Literature Review

Hope in oncology: Where art and science collide Medscape; by Sharon Worcester, MA; 6/12/24 Carlos, a 21-year-old, laid in a hospital bed, barely clinging to life. Following a stem cell transplant for leukemia, Carlos had developed a life-threatening case of graft-vs-host disease. But Carlos' mother had faith. "I have hope things will get better," she said, via interpreter, to Richard Leiter, MD, a palliative care doctor in training at that time. "I hope they will," Leiter told her. "I should have stopped there," said Leiter, recounting an early-career lesson on hope during the ASCO Voices session at the American Society of Clinical Oncology (ASCO) 2024 annual meeting. "But in my eagerness to show my attending and myself that I could handle this conversation, I kept going, mistakenly." ... Carlos' mother looked Leiter in the eye. "You want him to die," she said. ...Editor's Note: Click on the title's link to continue reading this insightful reflection and discussion about the importance of "hope." Engage your oncology/palliative/hospice chaplains (hopefully CPE trained and Board Certified) with your medical team members to explore this core belief in "hope." Alert: AI referrals for palliative and hospice care are increasing exponentially. Clinicians must be sensitive to the human dimensions and dynamics of "hope" (which shift and change), and not be driven just by technological data.

Union ratifies RN contract with Ascension Genesys WNEM-TV5, Genessee Co., Mich; by Hannah Mose; 6/5/24 The union representing the registered nurses (RNs) at Ascension Genesys Hospital announced the tentative agreement between the union and the hospital has been ratified. On May 20, Teamsters Local 322 president Dan Glass said there had been months of failed negotiations between the union and the hospital, and if there wasn’t an agreement made by May 24, the union would strike. However, on May 22, Teamsters Local 322 said a tentative agreement had been reached between the union and the hospital.

The role and professional standards of the Adult-Gerontology Nurse Practitioner in hospice and palliative careJournal of Hospice and Palliative Nursing; by Heather Coats, PhD, APRN-BC, Kelly Henrichs, Kelly DNP, RN, GNP-BC; 6/24The adult/gerontology (gero) nurse practitioner (NP) delivers primary and/or specialty palliative care to persons and their families who live each day with a myriad of serious illnesses. In this role, the adult/gero NP uses their skill set to address the whole person (physical, psychological, social, and spiritual/existential) to improve the quality of life for persons they care for. This article is the fourth in a series of 6 highlighting the different roles of the adult/gero NP and the advanced certified hospice and palliative registered nurse, and how these 2 roles overlap. The purpose of this article was to provide details of education and certification pathways for these NP roles, describe the overlaps in clinical care, and illustrate how the adult/gero NP in palliative and hospice care can contribute to leadership in program development for care of persons and their families who live with serious illness.

The latest research indicates massage therapy has benefits from birth to end of life Cision PR Newswire; by American Massage Therapy Association; 6/5/24 The American Massage Therapy Association (AMTA) is sharing recent research on how massage therapy can provide benefits from infancy through end of life. Across all ages, massage therapy can be a therapeutic approach to enhancing physical and emotional well-being. Explore the latest studies on how massage therapy can help improve the quality of life for infants, middle-aged individuals, and older adults. ... A nationwide survey of physicians, physician assistants, and nurse practitioners in palliative care documented recommendation rates of integrative therapies to target symptoms of palliative care patients. The survey found that massage therapy was the third most recommended integrative care modality behind mind-body interventions like meditation and biofeedback. The integrative therapies aimed to reduce pain, anxiety, mood disturbances, and distress.Editor's Note: While hiring a professional massage therapist might not be practical for your budget, explore contracting with massage therapist who is trained in working with medically-fragile persons to provide simple trainings for your nurses and nurse aides. Additionally, professionally trained massage therapists might be interested in volunteering their services, within appropriate parameters (i.e., not transferring the medically-fragile patient to a massage table, having a caregiver present to assist with communication, etc.). 

Hospice Certifying Physician edit in effectAAPC - American Academy of Professional Coders; by Rebecca Johnson; 6/3/24 The Centers for Medicare & Medicaid Services (CMS) and its Home Health and Hospice (HHH) Medicare Administrative Contractors (MACs) are all systems go for the new — and potentially troublesome — claims system edit. The edit went into effect June 3. ... In the 2024 Hospice Payment Rate Update final rule, CMS adopted a requirement that two categories of physicians must be enrolled in or validly opted out of Medicare for hospice services to be paid: the hospice medical director or the physician member of the hospice interdisciplinary group; and the attending physician that certifies the patient for hospice. CMS did at least grant hospices’ requests for an implementation delay at that time, moving the deadline from the proposed Oct. 1, 2023, to May 1, 2024. Then, on the eve of that start date, CMS bumped the edit for one more month. ...

ASCO updates Guidelines on Palliative Care Hematology Adviosor; by Jen Smith; 5/30/24 The American Society of Clinical Oncology (ASCO) has released an update to its guidelines on palliative care for cancer patients. The guidelines and related information were published in the Journal of Clinical Oncology and JCO Oncology Practice. To develop updated recommendations for integrating palliative care into cancer care, an expert panel reviewed randomized controlled trials, systematic reviews, and meta-analyses published during 2015-2023. Based on their findings, the experts recommend that patients with advanced cancer be referred to specialized interdisciplinary palliative care teams soon after diagnosis, while the patients are still receiving active cancer treatment.

Over 400 physicians from Delaware’s ChristianaCare move to unionize Portside; by Jennifer Henderson / MedPageToday; 5/28/24 More than 400 physicians from Delaware's Christiana Hospital, Wilmington Hospital, and Middletown Free-standing Emergency Department -- all part of the ChristianaCare health system -- filed to unionize with Doctors Council SEIU Local 10MD. "If successful, this will be the first physician union in Delaware and the first union of any kind at ChristianaCare," Doctors Council SEIU said in an announcement of the filing, which pointed to the ongoing corporatization of medicine as driving the physicians' efforts. Some of the specific concerns that physicians detailed in regard to their filing included understaffing and inadequate resources, corporate influence on medical decision making, limited input in matters affecting patient care and physician safety and autonomy, and moral injury caused by pressure to place profit over patients. Editor's Note: These "specific concerns" reflect consistent themes with other, recent healthcare unionization and strikes throughout the nation, within the scope of one's practice (e.g., physicians vs. nurses). 

AI, health care and the strange future of medicine American Medical Association (AMA); transcript of AMA podcast "Moving Medicine," hosted by Todd Unger;  5/28/24AMA President Jesse Ehrenfeld, MD, MPH, leads a discussion with three other physicians on the use of AI in health care. Panelists are Claire Novorol, MD, PhD, the founder and chief medical officer of Ada Health, a digital health company using AI to help diagnose and treat patients; Mark Sendak, MD, MPP, a population health data science lead at Duke Institute for Health Innovation; and Alex Stinard, MD, an emergency room physician and regional medical director of Envision Health Care in Florida.

From theory to practice: Collaboration shows how law and healthcare work together in real life Iowa College of Law; 5/22/24 A recent workshop collaboration between the [Iowa] College of Law and College of Nursing gave students preparing for both professions an opportunity to learn more about legal and healthcare issues surrounding end-of-life decision-making. The two-hour event, “Navigating the Intersection of Law and Healthcare: An Interactive Workshop for Future Practitioners,” brought together students from the Estate Planning and Law & Policy in Action clinics and graduate students in the College of Nursing. Topics included Medical Powers of Attorney (Medical POA), Living Wills, and other decision-making considerations for critical health issues. Elise Fenton, JD Candidate (2025), said the workshop illustrated the difference between how advance directives like Living Wills work in theory versus how they may be utilized in practice. 

Educating the future of hospice and palliative carePortage.life; by Center for Hospice Care; 5/21/24This spring students at the University of Notre Dame gained insight into the delivery of care to patients and families dealing with serious advanced illnesses. The university, in partnership with Center for Hospice Care (CHC), once again offered the course “Introduction to Hospice and Palliative Care” that was designed by Dr. Dominic Vachon, Director of Ruth M. Hillebrand Center for Compassionate Care in Medicine and Mike Wargo, COO and vice president of the Hospice Foundation. The five-week class covered a variety of topics focused on hospice and palliative care and was taught by CHC staff including physicians, social workers, chaplains, bereavement counselors and other hospice and palliative care support staff.

Senate ramps up push to reform doctors' Medicare pay Modern Healthcare; by Michael Mcauliff; 5/20/24Declining doctors' pay in Medicare is getting its most serious look in nearly a decade in the Senate, with a bipartisan push launched Friday by the Senate Finance Committee. Doctors have grown especially vocal in recent years about falling Medicare reimbursement. Groups including the American Medical Association have estimated doctors were effectively getting paid 26% less in 2023 than in 2001 because the physician fee schedule set by the Centers for Medicare and Medicaid Services is not adjusted for inflation. Physicians have also called for more flexibility within the pay system.

Nurse resilience, decompression off balance: Press GaneyBecker's Clinical Leadership; by Erica Carbajal; 5/14/24Nurses have a hard time disconnecting from work, and may benefit from additional workplace resources that support them in doing so, according to findings from a new Press Ganey report on nurse resiliency. ... Below are four key findings from the report: