Literature Review

Health systems abandon rigid hierarchies Becker's Hospital Review; by Laura Dyrda; 9/27/24 Health systems are relinquishing traditional leadership structures to reimagine a more effective healthcare delivery organization. The rigid hierarchies instilled within many hospitals and health systems years ago ensured a tight grip on quality and management. But times have changed; the rapid evolution of digital technology and need for nimbleness are forcing hospitals to change. "As an industry, healthcare must transition from hierarchical, top-down leadership to more agile, decentralized models that empower teams and promote innovation at all levels," said Wendy Horton, PharmD, CEO of UVA Health University Medical Center in Charlottesville, Va. "Excellent communication skills will be vital for navigating these changes, along with a strong emphasis on workforce well-being including strategies to address mental health, retention and burnout." ... Dr. Horton also elevates empathy and effective communication for healthcare leaders. ... The proliferation of artificial intelligence and other technologies in healthcare is streamlining the purely administrative tasks, further emphasizing the human connection between leaders and their teams.

NY home care agency pays $400K in racial prejudice lawsuit A home care agency in Brooklyn, NY, was ordered to pay $400,000 to settle a race and national origin discrimination lawsuit filed by the US Equal Employment Opportunity Commission. ACARE HHC Inc., doing business as Four Seasons Licensed Home Health Care Agency, routinely assigned home health aides based on clients’ racial preferences, according to a consent order filed with the US District Court for the Eastern District of New York. These workers, which included Black and Hispanic aides, would either be transferred to new client assignments based on clients’ wishes or lose their employment entirely, EEOC found. These practices were a violation of the Civil Rights Act, which prohibits employers from making job assignments based on workers’ race or national origin. Four Seasons will pay $400,000 in monetary relief for the home health aides affected, according to the consent order. It will also update its internal policies and training processes related to Civil Rights Act requirements, cease making home health aide assignments based on clients’ race or nationality preferences, and provide semi-annual reports to the EEOC regarding any reports or complaints surrounding race discrimination.

Employee engagement can define senior living’s value proposition: panel McKnights Senior Living, Washington, DC; by Kimberly Bonvissuto; 9/26/24 The senior living industry knew it had workforce challenges at least 15 years before COVID-19 hit, but it didn’t do enough about them. Today, the sector has the opportunity to be proactive and build a workforce to meet the rapidly increasing demand for senior living and care services by investing in workers and improving employee engagement. ... [Senior living leaders described the] pivotal role that cultivating a satisfied, engaged workforce plays in organizational success as well as the ability to significantly enhance operational efficiency, resident satisfaction and the bottom line through culture. Two-thirds of Fortune 500 companies invest resources in employee engagement, according to Todd Kiziminski, vice president of talent acquisition at Trilogy Health Services, who said they recognize the link between engagement strategies and the bottom line.

The power of collaboration: Pharmacists and nurses partner to enhance patient care American Society of Health-System Pharmacists (ASHP) News Center; by Karen Blum; 9/23/24 Pharmacists and nurses work together on today's most pressing health challenges - from managing heart failure to deprescribing in palliative care to tackling obesity in pre-transplant patients. The Collaborative Care Grant for Nurses and Pharmacists from the ASHP Foundation and American Nurses Foundation recognizes the potential impact of this interdisciplinary teamwork on improving healthcare outcomes. At UPMC Presbyterian Hospital, the grant program helped fund the creation of a medication optimization clinic (MOC) for those with heart failure with reduced ejection fraction. “It made a lot of sense to bring together our collective expertise to manage these patients to get them on more optimal medications,” said James Coons, a clinical pharmacist in cardiology at UPMC Presbyterian Hospital. Coons, an ASHP member and professor at the University of Pittsburgh School of Pharmacy, worked with nurse practitioner and longtime collaborator, Jennifer Kliner, on the project.

Building a clinic-based palliative care program Hospice News; by Jennifer Murtoff; 9/25/24 Palliative care is often delivered in the hospital setting or in the home, but a number of organizations have set up clinics to deliver those services. These locations often assist patients by offering a variety of services beyond symptom management. While they offer an alternative to home-based services, they present their own unique benefits and challenges. One of the agencies that uses the clinic model is Hospice of Northwest Ohio, which serves both Ohio and Michigan. Their palliative care subsidiary, Sincera — Supportive Care and Symptom Relief, launched in 2008 and recently opened a location in Oregon City, Ohio. At Sincera clinics, patients of any age who have chronic, serious illnesses can receive expert palliative care services. Creating the clinic-based model was a challenge, according to Richard Russell, president and CEO of Hospice of Northwest Ohio.

Why hospital-at-home, other providers are pressing worker safety Modern Healthcare; by Diane Eastabrook; 9/24/24 At-home care providers are testing strategies to better protect workers who are raising the alarm on workplace safety. A new survey of more than 400 home healthcare workers found more than half said they experienced or witnessed at least one act of violence or harassment in the workplace, according to Transcend Strategy Group, which conducted the poll on behalf of home care providers. The report, which echoes similar findings from a National Nurses United survey, comes as hospital-at-home programs expand and more care moves to where patients live. ... Home-based care providers are trying to address the issue because concerns about personal safety could make it harder to recruit and retain workers in a competitive job market. The concerns are also coming up in contract negotiations between unions and providers.

