Literature Review

The Joint Commission, Kaiser Permanente announce application period for 2024 Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity GlobeNewswire, by The Joint Commission; 3/5/24 The Joint Commission and Kaiser Permanente are now accepting applications for the 2024 Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity. The award program will recognize a healthcare organization that led an initiative that achieved a measurable, sustained reduction in one or more disparities. Bernard J. Tyson, the late CEO and chairman of Kaiser Permanente, worked tirelessly to address the disparities that plague the U.S. healthcare system. Now in its fourth year, the award honors Tyson’s legacy by presenting organizations the opportunity to earn national recognition for their efforts to improve healthcare equity, as well as share best practices and lessons learned with thousands of organizations across the country.

Scary ‘state’: Two-thirds of nursing home operators fear closure without staffing relief McKnights Long-Term Care News, by Josh Henreckson; 3/6/24Of nearly 450 nursing home providers surveyed, two-thirds are concerned that escalating workforce challenges may force them to close their facility. More than 70% of nursing homes reported staffing levels lower than before the COVID-19 pandemic, with fully 99% saying they are hiring for open positions.

Compassionate extubation and beyond: Is there a need for more guidance in managing end-of-life in the intensive care unit? Chest Physician, by Angela L. Birdwell, DO, MA; Nehan Sher, MD  Approximately 20% of deaths in the United States occur during or shortly after a stay in the ICU and approximately 40% of ICU deaths involve withdrawal of artificial life support (WOALS) or compassionate extubation. ... How the team approaches WOALS can make a difference to both patients and decision-makers. Unfortunately, there is striking variation in practice and lack of guidance in navigating issues that arise at end-of-life in the ICU. 

The strength it takes to suffer JAMA Intern Med., by Alice Curtis, Amy Hamblin, MA, and William E. Rosa, PhD, MBE, APRN; 3/4/24J. Randall Curtis, MD, MPH—my dad (A.C.) and my husband (A.H.)—was an intensive care and palliative medicine pioneer whose impact as a researcher, mentor, and humanist was legend long before his death. When Randy first revealed his diagnosis publicly, he said it was exhausting being strong. ... Throughout his career and illness [ALS], Randy came to appreciate medical aid in dying (MAID) as an ethical way for physicians to care for patients. The moral edict of medicine—first, do no harm—does not mean, nor can it mandate, the ultimate prevention of death, but rather that the physician’s role is to ease suffering at all stages of living and dying. For Randy, the only end to his extreme suffering while ALS was surely killing him was the overwhelming act of hastening his own death. In his case, he was his own most compassionate physician.Editor's Note: For the other perspective, see this newsletter's article "Editorial: 'Right to Die' debate comes to Illinois."

Nursing homes bury 63 percent of profits in related-party tunnels, but not all play the game: study McKnights Long-Term Care News, by Josh Henreckson; 3/8/24 As much as 63% of nursing home profits in Illinois were hidden from state regulators using related party transactions in 2019, according to the results of a new study from UCLA and Lehigh University researchers. Those results are likely indicative of a nationwide trend that has continued through the pandemic and into 2024, experts told McKnight’s Long-Term Care News Thursday.

Podcast: Outcomes post-cardiac arrest and palliative medicine consultation for seriously ill patientsThe Rounds Table Podcast, Episode 81; recorded 3/7/24 This week, Drs. Mike and John Fralick discuss two recent papers exploring patient outcomes after in-hospital cardiac arrest and the role of default Palliative Medicine consultation for seriously ill hospitalized patients. Two papers, here we go!

Samaritan gala raises record amount: Event helps fund services to the seriously ill and their families The Sun Newspapers, by Christine Harkinson; 3/7/24 Samaritan’s 2024 Celebration of Life Gala in Cherry Hill raised $275,000 last month to support the nonprofit’s life-enhancing services. ... Founded in Moorestown in 1980 as one of the first hospices in the country, Samaritan is now among New Jersey’s leading providers of hospice care, palliative (comfort) medicine, at-home primary care, grief support and other services. 

CMS to end Hospice MA Carve-In: Insights for home-based care providers Home Health Care News, by Andrew Donlan; 3/7/24Grand opening, grand closing. Hospice providers began to work with Medicare Advantage (MA) via the Value-Based Insurance Design (VBID) demonstration in 2021. At the end of 2024, the “hospice carve-in” model will cease. ... In this week’s exclusive, members-only HHCN+ Update, I dive into what CMS’ ditching of the hospice carve-in means for home health and hospice providers generally. I’ll also get into what it may mean for that space between home-based care providers and MA plans moving forward. 

Description and outcomes of a palliative care pharmacist-led Transitions of Care program J Palliat Med, by Connor McCormick, Mamta Bhatnagar, Robert M Arnold, Maria Felton Lowry; 3/6/24Background: Patients with palliative care needs are at high risk of medication errors during transitions of care (TOC). Palliative Care Pharmacist Interventions surrounding Medication Prescribing Across Care Transitions (IMPACT) program was developed to improve the TOC process from hospital to community setting for cancer patients followed by palliative care. Conclusion: Our pilot study demonstrates that integrating a pharmacist in TOC for seriously ill patients is feasible and valuable.

Home-based palliative care shows promise in reducing ER visits, hospitalizationsHome Health Care News, by Patrick Filbin; 2/28/24Patients who receive home-based palliative care (HBPC) services experience fewer emergency department visits, fewer hospitalizations and lower costs once they start receiving services. That’s according to a recent study conducted by the West Health Research Institute of Blue Shield of California.

Maryland: Medical aid-in-dying legislation won’t pass this yearThe Baltimore Banner, by Pamela Wood; 3/1/24The Maryland General Assembly will not vote this year on a bill that would allow terminally ill residents to be prescribed medication they could take to initiate their own death. Versions of the proposal have been considered, but not passed, in Maryland since 2015. 

Home health disparities: Medicare Advantage patients receive fewer visits, worse outcomes Home Health Care News, by Patirck Filbin; 3/1/24Home health patients under Medicare Advantage (MA) plans have worse functional outcomes compared to traditional Medicare patients, likely as a result of receiving fewer visits, according to a new study.

Contract CNA staffing associated with worse care quality outcomes: study McKnights Senior Living, by Kathleen Steele Gaivin; 3/1/24Nursing homes that use contract staffing to fill certified nursing assistant position vacancies are more likely to experience worse care quality than those that do not, according to the results of a study by PHI. The proportion of total CNA hours filled by contract CNAs in SNFs increased from 2% in 2017 to 11% in 2022, the study found.