Literature Review

States with the most rural hospital closures in the past 20 years Becker's CFO Report; by Mariah Taylor; 6/28/24 Since January 2005, 192 rural hospitals have closed or converted, according to data compiled by the University of North Carolina's Cecil G. Sheps Center for Health Services Research. Of those hospitals, 105 have completely closed, and 87 have converted, meaning the facilities no longer provide inpatient services, but continue to provide some services, such as primary care, skilled nursing care or long-term care. Since 2020, 36 hospitals have closed or converted. 

Apply now for AHA’s 2025 Circle of Life Award recognizing end-of-life and hospice care providersAmerican Hospital Association press release; 5/30/24Applications are open through July 24 for AHA’s 2025 Circle of Life Award, which recognizes hospitals and health systems that advance end-of-life and hospice care that is safe, timely, efficient, effective and equitable. There will be up to three recipients of the award, and Citations of Honor may also be presented to other noteworthy programs.

AMA Advocacy 2024 efforts American Medical Association; by AMA; Updated June 2024, 6/27/24 There are far too many everyday practice challenges interfering with patient care. That’s why the American Medical Association is advocating to keep physicians at the head of the health care team, reform the Medicare physician payment system, relieve the burdens of overused prior authorizations and so much more. [Key advocacy efforts include:]

Patient experiences of specialty palliative care in the perioperative period for cancer surgery Journal of Pain and Symptom Management; by Laura M Holdsworth, Rachel Siden, Anna Sophia Lessios, Mae Verano, Elizabeth Rickerson, Bridget Fahy, Fabian M Johnston, Brittany Waterman, Rebecca Aslakson; 6/19/24 online ahead of print  Context: Though patients undergoing treatment for upper gastrointestinal (GI) cancers frequently experience a range of sequelae and disease recurrence, patients often do not receive specialty palliative care soon after diagnosis and it is unknown in what ways they may benefit.  Results: We found five themes that characterized patient experiences and perceptions of specialty palliative care. Patients typically had limited prior awareness of palliative care (theme 1), but during the study, came to understand it as a "talking" intervention (theme 2). Patients whose concerns aligned with palliative care described it as being impactful on their care (theme 3). However, most patients expressed a focus on cure from their cancer and less perceived relevance for integration of palliative care (theme 4). Integrating specialist palliative care practitioners with surgical teams made it difficult for some patients to identify how palliative care practitioners differed from other members of their care team (theme 5).

Fixing the hospital-to-home health care transition Home Health Care News; by Andrew Donlan; 6/25/24 The transition between hospital discharge and home health care is often fraught with issues. Unfortunately, it also happens to be one of the most crucial parts of a patient’s care journey. With more sick and complex patients coming into home health care than ever, a swift start of home health care is also arguably more important than ever. ... The Discharge to Assess (D2A) Model was a response to this issue in England. The Supporting Older Adults at Risk (SOAR) program, following a similar framework to D2A, was also recently established in the U.S. A study of SOAR’s results within a pilot program in Pennsylvania was recently published in the Journal for Healthcare Quality.

20 most socially responsible hospitals, per Lown Institute Becker's Hospital Review; by Mackenzie Bean; 6/25/24 Duke Regional Hospital in Durham, N.C., is the most socially responsible acute care hospital in the U.S., according to a June 25 ranking from Lown Institute. The nonpartisan healthcare think tank assessed more than 2,700 acute care hospitals and 800 critical access hospitals nationwide across 54 metrics related to health equity, value of care and patient outcomes. ... The 20 most socially responsible acute care hospitals in the U.S., per Lown Institute:

Novant scraps $320M hospital deal with CHS Becker's Hospital Review; by Alan Condon; 6/18/24 Winston-Salem, N.C.-based Novant Health has called off its planned $320 million acquisition of two North Carolina hospitals from Community Health Systems after an appellate court granted the Federal Trade Commission an emergency injunction blocking the deal. In a 2-1 decision, the 4th U.S. Circuit Court of Appeals said it would allow the FTC to prevent the two-hospital acquisition from proceeding until its appeal is resolved. ... The FTC argues that the transaction would "irreversibly consolidate the market for hospital services in the Eastern Lake Norman Area in the northern suburbs of Charlotte."

