Literature Review

Making a health system merger succeed: Michigan Medicine’s journey toward a high-quality, coordinated statewide system of careNEJM Catalyst; by Scott A. Flanders, Margaret Dimond, David C. Miller; 4/26After its April 2023 acquisition of Sparrow Health, Michigan Medicine and its five-hospital system, University of Michigan Health, launched a major effort to advance business, clinical, and cultural integration across the new 11-hospital enterprise. The goal was to achieve a coordinated, integrated statewide system of care that delivered improved quality and better experience, while providing academic hospital-caliber care closer to home for patients across the state. Those efforts have led to improved financial performance, [increased employee satisfaction and reduced RN annual turnover]. Clinical integration, driven by the development of local clinical programs, initiatives to coordinate statewide care, and innovative technology solutions, has resulted in a higher quality of care delivered closer to home. For cultural integration, the keys to success have been leadership alignment, a clear vision and goals, a supportive infrastructure, strong systemwide communication, and achieving and celebrating early wins.

Rigorous assessment of leadership development programs in health careNEJM Catalyst; by Amanda Woods Herron, Katelyn J. Cavanaugh, Courtney L. Holladay; 4/26Effective leadership is increasingly recognized as a critical determinant of organizational performance within health care systems, but funding for such programs is frequently in jeopardy as revenues fail to keep up with other expenses. Therefore, the managers of such programs should adopt rigorous methods for evaluating the impact of their work. Despite the proliferation of leadership development programs, few institutions systematically evaluate these initiatives. This article presents a comprehensive framework for the evaluation of leadership development, grounded in implementation science and organizational research, as applied within a large academic health care institution. The framework emphasizes the necessity of clear eligibility criteria, integrated data sources, and alignment with institutional strategic priorities to assess program effectiveness and support continuous improvement. 

Bridging faith and palliative care: Catholic clergy and community engagement in the United States American Journal of Hospice and Palliative Care; by Clotilde Dudley-Smith and Brian Stiltner; 5/27/26 ... Spiritual care delivered by community clergy when disconnected from contemporary palliative care principles may, in some cases, unintentionally contribute to delayed hospice referral and increased use of aggressive, nonbeneficial treatments near the end of life. Drawing on interdisciplinary literature in palliative care, chaplaincy, and sociology of religion, this paper examines structural, educational, and cultural barriers that limit collaboration between palliative care teams and Catholic clergy in the United States.

From loss to calling: Nursing students’ experiences of family terminal illness and death in the formation of professional identity and humanistic care Death Studies; by Laurie Glick and Adi Finkelstein; 5/10/26 ... This qualitative study examined nursing graduates who experienced the terminal illness and death of a close family member, providing them with early exposure to clinical settings and shaping their emotional insight and sensitivity to the psychosocial dimensions of end-of-life care. Their experiences often deepened their desire to enter the nursing profession and deliver compassionate, humanistic, family-centered care as clinical practitioners. 

How to transform a health system’s organizational culture and hardwire it for the futureNEJM Catalyst; by Brian Carlson, Nancy M. Lorenzi, Paul Sternberg, Jr., Cassandra Hennessy, Dandan Liu; 4/26Organizational culture is a critical driver of workforce and patient experience, yet health care institutions often struggle to sustain their desired culture over time. In 2017, Vanderbilt Health identified inconsistencies in expected workforce behaviors through patient feedback, prompting the creation of a strategic cultural renewal initiative. The resulting program, Defining Personalized Care, had a 4-year road map of seven e-learning modules designed to reinforce core values and improve interpersonal behaviors across the workforce. This single-center pre–post study revealed statistically significant improvements in patient experience scores, particularly in the communication and courtesy domains. The initiative demonstrated that engaging, relevant content combined with visible support from leadership can drive voluntary participation and generate measurable outcomes. This case study offers a replicable framework for health care organizations seeking to hardwire their cultural expectations and align workforce behaviors with patient-centered care goals.

Potential adjunctive role of osteopathic manipulative medicine in the management of cancer-related bone pain: A narrative reviewCureus; by Ambrose Loc T. Ngo, Niki Gharavi Alkhansari, Chi Pham, Hong Nguyen, Monica Rubi, David Tanner; 4/26Osteopathic manipulative medicine (OMM) is known for its therapeutic potential on the musculoskeletal system, and its emerging role and potential benefits in oncology care are gaining attention. Patients with primary and metastatic bone cancer tend to experience pain, restricted movement, and lower quality of life due to the pathology and its treatment. This narrative review examines the mechanistic rationale and available clinical evidence supporting the use of OMM in the management of pain and functional impairment among patients with bone malignancies. Limited clinical studies suggest that select OMM techniques, including myofascial release (MFR), gentle soft tissue methods, and lymphatic approaches, may contribute to improvements in pain perception, mobility, and fatigue in oncology populations.

The state of hospice: Impacts on equity, quality, and nursing-An AAN consensus paperNursing Outlook; by Laura Fennimore, Kathleen O Lindell, Marjorie M Godfrey, Melissa Reider-Demer, Patrick J Coyne, Ronda G Hughes, Sharon Kozachik, Masako Mayahara, Patricia L Thomas, Nelson Tuazon, Polly Mazanec; 4/26Hospice care has been an integral component of the United States healthcare system for over fifty years. Hospice has transitioned from a volunteer activity supported by philanthropy to a highly sophisticated business funded by Medicare, increasingly offered by for-profit and private equity companies. This consensus paper examines the current state of hospice care in the US and the impact of changing hospice business models on health equity, healthcare quality, and nursing practice. Recommendations include updating policies to account for private equity involvement, evaluating current quality measures, addressing the existing Medicare Hospice Benefit, ensuring transparency and oversight for hospice agencies, and ensuring patient and caregiver education about hospice services. These recommendations aim to preserve the fundamental values of hospice, supporting compassion, dignity, and comfort while ensuring the quality of care to patients and families in need.