Literature Review
Compliance strategies for forthcoming hospice HOPE tool
05/26/24 at 03:35 AMCompliance strategies for forthcoming hospice HOPE toolHospice News; by Holly Vossel; 5/16/24Hospices will have a learning curve when it comes to implementing the Hospice Outcomes and Patient Evaluation Tool (HOPE) tool. The U.S. Centers for Medicare & Medicaid Services (CMS) is currently developing quality measures that will be included in the HOPE tool, which will replace the current Hospice Item Set (HIS). After years of development, the agency in its recent hospice proposed rule indicated that the HOPE tool’s implementation would begin in 2025.Notable Mentions: Jennifer Kennedy, CHAP; Kimberly Skehan, CHAP.
Psychological trauma can worsen symptom burden at end-of-life
05/26/24 at 03:30 AMPsychological trauma can worsen symptom burden at end-of-life Hospice News; by Holly Vossel; 5/15/24 Recent research has found that traumatic experiences can lead to increased pain and symptom burden at the end of life, along with a greater likelihood of emotional suffering and isolation. Collective trauma experiences have been associated with higher instances of pain and dyspnea among more than half of seniors nationwide, a recent study found, published in the Journal of Pain and Symptom Management. Traumatized seniors are also more likely to experience loneliness, dissatisfaction with their life and depression. ... Hospices need a greater understanding of both the depth of these patients’ suffering and the scope of their unique needs to improve trauma-informed care delivery, [Dr. Ashwin] Kotwal said, assistant professor of medicine at the University of California San Francisco’s (UCSF) Division of Geriatrics.
10 most common sentinel events in 2023: Joint Commission
05/26/24 at 03:25 AM10 most common sentinel events in 2023: Joint Commission Becker's Clinical Leadership; by Mackenzie Bean; 5/15/24 In 2023, patient falls were once again the most common sentinel event reported by healthcare organizations, according to a May 15 report from The Joint Commission. The Joint Commission defines a sentinel event as a patient safety event that results in death, permanent harm, severe temporary harm or intervention required to sustain life. ... The 10 most frequently reported sentinel events for 2023:
A Review of "Heartwood: The Art of Living with the End in Mind" by Barbara Becker
05/26/24 at 03:20 AMA Review of "Heartwood: The Art of Living with the End in Mind" by Barbara Becker CU Anschutz; by Darcy Campbell, AGNP-D, ACHPN; 5/14/24 This year, one of our [small group] readings was the book, Heartwood; The Art of Living with the End in Mind, by interfaith pastor Barbara Becker. The book is composed of small vignettes from her life that explore death and dying. Many of her experiences as a hospice volunteer are captured as well. Her book was to be about death, but she learned that in writing about death she really explored what it means to live. Heartwood is the inner core of a tree. While dead it does not decay as it is supported by the outer living rings of the tree. Becker, describes Heartwood as the ideal metaphor for our life, “where life and death cannot exist separately from each other.” ... Working in palliative care, we too are forced to look at our own mortality.
Home-based care investors show interest, but M&A pace remains cautious
05/26/24 at 03:15 AMHome-based care investors show interest, but M&A pace remains cautiousHome Health Care News; by Andrew Donlan; 5/13/24Home-based care dealmakers have been busier of late, but that has not yet translated into more transactions. There’s some feeling that sidelined private equity firms will eventually have to enter the game, but that may not be the case.
Breaking down walls: The other care models marking their territory in home-based care
05/26/24 at 03:10 AMBreaking down walls: The other care models marking their territory in home-based careHome Health News; by Joyce Famakinwa; 5/17/24Traditional home-based care companies aren’t the only ones serving seniors, while helping shift care away from brick-and-mortar settings. Adult day, PACE and continuing care retirement communities (CCRCs) without walls are a few of the care models working to meet the needs of seniors that want to age in place. In many ways, these care models are natural allies to home-based care providers.
PE sponsors of Comfort Keepers, New Day Healthcare are in home-based care for the long haul
05/26/24 at 03:05 AMPE sponsors of Comfort Keepers, New Day Healthcare are in home-based care for the long haulHome Health Care News; by Joyce Famakinwa; 5/13/24While some private equity investors have been sidelined by macro and micro headwinds, there are still plenty of PE firms invested in home-based care that like where they are.
Emerging leaders in hospice and palliative care
05/26/24 at 03:00 AMEmerging leaders in hospice and palliative care AAHPM - American Academy of Hospice and Palliative Medicine; webpage source for various press releeases of individuals; 5/24AAHPM developed the Emerging Leaders in Hospice and Palliative Care program to recognize the exceptional work accomplished by the next generation of leaders and bring increased exposure to the specialty of hospice and palliative medicine. In 2014, the first class of Emerging Leaders was named. AAHPM seeks to recognize accomplished early career professionals and the next generation of hospice and palliative care leaders. This award recognizes new Emerging Leaders in recognition of their career accomplishments, involvement in the Academy, mentoring of residents and students, and participation in charitable work. [Click on the title's link for the list of 36 honorees.]Editor's Note: Do you work with or know any of these honorees? If so, please share this with them and your colleagues, along with congratulations from Hospice & Palliative Care Today! (Invite them to register for free--no strings attached--to our daily newsletter.)
