Literature Review

Statement by the American Nurses Association on the importance of nursing specific science and research and the leaked FY 2026 HHS Budget Proposal American Nurses Association; Press Release, newsroom@ana.org; 4/17/25 Nursing-specific science and research is uniquely positioned to inform the health care delivery system on evidence-based approaches to patient-centered, quality care that meets the needs of patients as effectively and efficiently as possible. ... “The American Nurses Association (ANA) is deeply concerned about the recent reports surrounding the leaked draft FY 2026 proposed budget for the Department of Health and Human Services (HHS), specifically the elimination of National Institute of Nursing Research (NINR) and deep cuts to Title VIII Nursing Workforce Development Programs," expressed American Nurses Association President Dr. Jennifer Mensik-Kennedy, PhD, MBA, RN, NEA-BC, FAAN. “ANA firmly believes that NINR plays a vital role in ensuring that research guided by nurses’ education, experiences, and clinical training continue to enable our overall health care system to improve and be driven by evidence.” ... Further, ANA is grateful for the broad bipartisan support these programs have historically received from Congress and will work closely with lawmakers to safeguard funding for these programs during the FY2026 appropriations process.  ...

Transforming communities through leadership with Quint StuderTeleios Anatomy of Leadership podcast; by Chris Comeaux, Quint Studer; 4/9/25In this episode, Chris sits down with Quint Studer, Founder of Healthcare Plus Solutions Group and one of his most trusted mentors, to dive deep into the transformation of Pensacola, Florida. Quint reveals his powerful framework for community change, sharing essential leadership insights and the challenges of driving real transformation.

A mother’s goodbye-Barriers to microtransitions in careJAMA Internal Medicine; Aval-Na’Ree S. Green, Benjamin E. Canter; 3/25After a long, debilitating battle with lupus, my cousin died at the doorsteps of our health system. The funeral was at 11:00 am. I arrived at the facility at 8:45 am. Although the catheter was in place, my aunt was undressed, with remnants of breakfast on her gown. She had not been bathed. The staff and I wheeled my aunt outside and attempted to load her into the van. Once my aunt was in the chair, it could not fit through the van door. Because this transition was not a medical health care appointment, the facility did not coordinate the resources, including use of the van, that were necessary for it to occur successfully. In contrast, had this been a medical outing, such as a weekend dialysis appointment, the facility would have been required to provide transportation. If this microtransition had been treated like a major health care transition, perhaps it would have had a better chance of success. Nursing teams use checklists during major care transitions; similar procedures should apply to microtransitions.

Hospitalists in a bind when cancer prognosis hasn’t sunk inMedscape; by Jake Remaly; 4/15/25 When a patient with cancer is admitted to the hospital, the reason might not be related to the malignancy. But the hospitalist in charge sometimes becomes aware of a major disconnect: The patient, who they just met, does not grasp the severity of their cancer prognosis. On the one hand, the hospital medicine team and patient have advance directives and goals of care to consider, which may steer the course of the hospitalization and any use of hospice. The cancer prognosis — the patient might only have months to live, for example — could be a key component of those conversations. On the other hand, explaining the cancer situation should fall to the oncologist, right? ...Editor's notes: Pair this with today's posts, 

Today is National Healthcare Decisions Day - Make your advance care plans Institute for Healthcare Improvement - The Conversation Project; retrieved from the internet 4/14/25The links and resources [provided in this article] explore a variety of resources to help make, discuss and document future healthcare wishes and decisions in your advance care planning. ... The Conversation Project offers free tools, guidance, and resources to begin talking with those who matter most about your and their wishes.

Community Catalyst leads national response against new rule that threatens health care access Community Catalyst, Boston, MA; by Jack Cardinal; 4/11/25 Today, Community Catalyst organized hundreds of local, state and national partners to submit comments to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) opposing a new proposed rule from the Trump administration that would make it harder and more expensive for people to buy their own insurance on Affordable Care Act (ACA) Marketplaces and increase their medical debt. ... The administration’s own estimates suggest that as many as 2 million people will lose their coverage under this proposal, ...

