Literature Review

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

Implementation of a serious illness conversation program in a health system: A retrospective observational studyJournal of Palliative Medicine; by Glen Varns, Abbey Sidebottom, Katy Hentges, Sandra Castro-Pearson, Jan Richardson, Emily Downing; 6/26Serious illness conversation (SIC) is a structured conversation framework designed to improve shared decision making and promote goal-concordant care with patients anticipating end-of-life care decisions. Objective: Examine reach, timeliness, and quality of SIC implementation across a health system after implementation of a SIC Program (SICP) [and] examine factors associated with SIC completion for eligible patients. Factors associated with SIC included palliative care visits ... , a primary care provider in the system ... , and an inpatient admission with discharge to home care ... Patients with dementia ... were less likely to have SIC. Conclusion: Systemwide implementation of an SICP engaged [only] half of eligible patients; many of those had multiple documented conversations prior to death.

Impact of specialized pediatric palliative care on bereaved parents' mental and physical healthJournal of Pain & Symptom Management; by Claudia Delgado-Corcoran, Huong D. Meeks, Sarah E. Wawrzynski, Barry P. Markovitz, Brandy Harman, Jasmine R. Masih, Kuan Li, Mark Harousseau, Dominic Moore, Jacob Wilkes, Stefanie G. Ames; 6/26Pediatric death can lead to long-term adverse effects on parents’ health. [In this study] of 776 deceased children linked to 773 mothers and 711 fathers, 36.1% received a SPPC [specialized pediatric palliative care] consultation prior to death. Higher rates of mental and physical health burden were observed in mothers than fathers across all time points. Lack of SPPC was associated with increased risks for new mental and physical health burden for mothers within 12 months after the child’s death ... Conclusions: Bereaved parents, especially mothers, experienced new mental and physical health burden up to 24 months after a child’s death.

Palliative care for older adults with hip fracture: An explanatory sequential mixed-methods studyJournal of Pain & Symptom Management; by Daniel I Hoffman, Sydney Moore, Amanda J Reich, Christina Sheu, Mengyuan Ruan, Masami Tabata-Kelly, Kate Sciacca, Tamryn F Gray, Daniel Dohan, Charlotta Lindvall, Zara Cooper; 6/26After hip fracture, older adults experience burdensome treatments and high mortality; they may therefore benefit from palliative care (PC). Among 1,433 hip fracture admissions, GOCC [goals of care conversations], hospice discussions, and specialty PC were documented in view on their role in GOCC. Conclusion: Limited standardization, role uncertainty, and cultural factors limited PC documentation and delivery, highlighting opportunities to strengthen PC integration in surgical care.

Outcomes for hospitalized patients with comfort measures only ordersJournal of Palliative Medicine; by Gina Piscitello, Donna Durant, Tami Minnier, Marika Haranis, Robert M Arnold, Jane Schell; 6/26Clinicians place comfort measures only (CMO) orders for hospitalized patients at the end-of-life when a decision has been made to focus on patient comfort and allow the natural dying process to occur. Our primary aim was to assess the associations of specialty palliative consults (SPC) or documented goals of care conversations (GOCC) with in-hospital mortality among patients with CMO orders. Of 6,789 hospitalized patients with CMO orders ... seventy-three percent died in-hospital, and 22% were discharged with hospice. SPC placed anytime during hospital admission were associated with lower in-hospital mortality ... and higher discharge with hospice ... In contrast, documented GOCC anytime during admission were associated with higher in-hospital mortality ...  and lower discharge with hospice ...

Survival variation and predictors of length of stay in US hospice patientsInternational Perspectives and Future Directions for Practice, Research, and Policy; by Ian Duncan, Xiyue Liao, Terri Maxwell; 6/26End-of-life (EOL) patients in the US Medicare program represent a large and growing population, as well as a disproportionate share of Medicare’s costs. Survival of patients in hospice is, however, highly variable, implying an opportunity for improved management by enhancing the prediction of survival. Actuaries, health economists, policy analysts, and health services researchers have studied expenditures at the EOL for Medicare decedents for many years, finding that survival at EOL is highly variable. We discuss the utilization of hospice benefits for patients at the EOL in the United States.

