Literature Review

NYC Health + Hospitals/Bellevue opens new Palliative Care Serenity Unit for patients and families NYC Health+Hospitals Press Release; 3/7/24 NYC Health + Hospitals/Bellevue today announced the opening of a new Palliative Care Serenity Unit for patients and families. ... “We created the Serenity Unit because we noted an increasing number of patients either spending their dying days at the hospital or in need of extra support and symptom management expertise that palliative care provides,” said Susan E. Cohen, MD, director of the Palliative Care Program at NYC Health + Hospitals/Bellevue. “We want to ensure that patients who are here in their final days are being treated with dignity and expertise.”Editor's Note: NYC Health + Hospitals/Bellevue is the oldest hospital in America, tracing their roots back to 1736 when a six-bed infirmary opened on the second floor of the New York City Almshouse.

Compassionate extubation and beyond: Is there a need for more guidance in managing end-of-life in the intensive care unit? Chest Physician, by Angela L. Birdwell, DO, MA; Nehan Sher, MD  Approximately 20% of deaths in the United States occur during or shortly after a stay in the ICU and approximately 40% of ICU deaths involve withdrawal of artificial life support (WOALS) or compassionate extubation. ... How the team approaches WOALS can make a difference to both patients and decision-makers. Unfortunately, there is striking variation in practice and lack of guidance in navigating issues that arise at end-of-life in the ICU. 

Programmatic palliative care consultations in pediatric heart transplant evaluations Pediatr Cardiol, by Erika J Mejia, Rui Xiao, Jennifer K Walter, Chris Feudtner, Kimberly Y Lin, Aaron G DeWitt, Meeta Prasad Kerlin; 3/8/24 Guidelines advocate for integrating palliative care into the management of heart failure (HF) and of children with life-limiting disease. The potential impact of palliative care integration into pediatric HF on patient-centered outcomes is poorly understood. The present study sought to assess the association of programmatic implementation of palliative care into the heart transplant evaluation process with hospital-free days (HFD) and end of life (EOL) treatment choices. 

Palliative care across the spectrum of heart failure JACC Heart Fail;  y Laura P Gelfman, Moritz Blum, Modele O Ogunniyi, Colleen K McIlvennan, Dio Kavalieratos , Larry A Allen; online ahead of print 2/27/24; print 3/8/24 Persons with heart failure (HF) often suffer from poor symptom control, decreased quality of life, and poor communication with their health care providers. ... New models are required that are better informed by high-quality data, engage a range of health care providers in primary palliative care principles, and have clear triggers for specialty palliative care engagement, with specific palliative interventions tailored to patient's illness trajectory and changing needs.

WellSky ® and Millennium Physician Group set new standard for healthcare delivery with innovative new partnership Benzinga, by Business Wire; 3/5/24 WellSky, a leading health and community care technology company, and Millennium Physician Group, a value-based physician group with more than 800 healthcare providers across the Southeast, today announced a new multi-year partnership to drive improved outcomes for Millennium patients. ... WellSky serves more than 20,000 client sites — including the largest hospital systems, blood banks, cell therapy labs, home health and hospice franchises, post-acute providers, government agencies, and human services organizations. 

Judge: Iowa hospice program told worker to ‘let people die’ Iowa Capital Dispatch, by Clark Kauffman; 3/5/24An Iowa judge has awarded jobless benefits to a hospice worker who allegedly quit after being told to let patients die rather than provide them with services.

Healthcare access dimensions and racial disparities in end-of-life care quality among ovarian cancer patients Cancer Research Communications; by Shama Karanth, Oyomoare L. Osazuwa-Peters; Lauren E. Wilson, Rebecca A. Previs, Fariha Rahman, Bin Huang, Maria Pisu, Margaret Liang, Kevin C. Ward, Maria J. Schymura, Andrew Berchuck, and Tomi F. Akinyemiju; 3/5/24 This study investigated the association between healthcare access (HCA) dimensions and racial disparities in end-of-life (EOL) care quality among Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Hispanic patients with ovarian cancer (OC).

Understanding the role algorithms play in our lives and navigating palliative careListen - Life Matters, by Hilary Harper, presenter podcast; 3/4/24Every day, we interact with dozens of algorithms as we go about our lives, but many of us don't understand how they work. How do we get the the best out of these tools while keeping the potential dangers in check?Editor's Note: From palliative care experts Australia; information about algorithms and Artificial Intelligence (AI) transfers to our USA palliative care (of course, without applications to CMS systems).

Editorial: Illness trajectories in the age of big data The BMJ; by Peter Tanuseputro, Colleen Webber, and James Downar; 3/1/24For decades, healthcare providers have understood that patients follow typical trajectories of health decline as they approach the end of life, and they have used this understanding to help patients and families anticipate the dying process. Traditional trajectories focus on function or overall health status and include sudden death, terminal illness ..., organ failure ..., and frailty ... Two Education articles in the BMJ add novel dimensions to our understanding of health decline. Murray et al explain how declines in function do not always mirror declines in social, psychological, and spiritual dimensions. They also add a new trajectory, multimorbidity, to describe a person with conditions from multiple trajectories (such as heart disease from organ failure and cognitive impairment from frailty).

Creating comfort through communication: Strategies for supporting mental wellbeing in palliative careWorldHealth.net; 3/4/24... To provide comprehensive and compassionate care, this article explores the various strategies for communicating and supporting mental well-being in palliative care. 

Medicare’s new Dementia GUIDE Model: How can physicians, hospices, and home health agencies participate? Morgan Lewis Blog Post; 3/1/24If you have had a loved one suffer from dementia, you know the emotional, physical, and financial toll of this terrible disease. With advancements in dementia treatment, however, there is renewed hope on addressing this disease and increasing emphasis on fostering innovative care models. A central pillar of this effort is the Guiding an Improved Dementia Experience (GUIDE) model, announced by the US Department of Health and Human Service’s Centers for Medicare & Medicaid Services (CMS) in July 2023. This initiative—a new voluntary, nationwide alternative payment model—is designed to support Medicare beneficiaries with dementia, as well as their caregivers.

Obstacles and opportunities for palliative care in the ICU Palliative Care News, by Rachel Edwards; 3/1/24A growing body of research touts the benefits of palliative care for patients, families, and even providers. However, when evaluated through randomized clinical trials, the results tend to lean toward mediocre. Palliative Care News spoke with experts in the field to unpack the reasons behind those results and identify the obstacles that are getting in the way of a more effective approach.