Today's Encouragement
05/26/24 at 03:00 AMDance like no one’s watching; Sing like no one’s listening; Love like you’ll never be hurt; Play like there’s no winners; Behave like mom’s watching; Give like you have plenty; And SMILE. ~Adapted from William Watson Purkey
Sunday newsletters
05/26/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
The complexity of physician power
05/25/24 at 03:40 AMThe complexity of physician powerScience; by Laura Nimmon; 5/16/24Inequitable variation in physician effort and resource use is revealed. Power is present in all human relationships. Thus, there is no interaction in which power and its potential to exert influence is not relevant in medicine. Although the role of power in medical interactions is important, few studies investigate how physicians allocate effort and execute their power when interacting with patients. ... The nature of physicians’ relationships with patients is characterized as top down and asymmetrical (1). This unequal relationship is thought to be a product of physicians possessing legitimized expert knowledge and legal decision-making authority and patients who are reliant on care and services. Underpinning this power afforded to physicians is societal trust that physicians will always act altruistically and ethically toward patients.Publisher's Note: Also see the related article How power shapes behavior: Evidence from physicians by Stephen D. Schwab, Manasvini in the same issue. [They] investigate how physician power in the US Military Health System interfaces with sociological phenomena such as hierarchy, status, and authority. Their findings reveal the variability and complex mechanisms through which physician power is exerted, ultimately providing nuance about how the ethics of physician power is understood as it interfaces with other hierarchical systems of power.
Did COVID-19 ICU patient mortality risk increase as Colorado hospitals filled? A retrospective cohort study
05/25/24 at 03:35 AMDid 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.
Medical aid in dying to avoid late-stage dementia
05/25/24 at 03:30 AMMedical aid in dying to avoid late-stage dementiaJournal of the American Geriatrics Society; by Thaddeus Mason Pope, Lisa Brodoff; 4/24Many patients with dementia want the option of using medical aid in dying (MAID) to end their lives before losing decision-making capacity and other abilities that impact their desired quality of life. But, for over two decades, it has been widely understood that these patients cannot (solely because of their dementia diagnosis) satisfy three statutory eligibility requirements in all U.S. MAID laws: (1) decisional capacity, (2) the ability to self-administer the life-ending medications, and (3) a terminal condition with 6 months or less to live. Now, because of recent statutory amendments together with the use of voluntarily stopping eating and drinking (VSED) to quickly advance to a terminal condition, this dementia exclusion from MAID might no longer apply. If combining VSED and MAID is now a possibility for patients with dementia, then clinicians need more guidance on whether and when to support patients seeking to take this path. In this article, we begin to provide this guidance.
Physician Group Practices Accrued Large Bonuses Under Medicare’s Bundled Payment Model, 2018–20
05/25/24 at 03:25 AMPhysician Group Practices Accrued Large Bonuses Under Medicare’s Bundled Payment Model, 2018–20Health Affairs; by Sukruth A. Shashikumar, Zoey Chopra, Jason D. Buxbaum, Karen E. Joynt Maddox, Andrew M. Ryan; 5/24The Bundled Payments for Care Improvement Advanced Model (BPCI-A), a voluntary Alternative Payment Model for Medicare, incentivizes hospitals and physician group practices to reduce spending for patient care episodes below preset target prices. The experience of physician groups in BPCI-A is not well understood. We found that physician groups earned $421 million in incentive payments during BPCI-A’s first four performance periods (2018–20). Target prices were positively associated with bonuses, with a mean reconciliation payment of $139 per episode in the lowest decile of target prices and $2,775 in the highest decile. In the first year of the COVID-19 pandemic, mean bonuses increased from $815 per episode to $2,736 per episode. These findings suggest that further policy changes, such as improving target price accuracy and refining participation rules, will be important as the Centers for Medicare and Medicaid Services continues to expand BPCI-A and develop other bundled payment models.Publisher's Note: For those keeping an eye on alternative payment models...
Impact of a Nurse-Led Palliative Care Screening Tool on Medical Oncology Units
05/25/24 at 03:20 AMImpact of a Nurse-Led Palliative Care Screening Tool on Medical Oncology UnitsClinical Journal of Oncology Nursing; by Kaitlyn Whyman, Katherine Thompson, Michelle M. Turner; 2/24There is a lack of early integration of palliative care in patients with advanced cancer, which has been shown to result in suboptimal quality of life across their disease continuum. Standardized palliative care screening tools are valuable for identifying patients with early palliative care needs but have yet to be adapted into standard practice in the oncology community. This project aimed to determine whether a nurse-led palliative care screening tool increased palliative care consultations, decreased the average length of stay, reduced readmission rates among adult patients with solid tumor malignancies, and improved knowledge and confidence among nurses regarding palliative care.
