Literature Review

How poor communication is killing patients and burning out doctors Medpage Today's KevinMD.com; by Pamela Buchanan; 1/14/25 This week alone, I had two particularly heart-wrenching encounters [as an Emergency Room physician]: A 65-year-old man with metastatic lung cancer, convinced his shortness of breath was just pneumonia. When I explained the progression of his disease, he was shocked. No one had told him that his cancer was likely incurable. A 97-year-old woman brought in for “failure to thrive.” She was frail, pale, and not eating—classic signs of the final stages of metastatic cancer. When I suggested hospice care, she seemed blindsided, as if this reality was completely new to her. Both cases highlight a troubling trend: Patients often come to the ER not just for care, but for clarity. They don’t understand their diagnosis, prognosis, or treatment plan. ...

St. Croix Hospice to acquire Mayo Clinic Health System hospice operations in Southwest Minnesota PR Newswire, Oakdale, MN; by St. Croix Hospice and Mayo Clinic Health System; 1/13/25 St. Croix Hospice and Mayo Clinic Health System have entered into a definitive agreement for St. Croix Hospice to acquire Mayo Clinic Health System's hospice operations in Southwest Minnesota. The agreement remains subject to regulatory approval and is expected to close in the first quarter of 2025. ... "With more than 75 locations across the Midwest staffed by local care teams, St. Croix Hospice has been proudly providing hospice care for Mayo Clinic Health System patients throughout the Midwest for many years," says St. Croix Hospice Chief Clinical Officer Mandy Cogswell. ... "This marks the second recent transaction where St. Croix Hospice has acquired a health-system based hospice program, including a fourth quarter 2024 purchase in Iowa and Nebraska," said St. Croix Hospice CEO Heath Bartness.

Caregiver confessions: ‘How much more can we take?’ New York Magazine - The Cut - Family; as told to Paula Aceves and David mack; 1/13/25 Eleven people who care for aging and sick relatives share their fears, resentments, and guilt. “Where did those ten years ago?”: the daughter struggling to make ends meet while caring for her mother with Alzheimer’s. I never left home, like a good Cuban. My dad died when I was 9, and my mom never remarried, so I always felt a responsibility for her as her only child, especially since I’m not married and don’t have children of my own. [Click on the title's link to read this and other caregiver stories.]

Doctors, nurses press ahead as wildfires strain L.A.’s healthcare Los Angeles Times, produced by KFF Health News; by Emily Alpert Reyes, Bernard J. Wolfson and Molly Castle Work; 1/10/25 The rapidly spreading wildfires are not only upending the lives of tens of thousands of Los Angeles County residents and business owners, but also stressing the region’s hospitals, health clinics, first responders and nursing homes. ... Amid the maelstrom, doctors, nurses and other caregivers did their jobs. ... “All hospitals in close proximity to the fires remain on high alert and are prepared to evacuate if conditions worsen,” the Hospital Assn. of Southern California said in a statement. “The fires are creating significant operational hurdles,” the association added. ... [From a nurse,] "In times like this, this is when community si the most powerful."

Researchers compared hospital early warning scores for clinical deterioration—Here’s what they learnedJAMA Network; Roy Perlis, MD, MSc; Jennifer Abbasi; 1/24This conversation is part of a series of interviews in which JAMA Network editors and expert guests explore issues surrounding the rapidly evolving intersection of artificial intelligence (AI) and medicine. Arecent head-to-head study at Yale New Haven Health System compared 6 different early warning scores designed to recognize clinical deterioration in hospitalized patients, including 3 proprietary AI tools. Among the best was the National Early Warning Score (NEWS), a publicly available non-AI tool, while the Epic Deterioration Index “was one of the worst” of the batch, the authors reported in October in JAMA Network Open.

California wildfires and healthcare: Compiled articlesCompiled from various news sources; 1/9/25

'Never waste a good crisis': The keys behind a Louisiana system's financial comebackBecker's Hospital CFO Report; by Alan Condon; 12/27/24Franciscan Missionaries of Our Lady Health System, a 10-hospital system headquartered in Baton Rouge, La., achieved a $241 million turnaround in fiscal year 2024 under the leadership of CFO Mike Gleason, who told Becker's the feat was "a total team effort." By reimagining operational strategies, shifting from a holding company to an operating company model, and fostering a culture of innovation and collaboration, the 10-hospital system not only stabilized its finances but positioned itself for sustained growth. Mr. Gleason joined the Becker's Healthcare podcast to discuss the strategies that turned a financial crisis into an opportunity for sustainable growth and strengthened the health system's ability to reinvest in its people and future.

