Literature Review

Compassionate extubation and beyond: Is there a need for more guidance in managing end-of-life in the intensive care unit? Chest Physician, by Angela L. Birdwell, DO, MA; Nehan Sher, MD  Approximately 20% of deaths in the United States occur during or shortly after a stay in the ICU and approximately 40% of ICU deaths involve withdrawal of artificial life support (WOALS) or compassionate extubation. ... How the team approaches WOALS can make a difference to both patients and decision-makers. Unfortunately, there is striking variation in practice and lack of guidance in navigating issues that arise at end-of-life in the ICU. 

Bringing the hospital homePenn Medicine News, by Mary Beth Budnyk; 3/5/24Since his 2020 diagnosis with multiple sclerosis, Steve Lengle has had good and bad days. The bad days are becoming more frequent as his condition continues to decline, causing debilitating pain, weakness, and fatigue, and affecting everything from his memory to his ability to walk. The Lengles found the help they needed through Penn Medicine Advanced Home Health (PMAHH), a new program that aims to prevent hospitalizations by providing a higher level of in-home care to patients who are experiencing an acute medical concern. Editor's Note: This article describes an example of the fairly new Acute Hospital Care At Home program, launched by CMS in November 2020. 

The U.S. health system should focus on pre-acute care, not post-acuteForbes, by Howard Gleckman; 3/5/24The U.S. health system focuses an enormous amount of money and attention on post-acute care—the medical treatment patients receive after they have been discharged from a hospital. But it would more cost-effective, and far better for patients, to refocus on what you might call pre-acute care: what the U.S. can do to prevent those hospitalizations in the first place.

Revolutionizing Elderly Care: Palliative Care's growth and integration into Value-Based ModelsBNN, by Olalekan Adigun; 3/5/24Amid the rapidly evolving landscape of healthcare, palliative care is undergoing a significant transformation, marking a new era in the management and delivery of healthcare services to the elderly. Dr. Jason Black, a seasoned family medicine practitioner with a specialized fellowship in geriatrics, is at the forefront of this change. Working for Gilchrist, a hospice and palliative care organization in Baltimore and central Maryland, Dr. Black embodies the integration of palliative care into the broader healthcare framework, emphasizing value-based care models.

Home care nurse strike ends without deal Northwest Labor Press, by Mallory Gruben; 3/1/24Usually, PeaceHealth jointly bargains with the home health unit and a unit of about 1,500 hospital nurses, and all nurses are paid the same. But for this round of negotiations, PeaceHealth demanded that bargaining happen separately. Hospital nurses reached an agreement in August that raises wages 20.5% over four years. PeaceHealth’s latest offer to the home health nurses is a 14.75% raise over four years. [Erin] Grace [a nurse,] says without an equal contract for equal work, PeaceHealth will have difficulty attracting and retaining home care nurses. According to ONA, the unit has already lost a quarter of its members, and more say they plan to leave if a contract isn’t reached soon. 

3 predictions for the future of post-acute careBecker's Hospital Review, by Mariah Taylor; 2/28/24Robust in-home care, advances in technology and seamless access to nursing facilities are some of the ways leaders anticipate post-acute care may change in the next 50 years. Here, three leaders give their predictions and hopes for the industry in the future.

How AI will help the world's top hospital CEOs transform health careNewsweek, by Jeff Young; on 2/28/24Artificial intelligence is quickly showing the potential to revolutionize many aspects of care giving, from cancer diagnoses to clerical work. But AI also presents new risks, uncertainties and vexing ethical questions. With the release of Newsweek's ranking of the "World's Best Hospitals," executives at leading hospitals around the world told us how they are using the power of AI.

How new CEOs play tough handsBecker's Hospital Review - Leadership & Management, by Kelly Gooch and Alexis Kayser; originally posted 2/16/24, redistributed 2/26/24 It's a rare CEO that doesn't dream of a seamless transition. Unfortunately, the healthcare industry is riddled with seams. In addition to long-standing systemic challenges, each hospital and health system comes with its own set of concerns that may include high turnover, financial losses and/or recent job cuts. What's more, trust is paramount — but fragile — in the early days of a CEO's tenure. The responsibility can be tough to navigate as employees express doubts based on the past and boards bring demands for the future.

Barriers and facilitators to end-of-life care delivery in ICUs: A qualitative studyCrit Care Med; by Lauren M Janczewski, Adithya Chandrasekaran, Egide Abahuje, Bona Ko, John D Slocum, Kaithlyn Tesorero, My L T Nguyen, Sohae Yang, Erin A Strong, Kunjan Bhakta, Jeffrey P Huml, Jacqueline M Kruser, Julie K Johnson, Anne M Stey; 2/19/24Objectives: To understand frontline ICU clinician's perceptions of end-of-life care delivery in the ICU.Setting: Seven ICUs across three hospitals in an integrated academic health system.Subjects: ICU clinicians (physicians [critical care, palliative care], advanced practice providers, nurses, social workers, chaplains).Conclusions: Standardized work system communication tasks may improve end-of life discussion processes between clinicians and families.

Ascension posts $708M quarterly turnaroundBecker's Hospital CFO Report, by Alan Condon; 2/19/24Ascension reported a net income of $359.5 million in the fiscal second quarter ending Dec. 31, which is a $708 million improvement on the $238.1 million net loss it reported during the same quarter in 2022. "We remain focused on improving hospital operations, ensuring sustainability for the future and making purposeful decisions that improve the health of individuals and the communities we are privileged to serve,"CFO Liz Foshage said. "Our Q2 quarterly results are a demonstration of this commitment and a signal that we continue to move in the right direction."

Rural hospital alliance aims to increase access via telehealthModern Healthcare, by Alex Kacik; 2/14/24Rural hospitals are teaming up to provide specialty care to patients via a new telehealth program. Editor's Note: Full access to the article requires a subscription.

7 recent hospital, health system CEO moves - updated Feb. 14Becker's Hospital Review, by Alexis Kayser; 2/14/24[Click on the title above for] ... hospital and health system CEO moves recently reported by Becker's.