Literature Review

Family caregivers can help shape the outcomes for their loved ones – an ICU nurse explains their vital role The Conversation, by Beth Daley; 4/9/24 The floor nurse had just told me that my new patient – let’s call her Marie – would not stop screaming. ... No matter how much I comforted her, ... she was screaming for her daughter, April, who was on her way. ... As a seasoned bedside critical care nurse, I see firsthand the benefits that family caregivers bring to patient care in the hospital. I also witness the emotional stress that caregivers experience when their loved one comes to the ICU.

They work 80 hours a week for low pay. Now, California’s early-career doctors are joining unions Cal Matters, by Kristen Hwang; 4/8/24 ... In some California hospitals, early-career doctors make as little as $16 per hour working 80-hour weeks. It’s training, known as residency, that every board-certified doctor must complete. ... Last week, hundreds of resident physicians and fellows at Kaiser Permanente’s Northern California facilities became the latest to join the wave of medical trainees demanding better pay and working conditions. Their petition filed with the National Labor Relations Board comes after Kaiser Permanente refused to voluntarily recognize the union. 

Mixed reactions as St. Patrick Hospital nurses approve new contract KPAX-8 Missoula & Western Montana, by Claire Peterson; 4/8/24 The nurse's union at St. Patrick Hospital approved a three-year contract by a narrow vote. ... On Friday, April 5, the nurse’s union at Providence St. Patrick Hospital approved a three-year contract by a narrow vote, bringing months of negotiation to an end. ... The new contract was approved by 56% of the nurses who voted, according to Marmorato. St. Patrick Hospital nurses were fighting for higher wages, plans to prevent workplace violence and more effort to retain staff. 

Hospitals cash in on a private equity-backed trend: Concierge physician care KFF Health News, by Phil Galewitz; 4/1/24 Nonprofit hospitals created largely to serve the poor are adding concierge physician practices, charging patients annual membership fees of $2,000 or more for easier access to their doctors. It’s a trend that began decades ago with physician practices. Thousands of doctors have shifted to the concierge model, in which they can increase their income while decreasing their patient load. ...

Nursa Survey finds 98% of hospital CFOs view nurse staffing as top challenge Morningstar, provided by Business Wire; 4/2/24Survey results offer insight into C-suite perspectives on workforce trends and financial impact. Nursa, a nationwide platform that exists to put a nurse at the bedside of every patient in need, today released the results of a survey with healthcare decision-makers that examines their perspectives on the evolving social contract of employment, opinions on the 1099 workforce, and reflections on what makes a nurse truly valuable to an organization. Key findings from the survey include:

[Maine] Senate backs safe staffing bill with aim to increase patient safety, decrease nurse burnout Main Morning Star, by Lauren McCauley; 3/27/24 If passed, Maine would be the second state in the country to institute nurse-to-patient ratios. ... Sen. Stacy Brenner (D-Cumberland), who sponsored the bill, shared with the chamber her experience as a nurse and how the stress of being understaffed can contribute to burnout and what she described as “moral distress.” ... Brenner said the bill accomplishes two goals: increasing patient safety and increasing nurse retention. 

Interruptions: Bad for hospitalists and their patientsThe Hospitalist, by Larry Beresford; 4/1/24More than 10 years ago this magazine published an article by Winthrop Whitcomb, MD, MHM, a pioneer of hospital medicine and co-founder of the Society of Hospital Medicine, warning of the hazards of workflow interruptions for hospitalists, which he labeled a career satisfaction issue for clinicians but a safety and quality risk for their patients. A decade later, the problem has surely gotten worse as hospital financial pressures and staff shortfalls push caseloads higher and job stresses drive burnout and premature retirement for doctors who have been pulled in too many directions in their work. 

Integrating palliative care screening in the intensive care unit: A quality improvement projectCritical Care Nurse; by Traci N. Phillips, DNP, APRN, ACNP-BC, CCRN; Denise K. Gormley, PhD, RN; Sherry Donaworth, DNP, APRN, ACNP-BC, FNP-BC; 4/1/24Background: Patients admitted to the intensive care unit have complex medical problems and increased rates of mortality and recurrent hospitalization for the following 10 years ...  Delayed access to palliative care can result in untreated symptoms, lack of understanding of care preferences, and preventable admissions. Conclusion: The screening process can maximize the benefit of palliative care services with early patient identification, improved consultation efficiency, decreased critical care resource use, and reduced readmission rates.

[Rural Hospitals] A popular healthcare myth debunked Becker's Hospital CFO Report, by Laura Dyrda; 3/28/24Many in the healthcare industry assume rural hospitals are inherently worse off financially than urban hospitals. It's easy to see why. ... But a February Kaufman Hall report refutes the financial divide between rural and urban hospitals. When comparing rural and urban hospitals as a collective, the firm found no statistically significant difference in average operating margin. Rural and urban hospitals on average have similar operating margins and financial performance. So why do we often associate more dire financial struggles with rural hospitals over urban ones?

4 ways to drive transformational change in sustainabilityAmerican Hospital Association; 3/26/24Like a growing number of health care organizations, New Jersey’s Hackensack Meridian Health (HMH) system has been on a journey for some time now to reduce its environmental impact and boost sustainability practices. Recent achievements include:

Hospitalists more likely to recommend hospice than specialists: Study Becker's Hospital Review, by Mariah Taylor; 3/27/24 A New Haven, CT-based Yale School of Medicine study [published in the American Cancer Society Journals] suggests oncology hospitalists have better hospice utilization and reduce hospital stays for cancer patients compared to oncologists. Researchers compared referrals for hospice settings from hospitalist-led services and oncologist-led services. Hospitalist-led services referred 11.8% of patients to inpatient hospice settings, nearly double the referral rate of oncologist-led services (5.8%). The adjusted average length of stay before inpatient hospice care was 6.83 days for hospitalist-led care and 16.29 days for oncologist-led care. 

Palliative care in the cardiovascular intensive care unit: A systematic review of current literatureCardiovascular Revascularization Medicine, by Agastya D Belur, Aryan Mehta, Mridul Bansal, Patrick M Wieruszewski, Rachna Kataria, Marwan Saad, Annaliese Clancy, Daniel J Levine, Neel R Sodha, Douglas M Burtt, Gregory S Rachu, J Dawn Abbott, Saraschandra Vallabhajosyula; 3/24/24, online ahead of print Results: Of 5711 citations, 30 studies were included. All studies were published in the last seven years and 90 % originated in the United States. Heart failure was the most frequent diagnosis (47 %), and in-hospital mortality was reported in 67 % of studies. There was heterogeneity in the timing, frequency, and background of the care team that determined palliative care consultation. In two randomized trials, there appeared to be improvement in quality of life without an impact on mortality.

Eight nurses from St. Vincent Hospital filed suit yesterday in Worcester Superior Court against Tenet Healthcare for wrongful termination after blowing the whistle on unsafe patient care conditions ABC WATE.com 6 / Cision PR Newswire; by Massachusetts Nurses Association; 3/22/24 Eight registered nurses represented by the Massachusetts Nurses Association at St. Vincent Hospital filed a lawsuit yesterday in Worcester Superior Court against the hospital and its owner, Dallas-based for-profit owner Tenet Healthcare alleging they were fired for exercising their legal and professional obligation to report "unsafe and illegal conduct and conditions" that jeopardized the health and dignity of the patients under their care. ... last month the nurses' claims were validated by The Joint Commission, which conducted an investigation into the nurses' complaints and found the hospital to be "non-compliant with applicable Centers for Medicaid and Medicare Services (CMS) Conditions."