Literature Review

AMA Advocacy issue briefsAmerican Medical Association; 7/24/24 Issue briefs summarize key health policy issues by providing concise and easily digestible content targeting both relevant stakeholders and those who may know little about the topic. Contents: Medicare & Medicaid; Telehealth; Scope of practice; Prior authorization; Reducing physician burnout; Practice management; Overdose and mental health/substance use disorder parity; Access to affordable, high-value care; Health care costs & price transparency; Drug costs & pricing; Hospitals & health systems; State medical liability reform; LGBTQ+ health; The business of medicine; Public health improvement; Essential Tools & Resources.

Sasha McAllum Pilkington on grace and storytelling at the end of life Psychotherapy.net; by Lawrence Rubin; 7/22/24 Narrative Clinician, Sasha McAllum Pilkington [of New Zealand],  shares poignant stories she co-created with hospice clients which honor and celebrate their lives. [This interview includes: ...]

Medicare physician pay has plummeted since 2001. Find out why. American Medical Association - AMA; by Tanya Albert Henry; 7/17/24 Medicare physician payment—often called Medicare reimbursement—must be tied to an inflation index called the Medicare Economic Index (MEI). As part of its campaign to fix the unsustainable Medicare pay system, the AMA has outlined in a quick, easily navigable fashion why this payment fix needs to happen now. ... The AMA’s two-page explainer on the Medicare Economic Index (PDF) outlines how it incorporates these two categories reflecting the resources used in medical practices:

Navigating legal and ethical issues: Nurses’ role in accessing and using the Death Master File Daily Nurse; by Maya Payne; 7/22/24 Nurses have a great deal of responsibility when managing sensitive information, including access to the Death Master File (DMF), because they are healthcare professionals entrusted with patient care. This article explores the moral and legal issues that help nurses use the DMF in their practice in a morally responsible manner. ... Explore this detailed resource on DMF guidelines for further insights into responsibly using the Death Master File in healthcare settings. Editor's Note: About 10 years ago, the Social Security Office declared me as "dead." Yes. This affected everything financial and legal in my life. My husband even received standardized condolences from businesses with his name as my key contact. Clean up? A mess. Cause? The best that the Social Security Office could discern was that someone, somewhere entered a clerical mistake. I will never know. The effects of how this Death Master File is used--legally, ethically, and otherwise--cannot be understated.

Exhausted by prior auth, many patients abandon care: AMA survey AMA News Wire - American Medical Association; by Tanya Albert Henry; 7/18/24 Among America’s physicians, more than nine in 10 surveyed say that prior authorization has a negative impact on patient clinical outcomes. Most telling is that 78% of physicians reported that prior authorization often or sometimes results in their patients abandoning a recommended course of treatment, according to the results of the AMA’s annual nationwide prior authorization survey (PDF) of 1,000 practicing physicians. In addition to patients forgoing care, physicians also see the burdensome insurance company practice known as prior authorization leading to care delays and serious adverse events. [Click on the title's link for more specific stats.]

Bridge the gap: Addressing rural end-of-life care disparities and access to hospice services Journal of Pain and Symptom Management; by Asif Anwar, Muhammad Kashif Amin, Sherezaad Anwar, Moazzam Shahzad; 7/11/24 online ahead of print Rural hospices face many obstacles in delivering palliative and end-of-life care in the United States. We aimed to identify these barriers and their potential solutions. ...  We propose several potential solutions to overcome these hurdles and improve access. ... Advanced practice providers should be considered to serve as physician heads in rural hospices, which would expand resources in areas with physician shortages. A single per diem payment model should be implemented for rural hospices, regardless of the level of care provided, to help offset the higher cost of care. he Critical Access Hospital program and offering cost-based reimbursement for swing-bed stays could improve access to post-acute care, including hospice services. Telehealth can improve the timeliness of care and reduce travel costs for patients and providers.  [Continue reading for more solutions.]

Waverly nursing home put on probation, nurse suspended in connection to death of a resident, documents show ABC KETV-7, Omaha, NE; by Jake Anderson and Aaron Hegarty; 7/17/24 A nursing facility has been placed on probation by the Nebraska Department of Health and Human Services in connection to the death of a resident. Constance Glantz, 74, was mistakenly declared dead at The Mulberry at Waverly, a nursing home, in June. Glantz was then taken to a funeral home in Lincoln, which realized that she was still breathing. The 74-year-old, who was in hospice care, was declared dead hours later at a Lincoln hospital. A public records request by KETV Investigates shows that a state investigation into the facility in Waverly found the registered nurse on duty failed to take Glantz's blood pressure after it was believed she had died. That nurse was suspended, according to the state investigation. Documents show that the state also found a second case where a patient was not evaluated correctly. ... [Nebraska AARP Director Todd Stubbendieck] points to Medicare.gov's tool, which rates nursing homes, as a resource. He also points to a similar tool from ProPublica.

Fallen nurses are honored by ‘guards’ in white uniforms, capes and caps Radio Iowa; by Radio Iowa Contributor; 7/17/24 A hospital in southwestern Iowa is joining a national volunteer organization that pays tribute to nurses who have died or who are in hospice care. Registered nurse Sara Beth Jones spearheaded the effort to launch a local chapter of the Nurses Honor Guard at Cass Health in Atlantic. Jones says part of their uniform is to wear a cape that’s black on one side and red on the other, much like those worn by nurses who tended to soldiers in the 1800s. ... The Nurses Honor Guard is a comprised of current and former nurses. In addition to the funerals of nurses, they attend parades, honor walks and living tributes. Besides the cape, Jones says Honor Guard participants don the traditional white uniform and cap. 

Advanced practice providers have an important role in kidney supportive care Healio; by Christine Corbett, DNP, FNP-BC, CNN-NP, FNKF; 7/15/24For more than 2 decades, nephrologists and patients have recognized the key role nephrology advanced practice providers have played in the care of patients with chronic kidney disease. ... With its attention to the psychosocial and spiritual aspects of care in addition to the physical, it is expected that nephrology nurse practitioners would also play a major role in the palliative care for patients with kidney disease. ... As part of the kidney care team, APPs [advanced practice practitionsers] educate patients about kidney failure treatment options, including palliative dialysis and active medical management without dialysis. Also, nurse practitioners have been noted to play a significant role in the palliative care skills of goals-of-care conversations, advance care planning and Portable Orders for Life-Sustaining Treatment (POLST, or similar term depending on the state) completion.

In response to ‘Garnet lays off 26 people citing cost saving Warwick Advertiser, Letters to the Editor; by Ethel Hemsi; 7/15/24 For the past seven years I have been a volunteer with the Palliative Care team at Garnet Health Hospital. The whole team has been laid off to save costs. The article says it can be replaced by the hospitalist team of internal medicine providers. In my opinion this team can in no way be replaced by other doctors. Palliative care is a very complex and respectable practice in itself with specially trained doctors and nurses. It does much more than manage a patient’s pain. The palliative care providers are focused on helping patients and their families understand the patient’s condition and come together to make important decisions that patients with serious illnesses face. This includes weighing the pros and cons of various medical treatments as they pertain a patient’s quality of life. ... 

Prognoses associated with Palliative Performance Scale scores in modern palliative care practiceJAMA Network Open; by Kara E Bischoff, Kanan Patel, W John Boscardin, David L O'Riordan, Steven Z Pantilat, Alexander K Smith; 7/1/24The Palliative Performance Scale (PPS) is one of the most widely used prognostic tools for patients with serious illness. However, current prognostic estimates associated with PPS scores are based on data that are over a decade old. ... Conclusions and relevance: In this prognostic study, prognostic estimates associated with PPS scores were substantially longer than previous estimates commonly used by clinicians. Based on these findings, an online calculator was updated to assist clinicians in reaching prognostic estimates that are more consistent with modern palliative care practice and specific to the patient's setting and diagnosis group.

A journey shared: Navigating cancer as a caretaker, nurse, and patient Oncology Nursing News; by Charlotte Goor, BSN, RN, OCN; 7/9/24 An oncology nurse's experience with mother's cancer and her own BRCA2 diagnosis shapes her approach to patient care. “She had a tumor the size of a cantaloupe,” the surgeon said. I felt like the world had caved in on me and I was suffocating in its core. I was 22 years old when my mother developed a mysterious “bulge” in her lower abdomen—stage 4 ovarian cancer, as it turned out. As a bonus, we learned that both she and I carried the BRCA2 gene mutation, which meant that I was at an increased risk of developing breast and ovarian cancer as well." The ensuing journey from caregiver to nurse to patient has profoundly shaped my nursing practice by providing unique insights and deepening my empathy. ...

Rosewood nursing home staff demands experience pay, free coverage Times Union, Rensselaer, NY; by Jim Franco; 7/11/24 A group of Rosewood Rehabilitation and Nursing Center workers, represented by a national health care union, is demanding a new contract with higher wages for more experienced workers and a union-provided health insurance plan that would be fully paid by their employers. ... The workers, members of 1199SEIU United Healthcare Workers East, say a contract with the experience pay and no-cost health care coverage would help address staff shortages at the facility. The union, which has an office in East Greenbush, cites federal Department of Health and Human Services data showing total nursing staff turnover at the facility is 61.8 percent, higher than the national average of 52 percent and the New York average of 44.7 percent.Editor's Note: The reasons identified for this staff strike are consistent with other nursing/healthcare strikes across the nation: pay, benefits, staff shortages. Additionally, this facility's nursing staff turnover of 61.8 percent likely impacts--negatively--patient safety, another key factor for recent nursing strikes.