An end-of-life care approach defining a new standard of careJAMDA; by David N. Hoffman; 6/26The Institute for Healthcare Improvement (IHI) Leadership Alliance established an End-of-Life Care/Ending-Life Care Accelerator to define a continuum of care for patients as they progress from curative care, to palliative care, to hospice care, to final care planning, including ending life care interventions such as Medical Aid in Dying (MAiD), Voluntarily stopping eating and drinking (VSED), and palliative sedation. This accelerator defined as its goal the task of breaking down barriers between care providers which has been illuminated by research recently conducted by the Completed Life Initiative (CLI). CLI’s research efforts in this area started with an ongoing examination of nationwide hospice organization policies to provide referral for active intervention at the end of life. That effort was refocused on the widespread noncompliance of California and Washington state hospice organizations with a state law requirement to post on the organizations website a list of interventions made available by the hospice organization.

Saturday newsletters focus on headlines and research - enjoy!

Silverado announces leadership transition as Wayne Sanner assumes role of Chief Executive Officer and President FDL Reporter, Irvine, CA; Press Release; 7/9/26 Silverado enters a new chapter as Wayne Sanner assumes leadership, building on founder Loren Shook’s legacy of innovation and compassionate care. ... Effective July 1, 2026, Wayne Sanner assumed the role of Chief Executive Officer and President of Silverado. At the same time, founder Loren Shook transitioned to the role of Chairman of the Board, Executive Chairman, and Founder, where he will continue full time to support the culture and development of Silverado while providing strategic guidance and helping shape Silverado’s future.

Deep summer is when laziness finds respectability. ~ Sam Keen

Nonprofit-private equity joint ventures worth scrutiny, PESP report says Fierce Healthcare; by Anastassia Gliadkovskaya; 7/7/26 At least 568 healthcare facilities operate through nonprofit-private equity joint ventures, according to a new report calling for scrutiny into those arrangements. The figure is likely an undercount, considering only public data were used. The report (PDF) was published by the Private Equity Stakeholder Project (PESP), a nonprofit that advocates for more disclosure about private equity deals. More than a fifth of private equity (PE)-owned hospitals operate under joint venture arrangements with nonprofit health systems. ... Such joint ventures extend beyond hospitals, spanning subsectors such as inpatient rehab, hospice, home health, behavioral health, ambulatory surgery centers and urgent care, per the report.

Missed opportunities to promote flourishing in cancer care: a brief examination of multiple myeloma Supportive Care in Cancer; by Natalie Tuckey, Hannah R. Wardill, Xavier Symons, Melissa Cantley, Kathina Ali, Hayley Beer, Gregory B. Crawford, Angelina Yong & Matthew Iasiello; 7/8/26... We propose that certain elements of flourishing, such as meaning and purpose, deep personal relationships, and cultivating virtue, can be uniquely realized if targeted appropriately toward the end of life. ...  Participants reported personal growth following their diagnosis through acceptance, meaning-making, and connection, yet reported the loneliness of dying with cancer with a desire to have discussions about death with their clinicians in addition to them maintaining treatment. On the contrary, health professionals were hesitant to discuss death with their patients, balancing hope in treatments with preparation for dying. We argue that the hesitation to discuss death thwarts the opportunity to flourish and that existing solutions such as dignity therapy, meaning-centered psychotherapy, early palliative care, and multidisciplinary support can close this gap without diminishing hope in treatments.Editor's Note: For a recent, similar research article about "flourishing," examine "Flourishing within vulnerability: on human fragility and the conditions for a habitable environment."

Reynolds creates Iowa Medicaid fraud task force Insurance Newsnet; by Marissa Payne; 7/9/26 Gov. Kim Reynolds signed an executive order Wednesday [7/8] creating a new task force geared toward eliminating Medicaid fraud, waste and abuse, joining in the federal government's crackdown on potential misuse of public assistance programs. Reynolds signed the order establishing the Iowa Medicaid Fraud Elimination Task Force, which the Republican governor's office says will seek to ensure funds are used to support Iowans who qualify for benefits. "Safeguarding federal programs like Medicaid from bad actors requires accountability at every point in the process, from member eligibility verification to provider enrollment and billing," Reynolds said in a statement.