Literature Review

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.

CMS finalizes 2.9% cut in physician payments for 2025, including for palliative care Hospice News; by Jim Parker; 11/4/24 The U.S. Centers for Medicare & Medicaid Services (CMS) has finalized a nearly 2.9% cut for 2025 in physician payment rates used to reimburse palliative care care practitioners, among other professionals. The final rule also states that the telehealth flexibilities implemented during the COVID-19 public health emergency will expire at the end of this year unless Congress intervenes. Physicians and other professionals will have to follow pre-COVID restrictions on telehealth, with few exceptions. Industry organizations were quick to denounce the pay cut. “To put it bluntly, Medicare plans to pay us less while costs go up. You don’t have to be an economist to know that is an unsustainable trend, though one that has been going on for decades,” American Medical Association President Dr. Bruce Scott said in a statement.

Providence, nurses union step up war of words as new Portland-area hospital strike looms The Lund Report; by Jake Thomas; 10/31/24 Providence is accusing the state’s largest nurses union of “power flexing” after nurses at Providence St. Vincent signaled they are willing to strike in what could be another widespread work stoppage at the hospital system. The Oregon Nurses Association announced Thursday that 1,800 nurses at the hospital located in unincorporated Washington County, just west of Portland, gave union negotiators the green light to call for a strike. ... Nurses and allied health care workers at Providence’s Portland and Seaside hospitals as well as its Home Health & Hospice service went on strike in June last year. Each of the three workplaces eventually reached contracts with Providence. But the new contracts had shorter timeframes than usual because of the strikes and are set to expire on Dec. 31, 2024. All three began negotiations again with Providence management last month. 

The hurdles providers may face when setting up a palliative care program Hospice News; by Jim Parker; 10/30/24 Health care providers can have a bumpy road ahead of them when it comes to launching a new service like palliative care, in part due to complex legal and regulatory requirements. Before they launch a new program, operators must have a clear picture of their target population and the structure they want to build, according to Rachel Carey, counsel with the Virginia-based law firm Whiteford. Carey advises hospices establishing new services, pursuing acquisitions and other issues. Hospice News spoke with Carey about the regulatory and legal obstacles that health care providers may encounter when setting out to build a new program and what they should do to prepare. 

‘Let patients lead the way’: Hospice veterans’ advice for new nurses Hospice News; by Jim Parker; 10/25/24 ... A key barrier to building [the hospice and palliative care] workforce is that, with some exceptions, most clinicians receive little to no exposure to those types of care during their training. Nurses who are new to the hospice space often face a learning curve, according to Briana Hilmer, an Iowa-based admissions nurse for St. Croix Hospice.

The ever-rising importance of hospital chaplains RNS; by Robert L. Klitzman; 10/24/24 Frequently, chaplains are the only hospital staff member who has time to sit and speak with patients and families. ... “My religion is watching CNN,” a feisty elderly woman with cancer recently told a hospital chaplain who had knocked on the patient’s door to introduce himself. ...  [After initial resistance, they] developed a rapport, and she described her deep loneliness and terror of dying. At the end of their conversation, she felt better, grasped the chaplain’s hand firmly and said, “Thank you!” ... In recent decades, the proportion of Americans who are “religiously unaffiliated” has risen sixfold, and the percentage of “Christian” individuals has dropped about a third. Partly as a result, chaplains have, at the same time, increasingly gained training in interfaith and nondenominational approaches, and frequently see their profession as “post-religious” — extending beyond the boundaries of any one particular faith; taking nondenominational, multifaith and humanistic approaches; and commonly receiving training in counseling. With these skills they aid patients, from evangelical to agnostic, atheist and “nothing in particular,” in resetting priorities and finding sources of connection, meaning, purpose and hope. Strongly committed to aiding vulnerable and underserved populations, chaplains remind doctors to uphold the dignity of every patient.

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.  

State association launches support program for home, hospice, personal care workers The Journal Gazette, Fort Wayne, IN; by Lisa Green; 10/15/24 A statewide association for home and hospice care professionals is launching a support program today with features including training and one-on-one counseling to help with workforce retention. The CARE (Creating Action and Resources for Employees) Connect program is billed as the first of its kind in the U.S., a news release said. A recent report released by MissionCare Collective indicates that caregivers are three times more likely to suffer from anxiety and depression, and 21% of caregivers nationwide self-report poor mental health. And 55% of those workers receive some form of federal or state assistance, the Indiana Association for Home and Hospice Care said in a news release announcing the new support program.

4 trends in healthcare executive pay Becker's Hospital Review; by Kelly Gooch; 10/15/24 A 2024 survey conducted by SullivanCotter highlights a range of trends in healthcare executive pay, including a year-over-year jump in median base salaries. The consulting firm's "2024 Healthcare Management and Executive Compensation Survey" is based on data from more than 3,300 organizations representing nearly 45,110 executives and managers. Here are four trends from the survey, which was conducted from January to April:

More health care teamwork means less burnout: physician survey American Medical Association (AMA); by Georgia Garvey; 10/8/24 Physician burnout is largely influenced by workplace structure and experiences. That is where team-based and safe-care delivery can help, according to a study published in The Joint Commission Journal on Quality and Patient Safety. In the study, “Teamwork Climate, Safety Climate, and Physician Burnout: A National, Cross-Sectional Study,” 1,218 U.S. doctors nationwide were surveyed about burnout and workplace experiences, including teamwork and safety climate. ... The researchers concluded that there is a strong relationship between the amount of teamwork and safety in physicians’ work environments and burnout. It is a relationship that showed improvements on those metrics even when compared with slightly different work climates. Among the physicians surveyed, 27.4% reported high depersonalization, 39.9% reported high emotional exhaustion and 45.6% met the criteria for burnout. But even small increases in teamwork and safety climate were related to improvements in physicians’ feelings of depersonalization, burnout or emotional exhaustion.

Ellen McGirt on supporting caregivers at work Great Place to Work; by Roula Amire with Ellen McGirt; 10/8/24 This episode of Better features journalist, speaker, and podcast host Ellen McGirt. In this deeply personal conversation, we dive into the challenges of caregiving while balancing a career.  ...On how managers can better support caregivers at work: Flexible time off, no questions asked. A flexible schedule can change everything for people. ...On the impact a senior leader can have by talking about caregiving and grief: If a very senior person triggers this conversation in the workplace with a disclosure or concern, you're going to see new training, new conversations, new talking points, and new volunteers, and maybe even new staff positions around this. ...On how colleagues can support coworkers who are caretakers, or members of the sandwich generation: Kindness and compassion go a long way. ...

University of Maryland bolstering palliative care workforce via master’s degree, certification program Hospice News; by Molly Bookner; 10/7/24 The University of Maryland, Baltimore (UMB) School of Pharmacy is seeking to address the dearth of palliative care-trained clinicians and improve care among seriously ill patients. By 2060, the demand for palliative care is expected to nearly double, according to the World Health Organization. Yet, despite this need, significant gaps in training remain, with many professionals lacking exposure to hospice or palliative care during their schooling. UMB seeks to bolster the palliative care workforce through its online Graduate Studies in Palliative Care program, launched in 2017. While most palliative care clinical education programs see small cohorts of five or fewer students, UMB is seeing a larger crowd of professionals enter the workforce. Of the Class of 2024, 36 students received their Master of Science degree and seven received a graduate certificate. “We have an amazing diversity of students,” Mary Lynn McPherson, professor in the Department of Practice, Sciences, and Health Outcomes Research at the School of Pharmacy and executive program director of Graduate Studies in Palliative Care, told Palliative Care News.