Literature Review

Improvement plans for hospital car park BBC News; by Ruth Lucas; 3/18/25 ... NHS Frimley has announced plans to make "positive improvements" to the car park at Frimley Park Hospital in Surrey Heath. ... NHS Frimley says this will increase capacity by 10%, while LED lighting and improved parking bay markings will also be installed. ... Free parking is currently available for disabled people, frequent outpatient attenders, parents of sick children staying overnight and visitors with relatives who are gravely sick, terminally ill or under palliative care.Editor's note: For hospital-based hospice/palliative care, do you provide any type of free parking, vouchers, middle-of-the-night security, or some other type of support for families of persons in your hospice/palliative care units? Consider the common experience of the patient dying in the middle of the night, and family leaving the hospital--especially if your parking conditions are unsafe or expensive. 

Oz does not rule out Medicaid cuts during Senate confirmation hearing McKnights Home Care; by Adam Healy; 3/14/25 Mehmet Oz, MD, President Donald Trump’s pick to lead the Centers for Medicare & Medicaid Services, did not give a direct answer when asked whether he was for or against Medicaid cuts Friday during a Senate Finance Committee hearing. “I cherish Medicaid and I’ve worked within the Medicaid environment quite extensively practicing at Columbia University,” Oz said when asked by Sen. Ron Wyden (D-OR) if he would oppose cuts to Medicaid. “I want to make sure that patients today and in the future have resources to protect them if they get ill. The way you protect Medicaid is by making sure it’s viable at every level, which includes having enough practitioners to afford the services, paying them enough to do what you request of them, and making sure that patients are able to actually use Medicaid.”

Publisher's Dinner: Leaders of home care firm, hospital systems gather for dialogue on improving patient care Cincinnati Business Courier; by Trinity In Home Care; 3/14/25 The Cincinnati Business Courier in late February brought together the leadership of a leading Southwest Ohio home care agency with leaders of Greater Cincinnati’s hospital and hospice systems. The goal was to connect leaders of two essential aspects of the region’s health care system – inpatient hospital care and home care – to see how they could complement and support each other in delivering patient care and growing as organizations. [Click on the title's link for quotes from various leaders from this Cincinnati area.]

2010 to 2019 saw early palliative care billing up for advanced cancer HealthDay News; by Elana Gotkine; 3/17/25 For patients with distant-stage cancers, there was an increase in early palliative care (PC) billing from 2010 to 2019, but the level remained low, according to a study published online March 7 in the Journal of Clinical Oncology. ... The researchers found that in 2010 to 2019, there was an increase in the percentage with early PC billing among 102,032 patients treated by 18,908 unique physicians, from 1.44 to 10.36 percent. The likelihood of early PC billing was increased in association with treating physician's early PC referrals in the previous year and organizations' employment of any HPM specialist (3.01 and 4.54 percentage points, respectively). 

Is Medicare ready for an aging america? Home-based care offers hope RealClear Health; by Jonathan Fleece, JD (President and CEO of Empath Health) and Dr. Steve Landers (CEO of the National Alliance for Care at Home); 3/12/25Too often, families face an impossible situation: a loved one is ready to leave the hospital, but no home health provider is available. Or they’re told hospice is the best option, but administrative red tape delays access to comfort and support. These failures put patients at risk. ... This experience underscores why policymakers must protect and expand access to home-based care—before more patients fall through the cracks. ... According to one analysis, in a recent three year period, hospital stays for patients waiting to be discharged to post-acute care providers increased by 24 percent, deteriorating health outcomes and quality of life. Discharge delays – caused by hospital capacity issues and workforce shortages – not only cause harm to patients; they also add unnecessary strain and costs on our healthcare system.

Understanding and addressing the US hospital bed shortage—Build, Baby, BuildJAMA Network Open; Alexander T. Janke, MD, MHS, MSc; Arjun K. Venkatesh, MD, MBA, MHS; 2/25In the study by Leuchter et al, they provide simple yet provocative projections for the future of hospital care. They project that national hospital occupancy will exceed 85% by 2032, a critical threshold where basic hospital operations can become dysfunctional and even unsafe. Leuchter et al begin to quantify the story already felt at the bedside in hospitals across the nation—namely, a trajectory toward inadequate supply of hospital care for the anticipated demand of the coming decade. US residents are older and more medically complex than ever. Technologically sophisticated surgical interventions and medical therapies have transformed the long-term survival rates for serious conditions, such as end-stage kidney disease, heart failure, and chronic obstructive lung disease. The US needs greater hospital bed capacity, particularly for critical care and complex care services.

