglect, or abuse? What safety-in-the-home protocols were used by this hospice, especially when hospice team members followed up? Aware of not-knowing these many factors, I do not ask these with judgment but rather to raise awareness of core, preventive measures for other hospice patients.

Injurious fall risk differences among older adults with first-line depression treatmentsJAMA Network Open; Grace Hsin-Min Wang, PharmD, MS; Edward Chia-Cheng Lai, PhD; Amie J. Goodin, PhD; Rachel C. Reise, PharmD, MS; Ronald I. Shorr, MD, MS; Wei-Hsuan Lo-Ciganic, PhD, MS, MSPharm; 8/24One-third of older adults in the US have depression, often treated with psychotherapy and antidepressants. In this cohort study of older Medicare beneficiaries with depression, first-line antidepressants were associated with a decreased FRI risk compared with untreated individuals. These findings provide valuable insights into their safety profiles, aiding clinicians in their consideration for treating depression in older adults.

Reducing central nervous system–active medications to prevent falls and injuries among older adults-A cluster randomized clinical trialJAMA Open Network; Elizabeth A. Phelan, MD, MS; Brian D. Williamson, PhD; Benjamin H. Balderson, PhD; Andrea J. Cook, PhD; Annalisa V. Piccorelli, PhD; Monica M. Fujii, MPH; Kanichi G. Nakata, PhD; Vina F. Graham, BS; Mary Kay Theis, MA, MS; Justin P. Turner, PhD; Cara Tannenbaum, MD, MSc; Shelly L. Gray, PharmD, MS; 7/24This cluster randomized clinical trial found that a health system–embedded deprescribing intervention was no more effective than usual care in reducing medically treated falls among community-dwelling older adults prescribed CNS-active medications. For health systems that attend to deprescribing as part of routine clinical practice, additional interventions may confer modest benefits on prescribing without a measurable effect on clinical outcomes.

Person-centered, goal-oriented care helped my patients improve their quality of life Journal of the American Board of Family Medicine; by Lee A. Jennings and James W. Mold; orignially posted 5/24 issue, again on 8/15/24 When the goal is to help patients improve their quality of life, it makes sense to focus directly on the activities and relationships that are most important to each patient. This can be accomplished most effectively by following a three-step process that includes 1) connecting with the patient around what matters to them, 2) co-creating a goal-oriented plan, and 3) collaborating with patient, family, team members, and consultants to increase the probability of success. Once this approach has been mastered and the necessary systems, processes, and relationships are in place, this should not take more time than a problem-oriented approach, and it will almost certainly be more satisfying for both physician and patient. Editor's Note: Simple. Effective. Meaningful.

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. 

Alpharetta City Council considering fee for lifting assistance calls Appen Media, Alpharetta & Roswell, GA; by Jon Wilcox; 7/16/24 The Alpharetta City Council is considering a fee for residents and assisted living homes who make multiple calls a month for emergency responders to help people who have fallen. Director of Public Safety John Robison told the council July 15 that calls for lifting assistance come at significant cost and tie up responders who may be needed for other emergencies. Last year, Robison said, 328 calls for lift assistance cost the city $78,844, almost double the cost from the previous year, which saw 190 calls at a cost of $32,275.30. ... A proposed ordinance suggests a schedule of fees for calls asking responders to assess people who have fallen and may be injured. ... Hospice patients would be exempt from the fees. 

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.

‘Normalizing’ Trauma-Informed Hospice Care Delivery

Children’s Healing Center opens in Ypsilanti Township in July DBusiness Magazine, Detroit, MI; by R. J. King; 6/24/24 The Children’s Healing Center will open its doors in Ypsilanti Township on July 8, offering children with weakened immune systems and their families a safe and clean place to play. ... The facility is the Children’s Healing Center’s second location after first opening its doors in Grand Rapids in 2015. The new state-of-the-art 11,000-square-foot facility features a hospital-grade environment where families can engage in a diverse range of innovative programming free of charge. “It has always been our goal to open a second location of the Children’s Healing Center,” says Amanda Barbour, founder and CEO of Children’s Healing Center. “The kids, young adults, and families who rely on us have very few options for social interaction, so we provide an invaluable outlet to build friendships and fight the effects of isolation and loneliness. The Children’s Healing Center states it is a first-of-its-kind year-round recreational facility for kids and young adults aged 0-26 with weakened immune systems and their families that provides opportunities for play, programming, education, and socialization.