Literature Review

HHS proposal slashes Medicare SHIP funds MSN; by Mary Helen Gillespie; 4/22/25 The Trump administration is proposing federal budget cuts to Medicare State Health Insurance Assistance Programs (SHIP) and seven additional elder health care safety net programs that assist older Americans. ... SHIP programs have been under the umbrella of the Health and Human Services agency Administration for Community Living. The pre-decisional budget lists funds for seven other ACL programs that would be eliminated are:

Advance care planning in the inpatient setting: The role of the hospitalistAmerican Journal of Hospice and Palliative Medicine; Nikhil Sood, MD; Rohini Garg, MBBS; Anthony D. Slonim, MD, DrPH, FCCM; 3/25Advance care planning (ACP) is critical to patient-centered health care, particularly in hospital settings where acute and end-of-life decisions often occur. As frontline providers, hospitalists are uniquely positioned to initiate and guide ACP discussions. This article explores the role of hospitalists in ACP, identifies barriers to its implementation, and highlights strategies to overcome these challenges. Key barriers include time constraints, lack of formal training, and uncertainty regarding the appropriate timing of discussions. To address these issues, hospitalists can benefit from structured communication training, integration of ACP prompts into electronic health records, and collaboration with multidisciplinary teams. While ACP has demonstrated benefits, including the alignment of care with patient preferences, reduced unnecessary interventions, and improved satisfaction for patients and families, challenges remain in ensuring consistent and culturally sensitive implementation.

Without support, seniors aging in place may elect facility-based care, study finds McKnights Home Care; by Adam Healy; 4/16/25 Older adults aging in place may rethink whether they want to receive care at home if they do not receive certain aging-in-place supports from their care providers and loved ones, according to a new study published in the Journal of the American Geriatrics Society. The researchers interviewed nearly 300 older adults receiving care at home and in long-term care facilities. ... The first theme was participants’ personal health experiences. ... Similarly, loss of health of loved ones and friends may also influence where patients want to receive care. ... The final factor influencing older adults’ aging preferences was time, the study found. 

Patient-centered communication drives supportive care needs in incurable cancer Oncology Nursing News; by Kristie L. Kahl; 4/16/25 The Primary Palliative Care Communication Intervention (PRECURSOR) may improve the psychosocial experiences of patients with incurable gynecologic cancer and their caregivers in the outpatient setting, according to results of a pilot study presented at the 50th Annual ONS Congress. ... Currently, most of the conversation around supportive care is provider-driven, and clinical tendency is to insert palliative care in the terminal setting. However, the study investigators aimed to integrate supportive care across the cancer continuum.

“I Don’t Know What to Say”-A multimodal educational and environmental intervention to improve bedside nursing communication at end of lifeJournal of Hospice & Palliative Nursing; Wolownik, Gregory DNP, AGPCNP-BC, ACHPN; Wholihan, Dorothy DNP, AGPCNP-BC, ACHPN, FPCN, FAAN; 4/25... research shows inpatient medical-surgical nurses are not adequately trained to deliver end-of-life (EOL) care. This lack of foundational learning leads to gaps when communicating with patients and families and negatively impacts quality of care. A literature review and staff interviews identified barriers to communication, such as lack of formal education and experience; personal, cultural, and emotional challenges; and high workload. A multimodal intervention focusing on improving staff nurse communication skills was designed ...[including] environmental cues, engaging pocket cards, and an education module on communication techniques. Nurses demonstrated increased confidence and competence immediately following the education session, enduring at 4 weeks. Innovative, clinically relevant interventions can positively impact communication skills without requiring increased time commitments or high cost.

The cost of nurse turnover in 24 numbers | 2025 Becker's Hospital Review; by Molly Gamble; 4/7/25 Nurse shortages and mounting labor costs are among health system CEOs’ top concerns, and a new survey puts numbers to the financial risks hospitals face from nurse vacancies and churn. The 2025 NSI National Health Care Retention & RN Staffing Report features input from 450 hospitals in 37 states on registered nurse turnover, retention, vacancy rates, recruitment metrics and staffing strategies.  It found the average cost of turnover for one staff RN grew from January through December 2024 to $61,110, among other dollar figures and statistics that are helpful to understand the financial implications of one of healthcare’s most persistent labor disruptions. Here are 24 numbers that illustrate the cost of nurse turnover, according to the most recent edition of the report, which is available in full here. [Continue reading ...]

