Literature Review

Intervention increases palliative cancer care consultations/lowers EOL care CancerNetwork.com; by Roman Fabbricatore; 3/11/25A palliative care (PC) intervention combining algorithm-based automated identification of patients eligible for PC led to an increase in PC visits and a decrease in end-of-life systemic therapy among patients with cancer, according to a randomized clinical study (NCT05590962) published in JAMA Network Open. ... "...  Prior efficacy trials in oncology have tested early PC in controlled, primarily academic settings.2To our knowledge, this is the first effectiveness randomized clinical trial of algorithm-driven default specialty PC in community oncology.”

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. 

The Medical Minute: Measles cases rising in the US, what you can do PennState, Hershey, PA; 3/6/25 A case of measles in a child was confirmed in Montgomery County on March 2 ─ the first reported case in the state in 2025. Nationwide, the Centers for Disease Control and Prevention (CDC) has reported 164 measles cases in nine states. Texas alone has seen at least 140 cases since late January, including one unvaccinated child who died. Measles is a preventable, highly contagious, airborne virus that can cause serious health complications, including death, especially in children under 5, said Dr. George McSherry, division chief of pediatric infectious diseases at Penn State Health Children’s Hospital. “Measles is a very serious illness. It’s one of the most infectious of the infectious diseases,” McSherry said. “If you put a person with measles in a room with 100 unimmunized people, 90 will get it.” Click on the title's link for more important information. 

The twofold challenge of an older population — and how systems are adapting Becker's Hospital Review; by Kelly Gooch and Kristin Kuchno; 2/21/25 In less than a decade, older Americans are projected to outnumber children for the first time in U.S. history, sparking conversations about the need for age-friendly healthcare.  At the same time, declining birth rates and longer life expectancies — half of babies born in 2020 are expected to live past 100 years — pose potential workforce challenges. Becker's connected with four health system leaders to explore the challenges this demographic shift presents and how they are preparing to address it. [Click on the title's link to continue reading.]

Palliative care clinicians goals-of-care notes more extensive than other providers’ documentation Hospice News; by Jim Parker; 3/5/25 A team of researchers has developed a standardized goals-of-care note to document patient wishes in the electronic medical record. Many patients do not experience goals-of-care conversations in a timely manner. But even among those who have, their wishes can get lost if they are not documented. The standardized note created by a research team from the Regenstrief Institute, the Indiana University School of Medicine and Indiana University Health can help health care providers be aware of and access patients’ goals of care, according to lead investigator Dr. Alexia Torke. ... The research on the note was published in the American Journal of Medicine.

Duke Health, Novant to partner Becker's Hospital CFO Report; by Madeline Ashley; 3/4/25 Durham, N.C.-based Duke University Health System and Charlotte, N.C.-based Novant Health have shared plans to partner and build new campuses across the state to expand care. Under the partnership, clinicians from both systems will offer services in new locations to increase primary care and advanced specialty treatment access. The partnership also aims to reduce wait times, create more appointment availability and increase virtual access to specialists, according to a March 3 news release shared with Becker's. 

Mobile hospital-at-home pilot to deliver care to rural patients Modern Healthcare; by Diane Eastabrook; 2/26/25  Mobile medical units will deliver hospital-at-home care to patients in rural communities as part of a five-year pilot program aimed at expanding healthcare access in underserved areas. The Advanced Research Projects Agency for Health recently awarded an undisclosed amount of funding to Boston’s Mass General Brigham, University of Utah’s Huntsman Cancer Institute and Kentwood, Michigan-based Homeward Health to develop programs that will extend hospital-level care to patients in remote communities using mobile platforms.

Influence of culture and spiritual tradition on support for families of children dying in intensive care unitsJournal of Pediatric Nursing; Sung-Jin Jeanie Ju, Janie Ito, Aubree Lin, Dagmar Grefe, Jennifer Baird, Rebecca Ortiz La Banca Barber; 2/25Parents utilize spirituality as a means of coping during and after a child's death. Complexity of grief associated with loss of a child suggests the paramount importance of providing appropriate support for parents while experiencing their child's critical illness or end of life. Findings indicated three themes that illustrate the end-of-life and bereavement process: 1) Coping during hospitalization and the end-of-life stage; 2) coping during the bereavement stage; and 3) advice for parents and staff. To integrate the results into practice, hospital-wide education for staff on the importance of cultural and spiritual sensitivity is recommended. Additionally, collaboration with spiritual care teams, especially for patients and families facing complex diagnoses or advance care planning, will enhance the provision of culturally and spiritually sensitive care.

