Literature Review

Suffering revisited: Tenets of intensive caring Psychiatric Times; by Harvey Max Chochinov, MD, PhD, FRCPC Patients approaching death experience many losses, including losing a sense of self. This is perhaps one of the most substantive existential challenges dying patients face, as they find the essence of who they are—along with who they were or who they want to be—under assault. This notion of disintegration or fractured sense of personhood often lies at the heart of human suffering, which Eric Cassell, MD, MACP, defined as a person’s severe distress at a threat to their personal integrity. Although suffering can often lead to feelings of hopelessness and therapeutic nihilism for patients and health care professionals, it is important for those of us who care for the dying to understand the nature of suffering and how to be most responsive and therapeutically effective. [This author's Tenets of Intensive Caring include the following:]

Death is no enemy Psychiatric Times; by Sidney Zisook, MD; 9/17/24... As mental health clinicians, we often confine our conversations about death and dying to recognizing suicide risk and preventing suicide. And for good reason. Suicide is the 11th leading cause of death in the United States, ... Far less attention is paid by mental health clinicians to other aspects of death and dying. But we are human, first and foremost, and coping with a host of issues related to the end of life is inextricably bound to both our professional and personal lives. Like it or not, death is part of life. We, as mental health clinicians, are not always as prepared as we would like to be to help ourselves, our loved ones, our patients, and their loved ones deal with loss, dying, death, and bereavement. For many physicians, 1 or 2 hours in medical school and perhaps another few hours during residency are all the training we receive in these complex and challenging clinical issues. ...  Chochinov provides a clinician’s guide for “being with” dying patients. He offers ways of providing intensive caring to enhance empathy, respect, connectivity, and hope, and to make the experience of a dying patient more tolerable than it otherwise might be. ... I have utilized his Patient Dignity Question, which asks, “What do I need to know about you as a person to take the best care of you possible?” on several occasions with gratifying results for both the patient and me.

Breaking the barriers in information sharing: Changing the discussion from legal risk to C-suite opportunity N2K; by Rick Howard; 9/16/24 In the evolving landscape of cybersecurity, sharing information among institutions is critical to bolster defenses against increasingly sophisticated threats. Cooperation between organizations can strengthen everyone’s defenses, but such an approach requires openness and transparency, something that many organizations have been reluctant to do. ... The C-suite – comprising top executives such as the CEO, CFO, CIO, CISO, and others – plays a critical role in shaping an organization's approach to cybersecurity. In the context of information sharing, the C-suite's role is pivotal in driving the cultural and operational changes necessary to transition from a risk-averse stance to one that recognizes the strategic value of collaboration and information exchange. One of the most successful initiatives that C-suite leaders can champion is participation in industry-specific Information Sharing and Analysis Centers (ISACs). ... [Following discussions include:] The business case for information sharing ... Enhanced risk management ... Cost savings and resource efficiency ... Compliance and legal benefits ... Innovation ... Professional Development ... Challenges to information sharing ... Legal and regulatory complexities ... Risk of exposure and misuse ... Trust issues among organizations ... Technical barriers ... Cultural and organizational obstacles ... Sharing information ... Categorize information by sensitivity ... Assess recipients ... Vet the data ... Monitoring and oversight ... Engaging in industry-wide collaboration ... Real world examples - Health-ISAC and the faulty CrowdStrike update ... The path forward ... [Click on the title's link for the full article and a whitepaper.]

Innovative program reduces nurse turnover and fosters development Oncology Nursing News; by Heather Wood, RN, OCN and Marie Garcia, RN, OCN; 9/12/24 Cancer incidence is on the rise in the US, especially among the growing older population. ... Unfortunately, the current shortage of oncology nurses is expected to worsen, as fewer people enter the profession while aging nurses retire. By 2025, a shortage of 200,000 to 450,000 oncology nurses is predicted in the US. ... In response, The US Oncology Network (The Network) has developed one of the most comprehensive programs in the nation to support the professional development and retention of new oncology nurses. ... Designed to enhance their knowledge of fundamental oncology, OCEAN is a collaborative effort bringing together a multidisciplinary team of experts and speakers from across The Network. The program provides fundamental oncology knowledge around 12 core areas delivered over 22.5 hours of live virtual learning. Content ranges from ... various treatment modalities ... to palliative care and advanced care planning. OCEAN’s impact extends beyond skill development, fostering a sense of belonging and purpose among participating nurses. ... Early results from the program are promising, such as increased retention rates [12% better than the national average] and cost savings. 

More nonprofit hospices consolidating amid economic, regulatory pressures Hospice News; by Jim Parker; 9/12/24 As M&A in the for-profit space continues its two-year slump, nonprofits are consolidating in rising numbers. Recent years have seen an uptick in consolidation activity among nonprofits in the hospice space. Increasingly, nonprofits are pursuing acquisitions and affiliations, as well as forming regional collaboratives. In addition, some nonprofits have also been acquired by for-profit companies. Driving this trend are reimbursement and regulatory pressures, as well as a need to compete with larger, well-capitalized for-profit entities, according to Mark Kulik, senior managing director for the M&A advisory firm The Braff Group. [Click on the title's link to continue reading this significant article.] 

Seven pillars to put healthcare consumers at the heart of the digital transformation Forbes; by Hélène Musikas, Géraldine Maouchi, Lorenzo Mandelli, Daniel Brown; 9/6/24 The digital age has seen many industries undergo a profound transformation, evolving into agile "Hybrid Organizations" that blend traditional and digital business models. ... The healthcare sector, however, faces a unique set of challenges on its journey toward this transformation. ... One of the most significant shifts in healthcare is the rising concept of "Self-Care". Seven Ways To Harmonize The Digital Landscape In Healthcare ...

