Literature Review

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 doctors withhold futile treatments, that isn’t ‘assisted dying’ The Guardian; by Dr. James Haslam; 5/15/24 [Commentary / Letter] I write in response to Dr Jagat Aulakh’s letter (A form of assisted dying already happens in hospitals, 8 May). It must be made clear that withholding or withdrawing futile treatments is not and never has been assisted dying. Stopping – or not starting – treatments that are not wanted, are not working or are not worthwhile is good medicine and the law of the land. Whereas “assisted dying” is the modern euphemism for physician-assisted suicide and euthanasia, both forms of medicalised killing [the author's choice of words]. ... Intentions are important. ...Editor's Note: This thoughtful response puts forth ethical support against Medical Aid in Dying (MAiD), also known as "physican assisted suicide." Likely, different opinions can be inflammatory among your hospice and palliative employees, board, community, and more personally among your family and friends. As hospice and palliative leaders, we must address this issue with respectful dialogue, critical thinking, case studies, personal beliefs and values, empathy, and humanity.

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.

Beyond medicine: 'Being Mortal' challenges healthcare's approach to death and dying SwiftTelecast; by Shawn Butlere; 5/11/24 This video from the “Frontline” series, titled “Being Mortal,” follows Dr. Atul Gawande as he explores the complex relationships between doctors, patients, and end-of-life decisions. Based on his best-selling book “Being Mortal,” Gawande discusses how medical training often falls short in preparing doctors for the realities of death and dying. The documentary highlights personal stories, including Gawande’s own experiences with his father’s illness and death, to illustrate the challenges in balancing hope with realistic outcomes and the importance of quality life in the face of terminal illness. 

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.

Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia JAMA Health Forum - JAMA Network; by Cyrus M. Kosar, PhD; Bishnu B. Thapa, MPA, PhD; Ulrike Muench, RN, PhD; Christopher Santostefano, RN, MPH; Emily A. Gadbois, PhD; Hyesung Oh, MA, MBA; Pedro L. Gozalo, PhD; Momotazur Rahman, PhD; Elizabeth M. White, APRN, PhD; 5/10/24 Question: Is nurse practitioner (NP) care associated with end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias (ADRD), and do these associations differ between states with full vs restrictive NP scope of practice regulations? Findings: The results of this cohort study including 334 618 US nursing home residents with ADRD indicated that decedents with greater NP involvement at end of life had fewer hospitalizations and higher hospice use. The adjusted differences in outcomes between decedents with extensive vs minimal NP care were larger in states with full scope of practice regulations than in states with restrictive regulations.

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.

What nurses really need is better staffing: The common strategies to raise nurse morale need an updatePenn LDI - Leonard Davis Institute of Health Economics; by Karen Lasater, PhD, RN, and Jane Muir, PhD, APRN; 5/10/24Pizza. Coloring books. Goody bags. They could be activities at a 5-year-old’s birthday party. But they’re not: These are many employers’ attempts to lift the morale of nurses on the frontlines of chronically understaffed organizations. What nurses really want are better working conditions so they can deliver the best care possible to their patients. As researchers at the University of Pennsylvania School of Nursing, we asked thousands of nurses why they are leaving their profession. Their answers are straightforward — short staffing is so rampant that the public’s health care is at risk. The playbook of corporate health care asks nurses to do much with little, but nurses aren’t willing to skimp on quality and safety. There isn’t a nursing shortage — it’s nurses’ refusal to be part of a system that puts profits before safety.

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. ...

What every family should know about navigating hospice care: The keys to experiencing a peaceful, gentle, and dignified death Psychology Today; by Bob Uslander, MD; 5/7/24... As a physician with 35 years of experience, including 25 years as an emergency physician and 10 years as a palliative and end-of-life care specialist, I've witnessed firsthand the stark realities of palliative and hospice care.  ... Let me be clear: Hospice care is an enormous benefit to many people, and I am often awed by the level of compassion and commitment I witness among some hospice staff I encounter. Despite this, there are many gaps, the care can be inconsistent, and hospice care is frequently not the appropriate option for people who are encouraged down that path.

Hospice Certifying Physician Medicare Enrollment InformationPalmetto GBA email; 5/6/24Pursuant to our authority under section 6405 of the Affordable Care Act, and as part of CMS' larger strategy to address hospice program integrity and quality of care, certifying physicians, including hospice physicians and hospice attending physicians, must be enrolled in or opted-out of Medicare for the hospice service to be paid. Effective June 3, 2024, (delayed from May 1, 2024) CMS will begin implementing edits to enforce this new rule and will deny hospice claims if the physician entered in the Attending field on the claim is not in the Provider Enrollment Chain and Ownership System (PECOS) as an enrolled or opted-out physician.

Early-career physicians working temp roles to 'test drive' practice settings, survey finds Becker's Hospital Review; by Alan Condon; 5/3/24Physicians and advanced practice providers are opting for the flexibility of temporary, locum tenens work in seek of improved job conditions and to relieve burnout, according to an April 23 survey conducted by AMN Healthcare. AMN, the largest provider of healthcare interim leadership and executive search services in the U.S., asked physicians, physician assistants and nurse practitioners who recently have worked locum tenens why they do so. The number one reason, according to 86% of respondents, was a better work schedule, followed closely by addressing feelings of burnout (80%).

How Mass General Brigham provides emergency care at home Becker's Health IT; by Giles Bruce; 5/6/24Somerville, MA-based Mass General Brigham now treats patients needing emergency or urgent care at home. The health system's patients can request referrals to the Home Hospital Emergency Care program through their primary care providers, who decide if patients are stable enough to be treated at home. If they are, a nurse talks to the provider and schedules a home visit, where a paramedic completes a physical exam joined virtually by an emergency medicine physician. Editor's Note: Pair this article with others in today's newsletter: "Stranded in the ER, seniors await hospital care and suffer avoidable harm" (in our Post-Acute Care section), and "[Australia] Palliative patients can die peacefully at home with paramedic support, claims proposed framework" (in our International section).