Literature Review

Life support decisions are usually made within 72 hours. Is that too soon? Advisory Board; by Daily Briefing; 5/21/24After a patient suffers a traumatic brain injury (TBI) and is on a ventilator, when is the right time to withdraw life support? A new study published in the Journal of Neurotrauma suggests that doctors and patient family members should wait a bit longer than usual. ... The researchers found that the majority of patients whose life support wasn't withdrawn ended up dying in the hospital anyways within about six days. However, 42% of patients who continued life support recovered enough within the following year to have some level of independence, and a few even returned to their former lives.

The human side of AI: Insights on balancing automation and empathy Innovation & Tech Today; by Enrico Palmerino; 5/20/24 ... As AI automates more tasks with clinical precision, empathy is a critical human element we cannot overlook. That intangible ability to understand and share the feelings of another isn’t just a soft skill — it’s an essential catalyst for trust, loyalty, and genuine connection. Consider the healthcare industry, where empathy is (quite literally) often a matter of life and death. Can an AI-powered diagnostic system truly grasp a patient’s fear and vulnerability when facing a serious illness? ... Finding the delicate balance between leveraging AI automation and preserving human empathy is the new challenge before us. It’s a duality that will shape how businesses operate and how we interact with technology. ... Let the machines optimize processes while we optimize the ability to connect and inspire. In this harmonious future, AI is a tool that elevates us — not replaces us.Editor's Note: Is AI a hot topic among your leaders and interdisciplinary clinicians? Often, "empathy" and "communication" are cited as key cautions and conflicts. 

Providing culturally sensitive palliative care to children with cancer: A conversation with Justin Baker, MDThe ASCO Post; by Rikki Camarillo; 5/16/24In the fall of 2023, Justin Baker, MD, took on the role of Chief of the Division of Quality of Life and Pediatric Palliative Care and Director of the Quality of Life for All Program, Stanford Medicine Children’s Health, Stanford, California. He formerly worked at St. Jude Children’s Research Hospital, Memphis, as Chief of the Quality of Life and Palliative Care Division. The ASCO Post recently spoke with Dr. Baker about his new role in palliative care for the treatment of children with cancer at Stanford Children’s and the importance of culturally sensitive care for patients and their families.

Emerging leaders in hospice and palliative care AAHPM - American Academy of Hospice and Palliative Medicine; webpage source for various press releeases of individuals; 5/24AAHPM developed the Emerging Leaders in Hospice and Palliative Care program to recognize the exceptional work accomplished by the next generation of leaders and bring increased exposure to the specialty of hospice and palliative medicine. In 2014, the first class of Emerging Leaders was named. AAHPM seeks to recognize accomplished early career professionals and the next generation of hospice and palliative care leaders. This award recognizes new Emerging Leaders in recognition of their career accomplishments, involvement in the Academy, mentoring of residents and students, and participation in charitable work. [Click on the title's link for the list of 36 honorees.]Editor's Note: Do you work with or know any of these honorees? If so, please share this with them and your colleagues, along with congratulations from Hospice & Palliative Care Today! (Invite them to register for free--no strings attached--to our daily newsletter.)

When families fight over a relative with dementia, it’s time to call in the mediator The New York Times; by Paula Span; 5/13/24 Trained negotiators can help families struggling with vexing elder-care issues.  The four adult children were in agreement. Their father, William Curry, a retired electrical engineer and business executive, was sinking deeper into dementia. ... [But their mother] remained determined to continue caring for her 81-year-old husband at home, despite the increasing toll on her own health. ... As the weeks passed, “we were really at an impasse,” [a daughter] said. “Do you override your mother?” ...  [Increasingly,] families seek elder mediation privately, before disputes land in court and imperil or destroy family relationships. [Continue reading for descriptions of how mediation differs from arbitration, from family therapy, and for cautions about this being "a fairly new field with no nationwide certification or licensing requirements."]Editor's Notes: Executive leaders, what community education and resources are you providing for Advance Directives? What family systems education and and problem-solving are you providing for your interdisciplinary team members and grief counselors? Family conflicts are inherent--in some form or fashion--with almost anyone needing dementia care, especially when paired with palliative or hospice care. (If in doubt, ask your seasoned, front-line professionals.)

800+ California nurses to receive 22.5% pay hike Becker's Hospital Review; by Kelly Gooch; 5/10/24Members of the California Nurses Association have approved a new labor contract with Washington Hospital Healthcare System in Fremont, Calif. The four-year agreement covers roughly 840 nurses, according to a union news release. It was approved by union members May 3 and by the Washington Township Health Care District board of directors May 8. ... According to the CNA, the new deal includes a 22.5% across-the-board increase in wages over four years. It also includes "precedent-setting standard expanding infectious disease protocols and workplace violence protections"; language that protects union members' ability to take meal and rest periods; and protections for part-time positions, according to the union.Editor's Note: These new terms reflect nationwide trends of healthcare/nurse strikes and reasons for leaving their jobs, ie., pay, patient safety, workplace violence, work/home life balance, and more.

6 ways to cut EHR burdens for physicians AMA - American Medical Association; by Sara Berg, MS; 5/7/24 When Jane F. Fogg, MD, MPH, first became a doctor, patient charts were on paper. She looked forward to the rise of the EHR, believing electronic charting could help modernize the care she provided while also empowering herself and her patients. Funny how things turn out. “EHRs are a source of burnout—we have lots and lots of great evidence that has helped us understand the low usability and the high work burden that it adds to physicians,” Dr. Fogg, senior physician adviser at the AMA. ... Here are just a few ways that health systems and organizations can improve EHR workflows to reduce physician burden.

A narrative review of risk mitigation strategies in the management of opioids for chronic pain and palliative care in older adults: interprofessional collaboration with the pharmacist Annals of Palliative Medicine; by Insaf Mohammad, Candice L Garwood, Lisa Binns-Emerick Key content and findings: A variety of risk mitigation strategies to improve safety for older adults using opioids exist. They include risk assessment, tapering opioids, reducing high-risk concomitant medications, utilizing non-opioid therapies, screening for and treatment of opioid use disorder (OUD), toxicology testing, co-prescribing naloxone, utilizing controlled substance agreements, reviewing prescription drug monitoring program data, prescriber and patient education, and collaboration with pharmacists and palliative care specialists.

Top ten tips palliative care clinicians should know about the psychiatric manifestations of nonpsychiatric serious illness and treatments Journal of Palliative Medicine; by Gregg A Robbins-Welty, Paul A Riordan, Daniel Shalev, Danielle Chammas, Paul Noufi, Keri O Brenner, Joshua Briscoe, William E Rosa, Jason A Webb; 5/10/24... Among patients receiving palliative care (PC), psychiatric comorbidities are common and impact patient quality of life. ... This article, created collaboratively with a team of psychiatric-palliative care experts, is the second in a two-part series examining the bidirectional relationship between medical and psychiatric illness in PC. This article explores 10 prevalent psychiatric manifestations associated with severe illness and its treatment. [Additional access requires journal subscription or additional payment]

WSNA files unfair labor practice charge against PeaceHealth Southwest after 14 bargaining sessions WSNA - Washington State Nurses Association; 5/9/24 After 14 negotiation sessions for a new contract, WSNA filed unfair labor practice charges against PeaceHealth Southwest Medical Center on behalf of the 1,465 nurses the association represents at the facility. Nearly four months after bargaining began, the parties remain far apart on core contract issues like wages, sick leave benefits, and workplace violence prevention. Their previous contract expired on Feb. 28, 2024. ... One of the key issues over which PeaceHealth Southwest has refused to compromise is pay equity for home health and hospice nurses in the bargaining unit. ... PeaceHealth’s proposal would put home health and hospice nurses up to 5% behind their coworkers working at the hospital.

[Honoring Nurses Week] Too many nurses are being assaulted. Some say they are being blamed for the attacks. Chief Healthcare Executive; by Ron Southwick; 5/9/24 With disturbing regularity, nurses in hospitals and other healthcare settings are being physically assaulted and verbally harassed. More than half of emergency nurses say they’ve been assaulted or threatened within the past 30 days, according to the Emergency Nurses Association. In a separate study, researchers found that healthcare workers faced at least one violent or aggressive incident for every 40 hours worked, according to findings published by The Joint Commission Journal on Quality and Patient Safety. With the observance of National Nursing Week, the increased violence in healthcare can’t be ignored. Nursing leaders say the regular exposure to violence or threatening behavior is one factor adding to stress and burnout of nurses and, in some cases, spurring them to seek new jobs.

Honoring National Nurses Week: 11 hospital executives' thank-you notes to nurses Becker's Clinical Leadership; by Mariah Taylor and Kelly Gooch; 5/6/24 The American Nurses Association's theme of National Nurses Week, "Nurses Make the Difference," highlights nursing excellence and how nurses embody the spirit of compassion and care in every healthcare setting. ... [Click on the title's link for] Becker's collected messages of appreciation from hospital and health system leaders across the U.S. ...

Improving inclusive palliative care for transgender patients Hospice News; by Holly Vossel; 5/7/24... Nearly a quarter (21.3%) of 865 interdisciplinary palliative professionals indicated that they had observed some form of discriminatory care delivered to a transgender patient in a recent study published in Cambridge University Press’ journal Palliative Support Care. Furthermore, 85.3% of study participants said they witnessed disrespectful care, while inadequate and abusive care was observed by 35.9% and 10.3% of palliative teams, respectively. ... [Read more for descriptions and interventions, as discussed with Zachary Fried, licensed clinical social worker and training supervisor of Optum at Home, a subsidiary of UnitedHealth Group.]