How hospital merger oversight is shifting deal-making Modern Healthcare; by Alex Kacik; 3/12/25 Health systems are increasingly pursuing mergers and acquisitions in the South, a region where demand for care is growing and there are fewer regulatory barriers. More than a dozen states have passed laws over the past several years designed to increase oversight of healthcare transactions, but Southern states have largely stayed on the sidelines. As a result, deals involving hospitals are expected to pick up in the South, particularly in markets that feature growing populations, a high number of Medicaid patients and less stringent merger reviews, merger and acquisition advisers said. Potential Medicaid cuts could also drive up deal-making in the 16-state region spanning from West Virginia to Texas, as well as Washington, D.C., advisers said. 

Mid-Ohio Valley emergency rooms ask for breathing room as respiratory illnesses flare up The Parkersburg News and Sentinel, Marietta, OH; by Staff Reports; 3/11/25 As flu, COVID and other respiratory illnesses increase, Memorial Health System is advising people to take preventive measures, prioritize rest at home or seek medical attention elsewhere before heading to an emergency department. "When needed, seeking care through a primary care provider or at a Physicians Care Express location can help ensure timely treatment and help keep emergency departments available for those in urgent, life-saving situations,” according to a release from the Health System. ... Emergency care should be sought for respiratory illnesses if people experience the following:

Mass General Brigham begins 2nd round of layoffs Becker's Hospital CFO Report; by Alan Condon; 3/10/25 The second of two rounds of layoffs at Mass General Brigham began March 10, with about 1,500 employees reportedly affected by the overall workforce reductions, according to The Boston Globe. The layoffs, the largest in the Somerville, Mass.-based health system's history, were announced in early February. The workforce cuts stem from "the same unrelenting pressures affecting many healthcare systems across the country," as the system faces a projected budget gap of $250 million within two years, a spokesperson told Becker's. Mass General Brigham, the largest health system in the state, said the layoffs primarily affect nonclinical and nonpatient-facing roles to "enhance efficiency, reduce costs and maximize support for front-line clinicians." 

‘The weekend effect’: If you’re planning surgery, doctors say you should think twice about Fridays DailyDot.com; by Ilana Gordon; 3/7/25 Everybody’s working for the weekend, which, according to a new study, is incidentally the worst time of the week to undergo surgery. A paper published in the JAMA Network on March 4, 2025, concludes that patients experience worse outcomes during the weekends, as compared to weekdays. This phenomenon is known as the “weekend effect” and the study, which examined 429,691 patients in Ontario, Canada, determined that people whose surgeries began directly before the weekend “experienced a statistically significant increase in the composite outcome of death, complications, and readmissions at 30 days, 90 days, and 1 year.” 

Assessing pain, anxiety and other symptoms of nursing home residents unable to speak for themselves Regenstrief Institute, Indianapolis, IN; by Kathleen T. Unroe, MD, MHA; 3/10/25 Revamped tool reliably addresses physical and emotional distress, well-being and end-of-life symptoms. As many as half of nursing home residents are cognitively impaired and may be unable to communicate symptoms such as pain or anxiety to the staff and clinicians caring for them. Therefore, information needed for the evaluation of symptoms and subsequent treatment decisions typically does not reliably exist in nursing home electronic health records (EHRs). A new paper reports on the novel adaptation of a commonly used symptom assessment instrument to more comprehensively acquire this difficult-to-obtain data with the ultimate goal of enabling knowledge-based expansion of palliative care services in nursing homes to address residents’ symptoms. 

748 hospitals at risk of closure, state by state Becker's Hospital CFO Report; by Molly Gamble; 3/6/25 Nearly 750 rural U.S. hospitals are at risk of closure due to financial problems, with nearly half of those hospitals at immediate risk of closure. The count of 748 at-risk rural hospitals comes from the latest analysis from the Center for Healthcare Quality and Payment Reform, which is based on CMS' most recent hospital financial information. The center's analysis reveals two distinct levels of vulnerability among rural healthcare facilities: risk of closure and immediate risk of closure. In the first category, nearly every state has hospitals at risk of closure, measured by financial reserves that can cover losses on patient services for only six to seven years. In over half the states, 25% or more of rural hospitals face this risk, with 11 states having a majority of their rural hospitals in jeopardy. [Click on the title's link for the list.]Editor's note: On July 5, 2024, we posted from the same source (Becker's Hospital CFO Report) that "Since January 2005, 192 rural hospitals have closed or converted ... 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. Find the list here. This jump in number is both dramatic and traumatic for our rural communities.