Literature Review

More health care teamwork means less burnout: physician survey American Medical Association (AMA); by Georgia Garvey; 10/8/24 Physician burnout is largely influenced by workplace structure and experiences. That is where team-based and safe-care delivery can help, according to a study published in The Joint Commission Journal on Quality and Patient Safety. In the study, “Teamwork Climate, Safety Climate, and Physician Burnout: A National, Cross-Sectional Study,” 1,218 U.S. doctors nationwide were surveyed about burnout and workplace experiences, including teamwork and safety climate. ... The researchers concluded that there is a strong relationship between the amount of teamwork and safety in physicians’ work environments and burnout. It is a relationship that showed improvements on those metrics even when compared with slightly different work climates. Among the physicians surveyed, 27.4% reported high depersonalization, 39.9% reported high emotional exhaustion and 45.6% met the criteria for burnout. But even small increases in teamwork and safety climate were related to improvements in physicians’ feelings of depersonalization, burnout or emotional exhaustion.

Breaks for caregivers: Atlanta nonprofit helps parents of medically fragile children GPB PBS - NPR, Atlanta, GA; by Ambria Burton; 10/14/24 ... The Georgia Division of Family & Children Services (DFCS) defines medically fragile children as children with "medical status that can rapidly deteriorate, resulting in permanent injury or death; one that requires medical care and/or technology to maintain health; and/or a condition that requires extraordinary supervision and observation." The Georgia-based Fragile Kids Foundation reports that there are about 13,000 medically fragile children in Georgia, and the Georgia Pediatric Program (GAPP) requires a waiver to provide services to medically fragile children with multiple system diagnoses, including nursing and personal care support services at homes and communities. The National Center for Pediatric Palliative Care Homes (NCPPCH) aims to provide a pediatric respite home in every state, and Life House Atlanta is a nonprofit public charity aiming to open the first pediatric palliative care home in Atlanta — the first in the Southeast overall.

A ‘second wave’ of medical issues may slam the region in Helene’s wake, disaster response officials caution NC Health News, by Asheville Watchdog; 10/12/24 After the floods come the waves. Following the initial health crises in the aftermath of tropical storm Helene, Buncombe County and others inundated by the storm may be facing a secondary medical surge, one driven by infections and diseases and potentially exacerbated by a lack of running water, emergency response officials warned. Helene’s initial devastation in western North Carolina sent hundreds to the hospital with needs for everything from oxygen to traumatic wound care. Now, two weeks after the storm, doctors, health professionals and officials in charge of disaster relief say there could be a second wave of medical concerns affecting hospitals and clinics, and it could be here soon. … “The health consequences of flooding may be described in terms of time as immediate, medium-term, and long-term,” a 2009 study on the health impacts of floods said. “[I]mmediate is considered as the period when the flood is present, medium is the immediate recovery phase (days to weeks), and long-term is the reconstruction phase (months to years) after the flood.”

Pa. nonprofit to close; more than 100 people to be laid off Penn Live Patriot News; by Daniel Urie; 10/14/24More than 100 people will be laid off at a Philadelphia nonprofit. The Visiting Nurse Association of Greater Philadelphia has filed a Worker Adjustment and Retraining Notification notice with the Pennsylvania Department of Labor & Industry informing the state it will close, and that 114 people will be laid off at 4601 Market St. The nonprofit is expected to close on Oct. 28 but is subject to change based on client needs and operational issues. The Visiting Nurses Association of Greater Philadelphia is closing after 138 years, according to WHYY. The VNA’s home health care program had about 239 patients as of last month, and another 54 patients were being cared for in hospice and palliative care, the WHYY report said. The following employees will be laid off: [Click on the title's link for the list of roles and number of employees.]

A Life: James Heffernan ‘made a life out of appreciating and loving literature’ Valley News, Hanover, NH; by Elle Muller; 10/12/24 As a Dartmouth professor, writer, and father, James Heffernan inspired those around him with his love of literature and passion for life. Heffernan’s children, Virginia and Andrew, affectionately called their father’s lust for life, “Heffervessence.” “His life was shaped by what he loved,” Heffernan’s son, Andrew, said. “He found literature early on and he was deeply passionate about it.” Demonstrating the vivacity and enthusiasm that had long characterized him, Heffernan, who died in July at age 85 of metastatic prostate cancer, wrote 100,000 words of his memoir in the first few months of hospice care.