Perioperative integration of palliative care and urology for patients with serious urologic illness: A qualitative need finding inquiryJournal of Pain and Symptom Management; Bhagvat J Maheta, Nainwant K Singh, Jonathan Bergman, Cati G Brown-Johnson, Alekhya Gunturi, Nickolas Interrante, John T Leppert, Karl A Lorenz, Isabella G Raspi, Karleen F Giannitrapani; 3/25Many urologic serious illnesses are treated with surgical procedures, which may put patients at a further risk of diminished quality of life. [We] purposefully sampled urologists, palliative care physicians, and clinical team members at fourteen geographically distributed Veteran Health Administration sites. We identified one general overall theme, to "change culture" so that PC [palliative care] is not a "last resort" ... Utilizing telehealth and team member role expansion when discussing the initial diagnosis, with surgery as a potential treatment option, allows for multiple conversations ... Creating a process to ensure goal of care conversations occur, since "urologic procedures can have complications that significantly impact quality of life" ... [and] during the pre-operative visits, interdisciplinary input and evaluation of the patient prior to surgery allows the patient to "have a sort of joint meeting with us and the urologist."

Federal legislation would mandate hospice education upon hospital discharge McKnights Home Care; by Adam Healy; 4/2/25 A bill under consideration in Congress would require hospitals to educate patients about hospice care options upon discharge. HR 2437, introduced Thursday by Rep. Erin Houchin (R-IN), would amend Medicare policy to mandate that hospitals “provide information on available hospice programs to certain individuals upon discharge,” according to the bill. Although hospitals are not necessarily required to provide patients with information on available hospice programs upon discharge, they are encouraged to do so. [Continue reading ...]

Palliative care in the intensive care unit: An integrative review of intensive care unit health care professionals' views and experiences Dimensions of Critical Care Nursing (DCCN); by Berit Lindahl and Susan Kirk; May-Jun 2025 ... Our findings suggest there is variation in how palliative care in the ICU is conceptualized and interpreted. Intensive care unit professionals need enhanced competencies and training to develop their confidence in providing palliative care and improve role clarity. Such training should focus on serious illness conversations with patients/families and interdisciplinary teamwork. Integration of palliative consultants into the ICU could be further developed.

MaineHealth Memorial Hospital leverages telehealth in unexpected ways MaineHealth, North Conway, ME; Press Release; 3/312/25 When a patient presenting with stroke symptoms arrives at MaineHealth Memorial Hospital's emergency department, time is of the essence. It could take hours to arrange for medical transport and get that patient to a tertiary care center like MaineHealth Maine Medical Center to see a stroke neurologist. Using telehealth, these patients can receive this specialized care if it is necessary in less than 30 minutes. While telehealth is often associated with remote home visits, MaineHealth Memorial Hospital also uses it to enhance on-site care. Using remote consult technology, MaineHealth specialists can offer local care teams expert advice at the bedside or in the exam room. [Continue reading ...]

10 top health system workplaces, per USA TodayBecker's Hospital Review; by Giles Bruce; 3/21/25Ten health systems were named top workplaces March 21 by USA Today and human resources technology company Energage. The Top Workplaces USA 2025 list was determined using Energage’s confidential employee engagement surveys and participating company benchmarks that take into account years of workplace culture research.Here are the health systems that ranked in the top 100 among organizations with 2,500-plus employees:

‘Show up and share’: How one UCLA ICU helps patients and staff live with dying Los Angeles Times; by Corinne Purtill; 3/20/25 

Calvary Hospital doubles down on palliative care and hospice expansion Becker's Hospital Review; by Kelly Gooch; 3/24/25 Michael Fosina began serving as president of Calvary Hospital in New York City in January, bringing decades of healthcare experience to the role. ... Mr. Forsina told Becker’s he’s excited about Calvary’s mission as the organization celebrates its 125th anniversary. Recently, the hospital integrated services with its parent organization, ArchCare, the healthcare ministry of the Archdiocese of New York. Mr. Fosina shared his perspective on Calvary’s role in New York and its future in meeting patient needs. ... [Michael Fosina described:] "ArchCare has all of the components of post-acute care when you include our end-of-life hospital and our hospice program. The integration allows us to accept patients, move patients around, have them stay connected with the physician — the team physician. So the transitions of care are not as dramatic as if you’re going from one organization to the next organization." [Continue reading ...]