University Hospitals to cut more than 300 positions Modern Healthcare; by Paige Bennett; 6/19/24 University Hospitals is eliminating more than 300 positions amid challenges in the healthcare industry. The health system announced Wednesday, June 19, that it was reducing its leadership structure by more than 10% as part of an organizational reset. The move comes at a time when healthcare systems across the U.S. are grappling with rising costs and labor shortages. UH Chief Operating Officer Dr. Paul Hinchey said in a phone interview with Crain’s that the cuts focused on leadership and support services, not frontline workers. Affected employees began being notified by the health system on Monday, he said. The health system said the vast majority of the cuts were non-clinical and will not impact patient care. The move “complements a plan over the past three years to increase efficiency, consolidate service lines and close hospitals in Bedford and Richmond Heights,” according to UH. 

Hospice of Marion County trains first responders to care for dementia patients Hospice News; by Jim Parker; 6/18/24 Florida-based Hospice of Marion County, an affiliate of Empath Health, is training first responders in its community on how to treat dementia patients. For several years, the nonprofit hospice has been educating family caregivers and others in their community about the experiences of dementia patients and how to better interact with them. More recently, Hospice of Marion County [Ocala, Florida] has been expanding that training to include local law enforcement and fire departments, as well as medical students and staff at assisted living facilities, among others. The training uses a series of tools to simulate symptoms of dementia, related to visual, tactile, auditory senses, their ability to process information and perform certain tasks. The education helps first responders address the unique challenges associated with caring for dementia patients, according to Dr. Mery Lossada, chief medical officer of Hospice of Marion County.Editor's Note: Bravo, Hospice of Marion County!

Why doctors aren’t participating in organ donation after cardiac death Physician's Weekly; by Frank D. Brodkey, MD, FCCM; 6/13/24Organ donation after cardiac death (DCD) differs from the more traditional organ donation after brain death (DBD) insofar that DCD donors are alive and donate organs after discontinuation of life support so that a natural death with cessation of heartbeat and circulation may occur, followed by extraction of organs. This may increase the availability of transplantable organs, leading to improvement in the lives of other humans.  According to the Health Resources and Services Administration, 5896 donations, representing 36% of all donations in 2023, were DCD, representing an increase of 40.7% over the preceding three years. There, however, are significant ethical and scientific issues in the performance of DCD with concepts of end-of-life care, personal autonomy, and concepts of dignity of life and death. ...

Acting now to sustain and improve America’s healthcare system: Advice from innovative physicians and health system leadersSheppardMullin Healthcare Law Blog; by Kathleen O'Neill, John Golembesky, Jeralin Cardoso, Chi Huynh & Carolyn Young; 6/6/24 At [the recent] America’s Physician Groups Spring conference in San Diego, California, we listened as physicians and health system leaders described the ways in which they are responding to short and long term challenges to the sustainability of America’s healthcare system in its current form. It now stands at a critical juncture, facing challenges such as provider shortages and burnout, increasing concerns around access and cost for pharmaceutical products and other supplies, the increasing burden of managing chronic diseases, rising demand for services across the spectrum from an aging population, and balancing the transition to value-based care models in a predominantly fee-for-service environment. ... Here, we outline the key areas of focus described by leaders at the conference: ... 

White House enlists Microsoft, Google for rural hospital cyberdefense Becker's Health IT; by Naomi Diaz; 6/10/24 The Biden-Harris administration has secured commitments from Microsoft and Google to offer free and low-cost resources to rural hospitals nationwide to help them boost their cyber defenses. As part of the effort, Microsoft will be extending its nonprofit program to provide grants and up to a 75% discount on security products for independent critical access hospitals and rural emergency hospitals, according to a June 10 news release from the White House. Additionally, larger rural hospitals using eligible Microsoft solutions will also receive the most advanced security suite at no additional cost for one year. ... Meanwhile, Google committed to offering endpoint security advice to rural hospitals and non-profit organizations at no cost, alongside funding support for software migration. 

Higher sepsis mortality in safety-net hospitals linked to fewer post-discharge care options Contagion Live - Infectious Diseases Today; by Kenneth Bender, PharmD, MA; 6/9/24 Purportedly higher sepsis mortality in safety-net hospitals reflects less a difference in acute care than opportunities to discharge to hospice. By extending the measure of sepsis-related mortality from in-hospital events to occurrences within 30 days after the diagnosis, the purported higher mortality rate of sepsis treated in safety-net hospitals decreased to parity with non-safety-net hospitals, in a retrospective national cohort study. The investigators note the particular challenges of safety-net hospitals, which care for a disproportionately high share of low-income and underinsured patients, include fewer resources and narrower operating margins, as well as patient populations with decreased access to preventative care and more complex disease presentations.