Mirror, mirror 2024: A portrait of the failing U.S. health system - comparing performance in 10 nations The Commonwealth Fund; by David Blumenthal, Evan D. Gumas, Arnav Shah, Munira Z. Gunja, and Reginald D. Williams II Goal: Compare health system performance in 10 countries, including the United States, to glean insights for U.S. improvement. Methods: Analysis of 70 health system performance measures in five areas: access to care, care process, administrative efficiency, equity, and health outcomes. Key Findings: The top three countries are Australia, the Netherlands, and the United Kingdom, although differences in overall performance between most countries are relatively small. The only clear outlier is the U.S., where health system performance is dramatically lower. Conclusion: The U.S. continues to be in a class by itself in the underperformance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residents’ most basic health care needs, including universal coverage.

The ROI of interoperability in home health Home Health Care News; by Elizabeth Ecker; 9/16/24 Today’s home-based care organizations know there is value in interoperability among their technology vendors. Allowing for seamless data integration as well as ease-of-use for staff and clinical professionals, interoperability is an important consideration for technology decisions in today’s operating environment. But what is the true value of interoperability, and how can home-based care agencies measure their return on investment? Several leading professionals share their perspectives on how they approach ROI calculations in their organizations.

[UK] End-of-life care demand for dementia patients set to surge, study warns Jersey Evening Post, United Kingdom; by UK News; 9/16/24 The number of people living with dementia who require end-of-life care is set to “substantially increase” in the coming years, according to a study. ... Researchers said: “Previous projections of the number of people with dementia who will have palliative care needs in England and Wales were based only on the number of people who died with dementia, and did not take into account people living with dementia. Thus, it is likely that the prevalence of palliative care needs among people with dementia in England and Wales has been considerably underestimated. Our analysis shows that even if dementia incidence declines between 2018 and 2040, the number of people living with dementia in England and Wales who have palliative care needs will increase substantially by 2040, reaching levels far greater than previous estimates based on mortality data.”Editor's note: How do these projection processes in the UK compare or contrast with the USA data you use? For more immediate information about current resources, click here for the Alzheimer's Assocation "Support for People Living With Dementia" and click here for 

More home health providers sunset relationships with largest Medicare Advantage players Home Health Care News; by Andrew Donlan; 9/13/24 Essentia Health--a regional nonprofit health system with a substantial home health arm--announced this week that it will no longer serve as an in-network provider for UnitedHealth Group. ... Dr. Cathy Cantor, Essentia’s chief medical officer for population health, said in a statement ... “The frequent denials and associated delays negatively impact our ability to provide the timely and appropriate care our patients deserve. This is the right thing to do for the people we are honored to serve.” Headquartered in Duluth [MN], Essentia Health provides care across Minnesota, Wisconsin and North Dakota. Its network includes about 15,000 employees, 14 hospitals, 78 clinics, six long-term care facilities, six assisted living and independent living facilities, and much more. It also has a robust home health and hospice business. The company has informed patients that it will no longer serve as an in-network provider for the above-mentioned MA payers beginning Jan. 1. ... Sanford Health, a health system based in Sioux Falls, South Dakota, announced a similar plan this week. 

Telehealth palliative care helps people living with advanced cancer Cancer Health; by Liz Highleyman; 9/9/24 Virtual palliative care can be as effective as in-person care, according to a recent study. Oncology palliative care is intended to relieve symptoms and improve quality of life. It is not the same as hospice care, and it can help people at any stage of cancer. National guidelines recommend integrating palliative care from the time of diagnosis for people with advanced cancer, but it is underutilized in part due to a shortage of trained providers. This study included 1,250 adults at 22 U.S. cancer centers who were diagnosed with advanced non-small-cell lung cancer. They had palliative care sessions every four weeks conducted either via video or in person. After six months, quality-of-life scores were equivalent in the two groups. They also did not differ significantly in terms of depression or anxiety, coping skills, understanding treatment goals or perception of their prognosis.

Hospice of the Foothills announces umbrella name, Foothills Compassionate Care YubaNet.com; by Hospice of the Foothills; 9/10/24 As we celebrate 45 years as this community’s only nonprofit hospice, Hospice of the Foothills is excited to announce that we are formalizing our structure a bit to fit all of our programs under one all-encompassing organizational name. Going forward, Hospice of the Foothills, Sierra Community Palliative Care, Foothills Gift & Thrift Stores, and our Bereavement Programs will operate under the unified umbrella of Foothills Compassionate Care. Each program/service will maintain its name and identity but will be united under one umbrella.  We feel his strategic alignment will highlight all that we do more clearly and reinforce our commitment to providing compassionate, community-centered care without changing the ownership, staff, or core mission that our community has trusted for years. ... This is not about changing what works; it’s about creating a formal structure that reflects the comprehensive care we’ve always provided.