[Australia] Practice recommendations for culturally sensitive communication at the end of life in intensive care: A modified eDelphi studyIntensive and Critical Care Nursing; Laura A Brooks, Elizabeth Manias, Bodil Rasmussen, Melissa J Bloomer; 2/25Clinicians need specific knowledge and skills to effectively communicate with patients and their family when a patient is dying in the ICU. End-of-life communication is compounded by language differences and diverse cultural and religious beliefs. Recommendations prioritising use of professional interpreters and nurse involvement in family meetings achieved near perfect agreement amongst participants. Recommendations to facilitate family in undertaking cultural, spiritual and religious rituals and customs, advocate for family participation in treatment limitation discussions, and clinician access to professional development opportunities about culturally sensitive communication also achieved high level consensus. These practice recommendations provide guidance for ICU clinicians in their communication with patients and families from culturally diverse backgrounds. 

Hospitals may buckle under 'tsunami' of patients Modern Healthcare; by Alex Kacik; 2/25/25 Health systems are treating sicker patients, straining already full emergency departments and inpatient units. Many health systems are struggling to keep up with the increasingly complex healthcare needs of an aging population, leading to overcrowded emergency rooms and delays in care. Providers are ramping up strategies to treat patients more efficiently and keep those who aren't as sick out of emergency departments. These strategies are critical as capacity wanes and providers face a potential decline in federal healthcare funding, executives said. Health systems are revamping patient admission and discharge processes; bolstering virtual, home and urgent care offerings; expanding clinician recruitment efforts and adding observation beds. But providers are concerned they won't be able to act quickly enough to meet the growing demand for care.

North Texas doctor helps parents facing infant loss deal with the unimaginableCBS News - Texas; by Andrea Lucia, Lexi Salazar, Katie Standing; 2/25/25[Background story for parents Yvette and Thoms Ngo upon dealing with the news that their in-utero baby girl Zoe was diagnosed with Trisomy 13, would likely miscarry, or die soon after birth. Dr. Terri Weinman, their neonatologist offered rich palliative care interventions and support.] "When we met Dr. Weinman and her team the first time, she would say things like, 'So, what are we going to do when Zoey is here,' which changed my mindset completely," Yvette Ngo said. ... For the first time, the Ngos began to consider what Zoey's life, short as it might be, could look like. "It made us more comfortable with the situation, I mean as comfortable as you can be," Thomas Ngo said. "She just gave us hope." Zoey was born on April 18, 2024. She met her parents, her siblings and her grandparents. She was baptized. "They made us little crafts and mementos for us to take home, like footprints, really ways to help cherish Zoey's life," Yvette Ngo said. "They took her heartbeat and recorded it for us. Little things that we wouldn't necessarily think of." Zoey even had a chance to go home. But after 36 hours of life, Zoey passed away in her father's arms. The perinatal palliative care Zoey received remains rare. But for families like the Ngos, it provides a small sense of control when it's needed most. "Being able to plan so much in advance and think about all the different scenarios and how we wanted it," Yvette Ngo said. " I think, looking back on our time with Zoey..." "We wouldn't have done anything differently," Thomas Ngo said. Editor's note: Pair this with "Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing students," posted 2/24/25.

Pennsylvania lawmaker introduces ‘No Patient Left Behind Act’ WHTM - PA Homepage; by Brady Doran; 2/19/25 A Pennsylvania lawmaker introduced a bill that would ensure hospitals have visitation policies that balance patient needs with public health protocol. According to Sen. Doug Mastriano (R-33), elderly patients left alone in hospitals experience faster physical and cognitive decline. The No Patient Left Behind Act, introduced by Mastriano, would ensure Pennsylvanians with medical treatment or end-of-life care have support by their sides. “Hospitals should be places of healing. However, for far too many, they have become places of loneliness, despair, and unnecessary suffering,” Mastriano said.

13 hospitals, health systems cutting jobs Becker's Hospital CFO Report; by Kelly Gooch; updated 2/22/25A number of hospitals and health systems are reducing their workforces or jobs amid financial and operational challenges. [Click on this title's link for] workforce reduction efforts or job eliminations announced in 2025.