Literature Review

UW Health: Initiative enhances hospice and palliative care programs WisBusiness, Madison, WI; Press Release; 11/4/25 A new UW Health initiative improves the hospital’s hospice care process to ensure patients receive the best, most coordinated care possible throughout their end-of-life journeys. The initiative provides inpatient and emergency department hospice enrollment at University Hospital, ensuring that patients nearing the end of life receive timely, compassionate support and more coordinated care between the health system and the hospice agency. This program, created in partnership with regional hospice organizations and hospital staff, aims to improve continuity of care for patients already getting care in the UW Health system, according to Dr. Jeff Pothof, chief quality officer and emergency medicine physician, UW Health. 

Medicare finalizes controversial cut to specialty care next year HealthcareDive; by Rebecca Pifer; 11/3/25 The CMS finalized the Medicare physician fee schedule for 2026 on Friday [10/31], one day before the statutory deadline. Medicare has locked in a controversial pay cut for specialty doctors next year, normalizing reimbursement between specialists and primary care doctors and curbing the influence of a powerful physician association in setting rates. ...  The -2.5% adjustment is meant to account for non-time based services becoming more efficient over time as technology improves and workflows become smoother. As a result, they’re easier to perform, so Medicare is overpaying, regulators say.

Ana Maria Rodriguez files a bill to better ensure patient choices are honored in end-of-life care Florida Politics; by Andrew Powell; 10/31/25 Sen. Ana Maria Rodriguez wants to make sure physicians follow directives from Florida patients who communicate and preauthorize end-of-life care preferences. Those can include pain management choices and interventions that artificially prolong the process of dying. The Doral Republican filed a bill (SB 312) that aims to establish and regulate “patient-directed medical orders” within Florida law, ensuring that patient preferences, such as withholding or withdrawing life-sustaining interventions, are honored and respected across health care settings.

Essentia Health, Solvay staff reach contract deal Northern News Now, Duluth, MN; by Northern News Now staff; 10/30/25 Another agreement has been reached between Essentia and the Minnesota Nurses Association. On Wednesday [10/29], healthcare workers at the Solvay Hospice House finalized their first contract. As we reported, hundreds of MNA union members walked off the job in July. During the strike, care at the Solvay Hospice House was stopped. Solvay leaders made the decision to pause care saying the facility relies on Essentia Health’s nursing staff. Care started again at the end of July. On Wednesday [10/29], Essentia announced that a tentative three-year agreement has been reached with the Solvay team.

Compassionate care, measurable impact: Evaluation of embedded physician-led palliative care in a community oncology practiceJCO Oncology Practice; by Haibei Liu, Jillian Hellmann, Jessica Heintz, Geoffrey Daniel Moorer, Karen Miller; 10/25This analysis indicates that embedding palliative care physicians within a community oncology practice significantly increases hospice enrollment and LOS [length of stay] greater than 3 days. These findings support a cooperative care model as a practical strategy for integrating palliative care physicians into community-based oncology practices to improve patients’ EOL outcomes. 

Four nurses in two weeks assaulted at Essentia Hospitals: Nurses say violence is a consequence of unsafe staffing and inaction Minnesota Nurses Association, Brainer, MN; Press Release; 10/28/25Nurses with the Minnesota Nurses Association (MNA) are once again outraged and deeply concerned after two more violent assaults on nurses at Essentia Health. A nurse at Essentia Health St. Joseph’s Medical Center in Brainerd was attacked by a patient last Thursday, followed by another assault at the same facility over the weekend. The latest incidents come less than two weeks after two nurses were injured at Essentia Health St. Mary’s Medical Center in Duluth. Four nurses assaulted in under two weeks reflects a dangerous pattern in Essentia facilities—one that nurses have been warning about for years.Editor's Note: Continue reading for preventable actions and red flags, "True safety comes from care-based prevention." These were hospital settings; the home care settings your staff and volunteers enter provide much higher risks with less control. Ask your direct care staff for examples of professional situations that were unsafe. Office-based leaders, you might be surprised. Examine your workplace violence policies, procedures, trainings, incident reporting, and follow-up.

New ACP paper provides ethical guidance amid controversies and changing practices in organ transplantation American College of Physicians (ACP), Philadelphia, PA; Press Release; 10/28/25 The American College of Physicians today issued a position paper on ethical considerations surrounding organ transplantation, saying the needs of the donor patient and family must be prioritized and the process should be trustworthy and transparent. “Ethical Issues in Organ Transplantation: A position paper from the American College of Physicians” was published in Annals of Internal Medicine.  It clarifies the duties and roles of care teams of prospective donor-patients, recipient-patients, and organ procurement teams, reaffirming that end-of-life decision making for prospective donor-patients must center on their best interests independent of organ donation potential. ... “This guidance is relevant to all involved in organ transplantation and particularly to internal medicine physicians who advise their patients about advance care planning and organ donation, caring for them prior to organ transplantation,” said Jason M. Goldman, MD, MACP, President, ACP. 

Post-biographical dignity in the age of artificial intelligence: Narrative, ePROMs and ethical challenges in end-of-life care Palliative & Supportive Care; by Abel García Abejas, David Geraldes Santos, Helder Mota-Filipe, Àngels Salvador Vergés; 10/27/25 Significance of results: End-of-life care in the age of AI must move beyond autonomy-focused ethics to encompass the narrative, relational, and posthumous dimensions of dignity. A critical, philosophically informed ethics is essential to prevent depersonalisation in digitally mediated care.

Ensuring safe, effective transitions to hospice Hospice News; by Jim Parker; 10/22/25 Trust, coordination among staff and speedy processes are essential to hospice referral management. This is according to new research from Transcend Strategy Group. For the consulting firm’s most recent Insights Report it conducted in-depth interviews with hospice admissions and business development professionals to identify recurring themes, barriers and opportunities. ... “We have to remember that for the person calling this is probably one of the worst days of their life — if it’s a family member, or if they’re calling on behalf of themselves — and they need help urgently,” Tony Kudner, chief strategy officer for Transcend Strategy Group, told Hospice News.

Pumping irony: When the hospice is inhospitable Experience Life; by Craig Cox; 10/22/25 ... University of Michigan researchers, reviewing the health records of some 139,000 hospice patients diagnosed with dementia, found that nearly half of them were given benzodiazepines, a class of drugs designed to relieve agitation and anxiety. ... The results, in many cases, were deadly. ... “For patients who are not actively dying, patients and families may prioritize preserving cognition, communication, and function — goals that may be compromised by sedating medications,” she writes. “This further underscores the need for dementia-specific hospice interventions to help offer scalable, nonpharmacologic approaches, to equip hospice clinicians with effective alternatives.”

Hospice social worker and nurse perceptions of the usability of a hospice live discharge protocol (LDP)American Journal of Hospice & Palliative Medicine; by Stephanie P. Wladkowski, Susan Enguídanos, Tracy A. Schroepfer; 9/25Live discharges from hospice are often distressing for patients, caregivers, and hospice providers alike, disrupting care continuity and leading to emotional and logistical challenges. Despite Medicare’s discharge planning requirement, no standardized process currently exists for hospice-initiated discharges, resulting in variable quality of care transitions.  An explicit Live Discharge Protocol has strong potential to enhance the quality and consistency of a live discharge from hospice care. The LDP provides a framework to help smooth the transition from hospice care and provides patients and families with post-discharge support. Feedback from hospice professionals affirmed the relevance and usability of each step within the LDP, while also identifying opportunities for refinement for future implementation.

Teaching end-of-life care: Q&A with professor of medicine Medical Xpress; by Mahima Samraik, Yale University, edited by Sadie Harley; 10/20/25 Every year, thousands of families sit in hospital rooms hearing words no one wants to hear: "We have done everything we can." What happens next, whether doctors stay engaged or step away, can transform one of life's most difficult moments for patients and their families. Unfortunately, for too many patients, the shift from curative care to end-of-life care leaves them feeling stranded. ... "But it doesn't have to be this way," says Matthew Ellman, MD, professor of medicine (general medicine) at Yale School of Medicine (YSM) and director of Medical Student Palliative and End-of-Life Care Education. Ellman has spent decades at patients' bedsides and now teaches medical students about death and dying. In his recent essay in Academic Medicine, he draws from his personal experiences as a physician and encourages fellow doctors to embrace difficult conversations around end-of-life care.