Top 25 health systems' most-successful digital projects of '24Becker's Health IT; by Giles Bruce; 12/20/24Health systems experienced another year of digital advancement in 2024, with more big EHR moves and a push toward generative AI. Here are the most successful IT projects and top digital trends of the year, as told to Becker's by the head technology leaders at top 25 health systems across the U.S.

Holistic and seamless: How health systems advocate, Mass General Brigham are advancing at-home care Home Health Care News; by Joyce Famakinwa; 1/6/25 A big part of the evolution of health systems has been more meaningful engagement with the home as an extension of brick-and-mortar operations. In recent years, organizations like Advocate Health and Mass General Brigham have exemplified this shift. These major health systems are reevaluating their home-based care capabilities and partnerships, and leveraging technology and innovative care models–including hospital-at-home–to enable more integrated and cost-efficient services. ... In August, the organization was awarded $4.6 million from the Massachusetts Executive Office of Health and Human Services to study short-term rehab at home. The study is a randomized controlled trial that examines the impact of delivering short-term rehab care at home compared to a traditional post-acute care setting.

Patient sues California hospital network over ransomware attack Becker's Hospital Review; by Naomi Diaz; 1/6/24 PIH Health is facing a lawsuit over a ransomware attack that hit the health system on Dec. 1, Pasadena Star-News reported Jan. 5. Ferdinand Rivera has filed a lawsuit against PIH Health, accusing the health system of negligence, invasion of privacy and other violations following the ransomware attack. The cyberattack crippled information technology systems and phone lines across three hospitals — PIH Health Downey Hospital, PIH Health Whittier Hospital and PIH Health Good Samaritan Hospital in Los Angeles — as well as urgent care centers, physicians' offices, and home health and hospice services. Mr. Rivera's lawsuit, the first among more than a dozen filed in Los Angeles Superior Court, seeks unspecified damages, according to the Daily Journal.

Current challenges in neurocritical care: A narrative reviewWorld Neurosurgery; Safa Kaleem, William T. Harris II, Stephanie Oh, Judy H. Ch'ang; 1/25Neurocritical care as a field aims to treat patients who are neurologically critically ill due to a variety of pathologies. As a recently developed subspecialty, the field faces challenges, several of which are outlined in this review ... [including confusion around] brain death testing or the diagnosis of brain death itself ... Given these difficult scenarios encountered in the neuro-ICU, conversations with patients’ decision-makers are often done with the assistance of palliative care services ... the most common reasons for palliative care consultation in the neuro-ICU were discussing prognosis, eliciting patient and family values, understanding medical options, and identifying conflict. Collaboration with hospital chaplains and palliative care services can be helpful, but cultural humility also needs to be a priority for neurocritical care providers to be able to navigate difficult conversations.

Top Modern Healthcare stories of 2024 Modern Healthcare; by Mary Ellen Podmolik; 12/31/24 Ups and downs in healthcare kept Modern Healthcare reporters plenty busy in 2024, and 2025 is shaping up as a critical year for the industry, particularly as a new administration takes over in Washington, D.C. Our reporters this year did what Modern Healthcare excels at — bringing readers the news along with the context and analysis our audience needs to stay ahead. Get ready for 2025 by catching up on some hot topics during 2024.

The next health system C-suite obsessionBecker's Hospital Review; by Laura Dyrda; 12/30/24 Health system executives spent the last few years building financial stability after the pandemic and adjusting to workforce shifts. Those areas will remain important in 2025, but a new obsession for C-suite executives is emerging. Or, more accurately, re-emerging. Solving capacity issues and becoming more efficient with patient throughput is a top priority for next year, several CEOs and top health system executives recently told Becker's. Many are operating at or near capacity, especially with workforce challenges persisting, and leadership teams are looking for immediate solutions. ... A recent survey from Vizient shows 52.8% of hospital and health system leaders see patient access, throughput and capacity as top focus areas for 2025. Volumes are still elevated compared to pre-pandemic levels, according to Kaufman Hall's "National Hospital Flash Report," and while growth has slowed this year, leaders are still contending with big capacity issues.