Proposed FY26 Hospice Wage Index and Payment RateCMS press release; 4/11/25On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that proposes updates to Medicare payment policies and rates for hospices under the Fiscal Year (FY) 2026 Hospice Wage Index and Payment Rate Updated Proposed Rule (CMS-1835-P). [Major provisions include:]

Concordance of 30-day mortality and in-hospital mortality or hospice discharge after sepsisJAMA Network; by Hallie C. Prescott, Megan Heath, Namita Jayaprakash, Raymund B. Dantes, Chanu Rhee, Patricia J. Posa, Scott A. Flanders; 4/9/25In this all-payer, multihospital cohort of patients with community-onset sepsis, the proportion of hospitalizations ending in death or hospice discharge was similar to 30-day mortality and substantially higher than in-hospital mortality alone. Concordance between this composite outcome and 30-day mortality was high and greater than in-hospital mortality alone at the encounter level. These data suggest that the composite outcome of in-hospital mortality or hospice discharge may be a useful measure for national benchmarking of sepsis outcomes. While not identical to 30-day mortality, this composite outcome is available in real time for all patients and appears to have minimal systematic bias from variable hospital discharge practices.Publisher's note: An interesting study that includes "hospital discharge to hospice" as an important variable for consideration.

Ahead of National Volunteer Week and in celebration of National Volunteer Month, NPHI CEO urges Americans: “Step forward. Be present. Volunteer with your local hospice.” National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; by Matthew Wilkinson; 4/16/25 Ahead of National Volunteer Week next week, and in celebration of National Volunteer Month this April, the National Partnership for Healthcare and Hospice Innovation (NPHI) is shining a light on the often-unsung heroes of hospice: volunteers. These compassionate individuals are central to the mission of NPHI’s member providers nationwide, offering their time, energy, and hearts to patients and families during life’s most tender and vulnerable moments. NPHI member organizations rely on nearly 30,000 volunteers to keep their programs running—almost matching the number of full- and part-time staff employed across its national member network. Nationwide, hundreds of thousands of hospice volunteers contribute millions of hours of service annually. This deep tradition of volunteerism isn’t just symbolic—it’s built into the very structure of hospice care. All Medicare-certified hospices are required to have volunteers actively involved in patient and family support, reflecting the core values of compassion and community care that define the field.Editor's note: Throughout the year, find this and more national observances on our newsletters "Healthcare Observances" tab at the top of our website, https://www.hospicepalliativecaretoday.com/resources/healthcare-observances.

HHS restructuring and workforce reductions – key implications for the health care industry JD Supra; by Mintz.com; 4/15/25 ... As part of the department-wide restructuring plan, HHS is in the process of consolidating 28 different divisions into 15 divisions. As of April 4, 2025, it had also reduced the number of Regional Offices from ten to five. ... 

Closing the gap in end-of life care coverage: The role of nonprofits in policy advocacy Forbes; by James Dismond; 4/14/25... As the demand for end-of-life care grows, so will the gap between the care that patients need and what they receive. ... Workforce shortages, restrictive regulations, outdated reimbursement models and misconceptions around hospice services are keeping millions of Americans from accessing quality hospice and palliative care services. ... These barriers disproportionately affect low-income families, rural communities and communities of color. ... Unlike for-profit entities, we can prioritize community needs over shareholders. We can prioritize patient well-being over profits—or, to say it more directly, we put people over profits. And I’ve seen firsthand how advocacy can drive progress. Nonprofits must engage in:

National Alliance for Care at Home responds to the FY 2026 Hospice Proposed Rule National Alliance for Care at Home, Alexandira, VA and Washington, DC; Press Release; 4/11/25 The National Alliance for Care at Home (the Alliance) issued the following statement [Fri 4/11] in response to the Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2026 Hospice Wage Index proposed rule, which proposes payment and regulatory updates under the Medicare hospice benefit. The proposed 2.4% payment update fails to adequately address the mounting financial pressures facing hospices nationwide. With escalating operational costs driven by inflation, workforce shortages, and rising expenses for supplies and services, the proposed payment increase would threaten the ability of hospices to sustainably provide quality end-of-life care. “The proposed payment update for FY 2026 falls short of what is needed to sustain high-quality hospice care,” said Dr. Steve Landers, CEO of the Alliance. “Without meaningful adjustments, hospices across the country will face serious challenges—jeopardizing access to care for terminally ill patients and placing added strain on families already facing the unimaginable. ..."

Proposed FY26 Hospice Wage Index and Payment RateCMS press release; 4/11/25On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that proposes updates to Medicare payment policies and rates for hospices under the Fiscal Year (FY) 2026 Hospice Wage Index and Payment Rate Updated Proposed Rule (CMS-1835-P). [Major provisions include:]