Urgency to adopt AI intensifies for health IT leaders Becker's Health IT; by Naomi Diaz; 9/4/24 A Sept. 4 survey from healthcare data platform Arcadia revealed that 96% of healthcare technology leaders view the effective use of AI as crucial for gaining a competitive edge. ... The findings show that while 33% of these decision-makers see AI as essential today, that number rises sharply to 73% who believe it will be indispensable within the next five years. Despite their confidence in AI adoption, 96% of health tech leaders report feeling an increasing urgency to act, driven by pressure from data and analytics teams (82%), IT and tech departments (78%) and executive leadership (73%). However, the survey also highlights a significant challenge: 40% of leaders cite a talent shortage as a major barrier to AI implementation. This has led CIOs to place greater emphasis on skills such as data-driven decision-making (71%), data analysis, machine learning and systems integration (66%), as well as the need for roles focused on training and support for healthcare staff (59%).

“What I wish I knew about hospice”: A Cleveland Clinic palliative care physician’s insights The Healthy; by Dr. Patricia Varacall, DO; 9/3/24 End-of-life care is deeply personal and incredibly complex. An expert MD shares essential insights on hospice: "At its core, is about human connection." … Laura Hoeksema, MD, MPH, FAAHPM, medical director of Cleveland Clinic Hospice and staff physician in the department of palliative and supportive care, explains the importance of hospice: “Death is a part of life just as much as birth is. When time becomes limited, patients need to be able to spend time in a way that’s meaningful to them.” ... Dr. Hoeksema emphasizes that choosing hospice care is exactly that—a choice. The team offers additional support, guiding patients and their families through the last months of life. ... “When a patient has a serious illness, it’s common for their illness to become the primary focus,” reflects Dr. Hoeksema. The constant anticipation of how the disease might progress can create overwhelming anxiety. With hospice, the illness recedes into the background, allowing the emphasis to be on caring for the person as a whole. ... “The most profound healing I’ve witnessed as a physician has been in patients receiving hospice care,” Dr. Hoeksema adds. She recalls seeing families reconcile after years of tension and others coming together after long periods of distance. The joy on a patient’s face when surrounded by loved ones, laughing and reminiscing, is what it’s all about. “Hospice care, at its core, is about human connection.”

LifeTouch Hospice still providing end-of-life care in South ArkansasEl Dorado News-Times; by Keturah Smith; 8/28/24LifeTouch Hospice said Monday they would like the South Arkansas community to know the company remains fully operational and continues to offer care to terminally ill patients after merging with Little Rock-based Arkansas Hospice last year. "There has been some misconception in El Dorado with the closing of the hospice house," said Hannah Odell, LifeTouch provider relations representative, at the El Dorado Rotary Club meeting. "LifeTouch Hospice is very much still around." While the physical location of LifeTouch has closed, Odell mentioned their services can be provided at the nursing home, local hospital, assisted living, home or wherever care is needed. "We're contracted with South Arkansas Regional Hospital for [general inpatient care] for the most critical patients," Odell said. ...

VNA Hospice and Don Quijote supports Meals on Wheels with annual benefit dinner GreatNews.Life, Valparaiso, IN; by Garrett Spoort; 8/27/24 Don Quijote Restaurant hosted its fourth annual VNA Hospice NWI Meals on Wheels benefit dinner on Sunday, August 25. The event serves as a traditional fundraiser while educating the community and sharing stories about the program. Bob Franko, CEO of VNA Hospice NWI, has high anticipation every year as this event inches closer. “This is something that we look forward to every year,” Franko said. “We have about 250 people in our Meals on Wheels program. Every $125 that we raise today will feed a senior for a month. Food scarcity has become more of an issue in our community for the seniors, so this event is really important for us.” Don Quijote has supported the mission for VNA Hospice’s Meals on Wheels program. The restaurant covers all of the event costs, allowing all of the funds raised to go directly to feeding seniors in need.Editor's Note: What a wonderful community partnership. Typically, nonprofit organizations are raising money for their own services. This initiative has a larger, collective purpose and community engagement that benefits all involved.

Between the hospital and the street: Addressing a crucial gap in care healthleaders.com; by Eric Wisklund; 8/23/24 A unique program in Salt Lake City is managing care for underserved patients who live on the street or in an unsafe location, and helping hospitals reduce ED crowding, improve care coordination and reduce costs in the process. The INN Between is a nine-year-old program that began as a 16-bed Catholic convent and is now an 80-bed “assisted living facility” of sorts, offering everything from hospice care to rehabilitation and care management services. The organization addresses a significant care gap for health systems and hospitals who see these patients in their Emergency Departments and ICUs—and who often discharge them to an uncertain care landscape. ... The INN Between, which operates year-to-year on a budget of $1.6 million (recently cut down from $2 million), exists on a mishmash of charitable donations, grants, and the occasional federal or state subsidy. Editor's Note: Pair this compassionate solution with the scathing article about hospice fraud and abuse of homeless persons, Fraudulent hospices reportedly target homeless people, methadone patients to pad census, by Jim Parker at Hospice News.

How to integrate AI into your business: A 2024 guide eWeek; by Sam Rinko; 8/22/24 If you’re an IT professional or executive, the question of how to integrate AI into your business has probably been top of mind since the recent generative AI boom. You know you should be using AI tools to improve your operational efficiency, but you might worry you lack the policies, data quality and implementation strategy to do so effectively. ... Key Takeaways: