Literature Review

Implementation of a serious illness conversation program in a health system: A retrospective observational studyJournal of Palliative Medicine; by Glen Varns, Abbey Sidebottom, Katy Hentges, Sandra Castro-Pearson, Jan Richardson, Emily Downing; 6/26Serious illness conversation (SIC) is a structured conversation framework designed to improve shared decision making and promote goal-concordant care with patients anticipating end-of-life care decisions. Objective: Examine reach, timeliness, and quality of SIC implementation across a health system after implementation of a SIC Program (SICP) [and] examine factors associated with SIC completion for eligible patients. Factors associated with SIC included palliative care visits ... , a primary care provider in the system ... , and an inpatient admission with discharge to home care ... Patients with dementia ... were less likely to have SIC. Conclusion: Systemwide implementation of an SICP engaged [only] half of eligible patients; many of those had multiple documented conversations prior to death.

Impact of specialized pediatric palliative care on bereaved parents' mental and physical healthJournal of Pain & Symptom Management; by Claudia Delgado-Corcoran, Huong D. Meeks, Sarah E. Wawrzynski, Barry P. Markovitz, Brandy Harman, Jasmine R. Masih, Kuan Li, Mark Harousseau, Dominic Moore, Jacob Wilkes, Stefanie G. Ames; 6/26Pediatric death can lead to long-term adverse effects on parents’ health. [In this study] of 776 deceased children linked to 773 mothers and 711 fathers, 36.1% received a SPPC [specialized pediatric palliative care] consultation prior to death. Higher rates of mental and physical health burden were observed in mothers than fathers across all time points. Lack of SPPC was associated with increased risks for new mental and physical health burden for mothers within 12 months after the child’s death ... Conclusions: Bereaved parents, especially mothers, experienced new mental and physical health burden up to 24 months after a child’s death.

Palliative care for older adults with hip fracture: An explanatory sequential mixed-methods studyJournal of Pain & Symptom Management; by Daniel I Hoffman, Sydney Moore, Amanda J Reich, Christina Sheu, Mengyuan Ruan, Masami Tabata-Kelly, Kate Sciacca, Tamryn F Gray, Daniel Dohan, Charlotta Lindvall, Zara Cooper; 6/26After hip fracture, older adults experience burdensome treatments and high mortality; they may therefore benefit from palliative care (PC). Among 1,433 hip fracture admissions, GOCC [goals of care conversations], hospice discussions, and specialty PC were documented in view on their role in GOCC. Conclusion: Limited standardization, role uncertainty, and cultural factors limited PC documentation and delivery, highlighting opportunities to strengthen PC integration in surgical care.

Outcomes for hospitalized patients with comfort measures only ordersJournal of Palliative Medicine; by Gina Piscitello, Donna Durant, Tami Minnier, Marika Haranis, Robert M Arnold, Jane Schell; 6/26Clinicians place comfort measures only (CMO) orders for hospitalized patients at the end-of-life when a decision has been made to focus on patient comfort and allow the natural dying process to occur. Our primary aim was to assess the associations of specialty palliative consults (SPC) or documented goals of care conversations (GOCC) with in-hospital mortality among patients with CMO orders. Of 6,789 hospitalized patients with CMO orders ... seventy-three percent died in-hospital, and 22% were discharged with hospice. SPC placed anytime during hospital admission were associated with lower in-hospital mortality ... and higher discharge with hospice ... In contrast, documented GOCC anytime during admission were associated with higher in-hospital mortality ...  and lower discharge with hospice ...

An end-of-life care approach defining a new standard of careJAMDA; by David N. Hoffman; 6/26The Institute for Healthcare Improvement (IHI) Leadership Alliance established an End-of-Life Care/Ending-Life Care Accelerator to define a continuum of care for patients as they progress from curative care, to palliative care, to hospice care, to final care planning, including ending life care interventions such as Medical Aid in Dying (MAiD), Voluntarily stopping eating and drinking (VSED), and palliative sedation. This accelerator defined as its goal the task of breaking down barriers between care providers which has been illuminated by research recently conducted by the Completed Life Initiative (CLI). CLI’s research efforts in this area started with an ongoing examination of nationwide hospice organization policies to provide referral for active intervention at the end of life. That effort was refocused on the widespread noncompliance of California and Washington state hospice organizations with a state law requirement to post on the organizations website a list of interventions made available by the hospice organization.

What do UK hospice websites communicate about the meaning of palliative care? BMJ Supportive & Palliative Care; by Lucy Williams, Charlotte Browne, Paul Perkins, and Vanessa Taylor; 6/30/26Objectives: Hospice websites are an important source of information for the public. This study examined whether information communicated about palliative care aligned with WHO and the International Association for Hospice and Palliative Care (IAHPC) definitions of palliative care. ... Conclusions: Key information was often missing, and opportunities to educate the public and address misconceptions are being lost. Hospice websites need reviewing and content updating to help improve public understanding of palliative care. Editor's Note: What does your website communicate? What information does it omit, and why? In a time of heightened scrutiny and rampant fraud, examine your website for strengths, gaps, and opportunities to educate and support the public with integrity, authenticity, and empowered choice.

Clinical Artificial Intelligence as a novice nurse: Leadership responsibilities for safe implementationNurse Leader; by Asiah Ruffin; 5/26Clinical artificial intelligence (AI) technologies are increasingly integrated into health care environments, influencing clinical workflows, documentation, decision-making, and patient communication. While AI is often introduced as a technical innovation, its implementation presents significant leadership responsibilities related to safety, workforce readiness, and organizational oversight. This commentary proposes an analogy that conceptualizes clinical AI systems as novice nurses—entities that require structured orientation, supervision, feedback, and ongoing development rather than autonomous trust. Using this analogy, the article examines risks associated with premature reliance on AI, including workflow disruption, performance variability over time, and limited user understanding of system capabilities and limitations. The commentary also outlines practical leadership considerations, including investing in workforce education, collaborating with human factors experts, establishing governance processes, and engaging in policy advocacy.

Palliative care or hospice? Flipping the classroom for 1st year pre-clinical medical students with interactive online contentAmerican Journal of Hospice & Palliative Care; by Maxwell Vergo, Charles Wang, Lawrence Myers; 5/26Although palliative care competencies appear on USMLE [United States Medical Licensing Examination] examinations, pre-clinical curricula devote minimal time to end-of-life education. We created a 30-minute interactive online module in Articulate 360™ for first year students covering palliative care definitions, eligibility criteria, and care settings. In-class time was restructured to small group case discussions distinguishing primary palliative care, specialty palliative care, and hospice. Correct responses on a palliative care examination question improved from 57% (2020-2021, virtual lecture) to 66%, 67%, and 80% in subsequent years with the flipped intervention. The pre-work engaged students in learning (79-89% agreement), enabled focus on advanced topics during class (73-77% agreement), and was described as interactive and helpful in teacher evaluations.

Pediatric home-based hospice and palliative care: A scoping reviewBMC Palliative Care; by Ellen Davis, Daniel H Grossoehme, Toluwalase Ajayi, Justin N Baker, Pamela S Hinds, Lisa Humphrey, Jill Ann Jarrell, Rachel Thienprayoon, Sarah Friebert; 5/26Pediatric palliative and/or hospice care is provided across a broad spectrum of settings, ranging from inpatient to outpatient to a child's home. Pediatric home-based hospice and/or palliative care teams offer a specialized, interdisciplinary approach to care, allowing children to stay in the home while offering comprehensive support. Common themes emerged [in this review] including studies analyzing models of care, characterizing the population, end-of-life decision making, clinical outcomes of home-based hospice and/or palliative care, costs and economic impact, family experiences, quality domains, specific treatment modalities, and the use of telehealth. Overall, the available literature supported home-based hospice and/or palliative care as an effective model of care, reducing the burden on families, improving quality of life, and allowing families to stay in their preferred setting for care without sacrificing clinical outcomes.

Referral and utilization patterns for home-based palliative care services among older adults BMC Palliative Care; by Joohyun Chung, Aaron Langlois, TylaAnn Burger, David L Chin; 6/11/26 Background: Home-based palliative care (HPC) improves quality of life for individuals with serious illness but remains underutilized in the United States, with persistent disparities in access. HPC is also frequently misconceived as appropriate only at the end of life. ... Results: ... Patients who received HPC were more likely to be older, female, insured through Medicare Part B, and referred from larger hospitals. Conclusion: These findings underscore ongoing structural disparities in access to home-based palliative care and highlight the need for targeted strategies to improve equitable access to HPC services.