Antipsychotics for Dementia Tied to More Serious Harms Than Expected
05/25/24 at 03:15 AMAntipsychotics for Dementia Tied to More Serious Harms Than ExpectedJAMA; by Emily Harris; 5/24Prior research has suggested that antipsychotic drugs might be overprescribed for people with dementia, despite known risks of stroke and sudden cardiac death. Now, findings from a new study in The BMJ indicate that the range of serious adverse outcomes associated with antipsychotics in these patients might be broader than previously thought.
Training opportunities for managers in home health, hospice, and community-based care settings
05/25/24 at 03:10 AMTraining opportunities for managers in home health, hospice, and community-based care settingsThe Journal of Nursing Administration; by Ann M Nguyen, Alfred F Tallia, Tami M Videon, Robert J Rosati; 6/24The aim of this study was to identify areas for developing management skills-focused continuing education for managers working in home health, hospice, and community-based settings. For all 33 management tasks, managers with 6+ years of experience reported greater confidence than managers with 0 to 5 years of experience. Tasks with the lowest confidence were budgeting, interpreting annual reports, strategic planning, measuring organizational performance, and project planning. Managers were clustered into 5 "profiles." Management training is not 1-size-fits-all. Healthcare organizations should consider investing in training specific to the identified low-confidence areas and manager roles to better support and develop a robust management workforce.
An age group comparison of concurrent hospice care: A cost-effectiveness analysis
05/25/24 at 03:05 AMAn age group comparison of concurrent hospice care: A cost-effectiveness analysisJournal of Hospice and Palliative Nursing; by Radion Svynarenko, Melanie J Cozad, Lisa C Lindley; 5/24This study
Saturday newsletters
05/25/24 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
Today's Encouragement
05/25/24 at 03:00 AMWe now no longer camp as for a night, but have settled down on earth and forgotten heaven. ~Henry David Thoreau
Hospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from Hospice
05/25/24 at 03:00 AMHospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from HospiceJAMA Network; by Elizabeth A. Luth, Caitlin Brennan, Susan L. Hurley, Veerawat Phongtankuel, Holly G. Prigerson, Miriam Ryvicker, Hui Shao, Yongkang Zhang; 5/24This retrospective cohort study of burdensome transitions following live hospice discharge found that non-Hispanic Black race, short hospice stays, and care from for-profit hospices were associated with higher odds of experiencing a burdensome transition. These findings suggest that changes to clinical practice and policy may reduce the risk of burdensome transitions, such as hospice discharge planning that is incentivized, systematically applied, and tailored to needs of patients at greater risk for burdensome transitions.
Medical aid in dying bill didn’t cross finish line this MN Legislature session
05/24/24 at 03:00 AMMedical aid in dying bill didn’t cross finish line this MN Legislature session Twin Cities Pioneer Press; by Dene K. Dryden; 5/22/24 Despite advancing through several House committees, Minnesota’s End-of-Life Option Act did not receive a floor vote in the House or Senate during the 2024 legislative session, which ended earlier this week. The legislation, co-authored by Rep. Andy Smith, DFL-Rochester, and Sen. Liz Boldon, DFL-Rochester, would have permitted medical aid in dying, also known as physician-assisted suicide. The measure would have allowed terminally ill adults to request a prescription for life-ending medication, which they would have to self-administer.
Other Business Headlines of Interest, updated 5/23/24 per nasdaq.com
05/24/24 at 03:00 AMOther Business Headlines of Interest, updated 5/23/24 per nasdaq.com
21 hospitals, health systems raising workers' pay
05/24/24 at 03:00 AM21 hospitals, health systems raising workers' pay Becker's Hospital Review; by Kelly Gooch; 5/20/24 The following hospitals and health systems have announced or shared plans for raising workers' pay this year. Note: This is not an exhaustive list. This webpage was last updated May 20. [Click on the title's link for the detailed list.]
Tuesday Health launches revolutionary Supportive Care solution with $60 million of strategic investment from healthcare leaders
05/24/24 at 03:00 AMTuesday Health launches revolutionary Supportive Care solution with $60 million of strategic investment from healthcare leadersInvestors Observier; by PR Newswire; 5/21/24Tuesday Health, a pioneer in value-based care dedicated to transforming serious illness, has launched its innovative supportive care solution in partnership with Valtruis, Blue Venture Fund, Mass General Brigham Ventures , and CareSource. This alliance brings a $60 million strategic investment to Tuesday Health, fueling its mission to redefine supportive care for patients and caregivers facing serious illnesses. "Leveraging clinical expertise, advanced data solutions, and cutting-edge technology, while partnering with Ohio's largest Medicaid plan, its largest hospice provider and the unmatched palliative care experience of Mass General, Tuesday Health is dedicated to tackling one of healthcare's biggest challenges-providing support and care in the right setting, at the right time, for those facing serious illness", said Jim Wieland, CEO of Tuesday Health.Editor's Note: What is the difference between supportive care and palliative care? Click here for a description from ASCO, the American Society of Clinical Oncology.