Literature Review

Why doctors aren’t participating in organ donation after cardiac death Physician's Weekly; by Frank D. Brodkey, MD, FCCM; 6/13/24Organ donation after cardiac death (DCD) differs from the more traditional organ donation after brain death (DBD) insofar that DCD donors are alive and donate organs after discontinuation of life support so that a natural death with cessation of heartbeat and circulation may occur, followed by extraction of organs. This may increase the availability of transplantable organs, leading to improvement in the lives of other humans.  According to the Health Resources and Services Administration, 5896 donations, representing 36% of all donations in 2023, were DCD, representing an increase of 40.7% over the preceding three years. There, however, are significant ethical and scientific issues in the performance of DCD with concepts of end-of-life care, personal autonomy, and concepts of dignity of life and death. ...

Acting now to sustain and improve America’s healthcare system: Advice from innovative physicians and health system leadersSheppardMullin Healthcare Law Blog; by Kathleen O'Neill, John Golembesky, Jeralin Cardoso, Chi Huynh & Carolyn Young; 6/6/24 At [the recent] America’s Physician Groups Spring conference in San Diego, California, we listened as physicians and health system leaders described the ways in which they are responding to short and long term challenges to the sustainability of America’s healthcare system in its current form. It now stands at a critical juncture, facing challenges such as provider shortages and burnout, increasing concerns around access and cost for pharmaceutical products and other supplies, the increasing burden of managing chronic diseases, rising demand for services across the spectrum from an aging population, and balancing the transition to value-based care models in a predominantly fee-for-service environment. ... Here, we outline the key areas of focus described by leaders at the conference: ... 

White House enlists Microsoft, Google for rural hospital cyberdefense Becker's Health IT; by Naomi Diaz; 6/10/24 The Biden-Harris administration has secured commitments from Microsoft and Google to offer free and low-cost resources to rural hospitals nationwide to help them boost their cyber defenses. As part of the effort, Microsoft will be extending its nonprofit program to provide grants and up to a 75% discount on security products for independent critical access hospitals and rural emergency hospitals, according to a June 10 news release from the White House. Additionally, larger rural hospitals using eligible Microsoft solutions will also receive the most advanced security suite at no additional cost for one year. ... Meanwhile, Google committed to offering endpoint security advice to rural hospitals and non-profit organizations at no cost, alongside funding support for software migration. 

Higher sepsis mortality in safety-net hospitals linked to fewer post-discharge care options Contagion Live - Infectious Diseases Today; by Kenneth Bender, PharmD, MA; 6/9/24 Purportedly higher sepsis mortality in safety-net hospitals reflects less a difference in acute care than opportunities to discharge to hospice. By extending the measure of sepsis-related mortality from in-hospital events to occurrences within 30 days after the diagnosis, the purported higher mortality rate of sepsis treated in safety-net hospitals decreased to parity with non-safety-net hospitals, in a retrospective national cohort study. The investigators note the particular challenges of safety-net hospitals, which care for a disproportionately high share of low-income and underinsured patients, include fewer resources and narrower operating margins, as well as patient populations with decreased access to preventative care and more complex disease presentations.

These MD architects want to redesign your hospital Medscape; by Amanda Loudin; 6/5/24Little known fact: Florence Nightingale might have been the most famous clinician to notice and openly comment on the role of hospital design in patient care. In her now well-known writings on nursing, Nightingale advocated for "open windows to maximize light and ventilation," among other elements. Today, a growing group of physician-designers are paying attention to many such details — windows in patient rooms included. Their goal: To build hospitals and medical facilities where design can enhance patient and clinician well-being. ...

Dr. Marc Boom confronts the new dynamics of CEO burnoutBecker's Hospital Review; by Kelly Gooch; 5/23/24While the topic of burnout among hospital CEOs is not new, there are new dynamics in play to consider as part of the discussion. Those in the role today encounter increased pressures ranging from financial to operational. "There are new pressures that have emerged in the healthcare delivery world - everything from reimbursement cuts and escalating drug and supply costs, and labor expenses - that have created a lot of financial headwinds for organizations," said Scott Sette, a partner with Chicago-based executive search firm Heidrick & Struggles. "Plus, regulatory changes have forced CEOs to spend more resources on compliance, cybersecurity, EMR administration." Additionally, "there have just been so many workforce challenges. ... Then you have the impact of the remote and hybrid workforce and the impact of that on organizational culture. Plus, you've got many social issues going on. Clearly, [diversity, equity and inclusion] continues to be top of mind, but also you've got political unrest. You have mass shootings. You have gender-affirming care and other social issues that organizations have to address. And all of these topics [have] created even more pressures for hospitals and health systems to deal with, in addition to delivering high-quality care and delivering customer-centric experiences. There is a lot for CEOs to deal with on a daily basis." Marc Boom, MD, has served as president and CEO of Houston Methodist, an eight-hospital system with more than 32,000 employees, since 2012. He acknowledged these pressures in a recent interview with Becker's. He also discussed the prevalence of burnout and shared advice for how leaders can reduce the potential for it.