If you love the work you are doing, then you will love Tuesday! ~ Catherine Pulsifer

Hospice in a hurricane: How Empath Health responded to back-to-back disasters Hospice News; by Jim Parker; 10/11/24 Hospice providers in the southeastern United States are reeling from the impacts of two massive hurricanes that have occurred during the past two weeks. ... The Florida-based hospice and senior services provider Empath Health saw the majority of its service region affected by [Hurricane Milton], which caused substantial damage to infrastructure in many communities. Empath reported no major injuries among its employees, according to CEO Jonathan Fleece. However, some employees did lose entire homes or experienced significant damage, as well as cars and other essentials. ... “We do our best through pre-storm planning to come up with our communication plans with our patients and their families, ...” Fleece told Hospice News. “When we can’t reach people by phone, once we have any kind of access to roads, we will do our very best to do some sort of a check in.” These efforts are coordinated through an emergency management team, led by commander Matt Chaloux, that engages in disaster planning and response, Fleece said. Building on lessons learned from Hurricane Ian in 2022, Empath also established a mobile response unit — a vehicle designed to provide clinical, communications and logistical support during catastrophic events. The unit is modeled after similar vehicles used by the Federal Emergency Management Agency. Empath Health has set up a fund to aid employees who were affected by the hurricanes, helping to provide them with housing, transportation, child care and other needs, according to a statement posted by Fleece on LinkedIn. The organization's board of trustees has pledged to mathc donations dollar-for-dollar up to $500,000.Editor's note: Click here to donate to Empath Helath's fund to aid employees. 

Top questions people ask about hospiceThe Star News, Medford, WI; 10/9/24

Clinical scenario: Patient care through POLST  The Hospitalist; by Mihir Patel, MD, MPH, FACP, CLHM, SFHM; 10/10/24 Physician orders for life-sustaining treatment (POLST) forms are crucial tools in ensuring that patient treatment preferences are respected and followed, particularly during medical emergencies. As hospitalists, integrating POLST into patient care can significantly enhance decision-making processes, aligning treatments with the patient’s wishes. Here, we present a clinical scenario demonstrating the application of POLST in a hospital setting, emphasizing the importance of electronic documentation in the patient’s medical record. ... [Click on the title's link for this Case Study, which includes the Case, Hospitalist Actions,Outcome, and Conclusion.]

Why recent outages are a wake-up call for healthcare and regulators Forbes; by Chris Bowen; 10/11/24 When the CrowdStrike outage first started to show itself in the early hours of that hazy July morning, it was hard to believe that this wasn’t a hack or cyberattack. I was driving in my car that morning and looked up to see a digital billboard glitch into the "blue screen of death" before my eyes. Flights were grounded, travel was delayed, and nearly every Windows machine in the world was unusable. It was total mayhem. Clearly, this was an outage of major proportions, as millions of Windows systems worldwide essentially cratered. Caused by a faulty misconfiguration, we saw firsthand how the very digital advancements that have helped transform and modernize our world also expose us to more vulnerabilities than ever. ... In healthcare, this event laid bare the vulnerabilities we cannot overlook—the gaps that directly threaten patient care and safety. It’s a clear reminder of our industry’s utmost responsibility to patient privacy and well-being. ...

Integration of palliative care in the management of multiple chronic conditions: An expert consensus paper with policy implications George Washington University; by Kim Kuebler, DNP, ANP-BC, FAAN, Todd Monroe, PhD, RN, FAAN, Richard Ricciardi, PhD, CRNP, FAAN, Cheryl Westlake, PhD, ACNS-BC, FAAN, Matthew Sorenson, PhD, ANP-C, FAAN, Jane Pederson, MD, MS, Michael Neft, PhD, CRNA, FAAN, Sandra A. Mitchell, PhD, CRNP, FAAN, Kathryn Daniel, PhD, AGNP, FAAN, Susan De Santo-Madeya, PhD, APRN-CNS, FAAN, Susan Renda, DNP, ANP-BC, FAAN, Elizabeth Henneman, PhD, RN, FAAN, Eduardo Bruera, MD; 10/10/24 This paper was jointly developed from members of the American Academy of Nursing Expert Panels on Palliative and End of Life Care, Primary Care, Aging, Acute and Critical Care, and two expert physicians. Purpose: The overarching goal is to promote the integration of palliative care as symptom management into the primary care setting to transform care for patients living with multiple chronic conditions. ... Discussion: Earlier palliative interventions reduce disease exacerbation, prevent hospitalization, maintain physical functioning, and support health-related quality of life. Conclusion: This is a needed paradigm shift as the nation’s aging population escalates, Americans are living longer, and the healthcare costs for the nation are unprecedented. [Click on the title's link for this full description; then scroll down to "Download PDF" for the actual paper.]

Women’s Club donates to local hospice care workers The Point/Plover Metro Wire, Portage County, WI; by Metro Wire Staff; 10/11/24 The GFWC-Stevens Point Women’s Club donated more than 60 caregiver baskets to Heartland Hospice in Stevens Point during its Oct. 10 meeting. The baskets were assembled by members to show gratitude for the care hospice workers provide to their patients. The GFWC-Stevens Point Women’s Club, founded in 1895, is part of the General Federation of Women’s Clubs (GFWC), an international organization established in 1890 that focuses on community improvement through volunteer service.Editor's note: November's Hospice & Palliative Care Month is near. What community groups might want to provide simple, meaningful thank-you's to your hospice staff?