Kaiser physicians vote to unionizeBecker's Hospital Review; by Kelly Gooch; 5/24/24Resident and fellow physicians employed by Kaiser Permanente hospitals in Northern California voted to join the Committee of Interns and Residents, a local chapter of the Service Employees International Union. Nearly all participating voters (99%) cast ballots in favor of unionization, according to a May 23 CIR/SEIU news release. The National Labor Relations Board has not yet certified the results. Pending certification, the total percentage of residents represented by CIR/SEIU in California will reach 82%, according to the union.

US News adds Medicare Advantage data to rankingsBecker's Hospital Review; by Laura Dyrda; 5/22/24U.S. News & World Report is now including Medicare Advantage data in the rankings for Best Hospitals, according to a U.S. News blog post. The publication previously relied on Medicare data, but as more beneficiaries opt for commercial Medicare Advantage plans, U.S. News decided to expand its scope. The next set of rankings, scheduled for publication on July 16, will include risk-adjusted mortality rates for Medicare Advantage beneficiaries in 11 adult specialties. U.S. News weighted mortality scores at 36% of the overall ratings with traditional Medicare data. The weight will shift with the combined mortality score from both Medicare and Medicare Advantage plans.

Healthcare sees highest Chapter 11 bankruptcy filings in 15 years: reportMcKnights Senior Living; by Kathleen Steele Gaivin; 5/20/24Chapter 11 bankruptcies in healthcare, including senior living reached a multiyear high in the first quarter of 2024. That’s according to the newest Polsinelli-TrBK Distress Indices Report, published Wednesday. “We continue to see intense stress in senior living,” Jeremy R. Johnson, a bankruptcy and restructuring attorney at Polsinelli and co-author of the report, said in a press release issued in conjunction with the report. ... The Southeast continues to outpace the rest of the country as the busiest region for bankruptcy filings, according to the report. The Southeast region reported 33.4% of the filings in the first quarter, followed by Northeast and Delaware at 30.8% and 16.1%, respectively. Since the benchmark period of 2020, the Northeast has shown the biggest increase in filings.

Did COVID-19 ICU patient mortality risk increase as Colorado hospitals filled? A retrospective cohort studyBMJ Open; by David R Johnson, Debashis Ghosh, Brandie D Wagner, Elizabeth J Carlton; 5/24Overall, and especially during the Delta era (when most Colorado facilities were at their fullest), increasing exposure to a fuller hospital was associated with an increasing mortality hazard for COVID-19 ICU patients.

HHS puts $50M toward hospitals' ransomware fightBecker's Health IT; by Molly Gamble; 5/20/24A new agency within the National Institutes of Health is launching a $50 million initiative to develop tools for hospital IT teams that enhance their cybersecurity measures and resources to combat ransomware. On May 20, the Advanced Research Projects Agency for Health introduced its Universal PatchinG and Remediation for Autonomous DEfense, or UPGRADE, program. "What if every hospital could autonomously protect itself and patients from cyber threats?" That is the guiding question for the initiative, which aims to develop a tailored and scalable software suite of remediations and patches for hospitals, reducing the patching time for vulnerable healthcare products to days or weeks.

Union president speaks on possible Ascension Genesys nurses strikeWNEM-TV5, GeneseeCo., MI; by Zain Omair and Hannah Mose; 5/20/24Registered nurses are ready to strike this week if union negotiations with a mid-Michigan hospital aren’t successful. Union president Dan Glass said if the union and Ascension Genesys don’t have a tentative agreement by Friday morning, May 24, the nurses represented by the union will hit the picket line for a strike. ... According to Glass, the union is looking for wage increases, but the biggest piece is staffing shortages and patient care concerns. 

Leaders leave patients in PE hospital shell gameBecker's Clinical Leadership; by Molly Gamble (Twitter); 5/16/24A bankrupt hospital that remains open is - in some ways - just as worrisome for patients as if it closed. The demise of Dallas-based Steward Healthcare is the latest example of this, and a stark reminder that watchdogs for patients only safeguard their interests up until a certain point. The situation is now a shell game for patients, who might have Steward hospitals open and available to them, but with questionable levels of staffing, safety or timely access to essential services.