Literature Review

Today's Encouragement: You think winter will never end, and then, when you don’t expect it, when you have almost forgotten it, warmth comes and a different light.” ― Wendell Berry

MedPAC releases March 2024 report on Medicare payment policy CMS MedPAC; 3/15/24 Washington, DC, March 15, 2024—Today, the Medicare Payment Advisory Commission (MedPAC) releases its March 2024 Report to the Congress: Medicare Payment Policy. The report presents MedPAC’s recommendations for updating provider payment rates in traditional fee-for-service (FFS) Medicare for 2025 and for providing additional resources to acute care hospitals and clinicians who furnish care to Medicare beneficiaries with low incomes. ... MedPAC recommends ... eliminating the payment update for hospice providers; and payment reductions for three post-acute care sectors (skilled nursing facilities, home health agencies, and inpatient rehabilitation facilities).Click here for this report's "Chapter 9: Hospice Services"

What's not talked about in healthcare enough? Becker's Health IT, by Naomi Diaz; 3/14/24 In the rapidly evolving landscape of healthcare technology, industry leaders express a common concern: the overshadowing of fundamental practices by the allure of cutting-edge innovations. Becker's asked seven hospital and health system leaders at the HIMSS 2024 annual meeting: What's something in healthcare or the health tech space that is not talked about enough?

Home Care costs continue to increase, outpacing other long-term care settings Home Health Care News, by Andrew Donlan; 3/12/24 The pricing increases in home care have again outpaced other long-term care sectors, according to Genworth’s annual cost of care report. 

Why I chose palliative care: A nurse's personal journey to providing comfort careAnschutz, by Lauren Carter; 3/5/24My interest in palliative care started with my grandma’s use of hospice services seventeen years ago. She suffered with multiple sclerosis for over forty years. ... What may have been a terrible experience for most people was actually made very positive for me. ... Unfortunately, I had another opportunity fifteen years later, to once again be there for my family in this way. ... It takes empathy and specialized training to assist in end-of-life care. It may be something that we are called to. I care deeply about these patients and their families. I am able to have difficult conversations when necessary. I try to create space for family members to talk about who the person in the hospital bed is, when that person can no longer talk for themselves. ...

Jimmy Carter has spent over a year in hospice care. How has he defied the odds? Northeastern Global News, by Tanner Stening; 3/12/24 End-of-life advocates and experts cite Carter’s stay in hospice as having a positive impact on the discourse of end-of-life care, which Northeastern University experts say many people put off until it’s too late. ... According to the National Institutes of Health, more than 90% of patients who enter hospice care die within the first six months. Roughly 36% of patients die within a week of entering hospice.Editor's Note: This article includes an important, transparent piece of information that many articles about President Carter's 1-year hospice anniversary have not mentioned: "If the patient lives past six months, the medical professionals would need to recertify the patient for continued care." Click here for the CMS "Face-to-Face Requirement Affecting Hospice Recertification."

10 urgent patient safety challenges in 2024 Becker's Clinical Leadership, by Ashleigh Hollowell; 3/11/24While employment for new clinicians was positive in the last year with 96% of new nurses finding work, the issue is transitioning those clinicians from education into bedside and hospital practice, which is the most pressing safety challenge of 2024, according to the ECRI's annual report on patient safety. ... Here are the 10 most urgent patient safety challenges facing providers in 2024 ...

Rising suicide risk among seniors due to loneliness, mobility, financial insecurity, study finds McKnights Home Care, by Adam Healy; 3/5/24As the number of adults over 65 continues to grow, suicide rates among older adults have also been rising, according to data from the National Center for Health Statistics. Between 2008 and 2017, the share of suicide-related emergency department visits among adults 65 years and older more than doubled. These older adults face age-related stressors that can negatively affect mental health, such as declining physical health, reduced mental sharpness, or the loss of friends or loved ones, which can heighten the risk of suicide. 

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

The PACT Project: Feasibility of a multidisciplinary, multi-faceted intervention to promote goals of care conversationsAmerican Journal of Hospice and Palliative Medicine, by Eytan Szmuilowicz, MD; Rebecca K. Clepp, MA, MEd, MHA; Jayson Neagle, MD; Adeboye Ogunseitan, MD; Martha Twaddle, MD; Gordon J. Wood, MD, MSCI; 4/24Patients living with serious illness generally want their physicians to facilitate Goals of Care conversations (GoCc), yet physicians may lack time and skills to engage in these conversations in the outpatient setting... A multifaceted quality improvement intervention focused on serious illness communication skills can support a diverse clinical workforce to facilitate inpatient GoCc over time.

Perceptions of palliative care: Demographics and health status among the general population in Florida and the United StatesAmerican Journal of Hospice and Palliative Medicine, by Brenda W. Dyal, PhD, DNP; Saunjoo L. Yoon, PhD; Keesha L. Powell-Roach, PhD, RN; Derek M. Li, MSc; Sheri Kittelson, MD; Michael Weaver, PhD, RN, FAAN; Janice L. Krieger, PhD; Diana J. Wilkie, PhD, RN, FAAN; 4/24Palliative care (PC) helps maintain quality of life for seriously ill patients, yet, many Americans lack knowledge of PC. Young adults compared with adults, middle-adults, and older-adults were less likely to agree that the goal of PC is to help friends and family cope with a patient’s illness, and that the goal of PC is to manage pain and other physical symptoms compared with adults, middle-adults, and older-adults. Participants with greater rural identity were more likely to agree that accepting PC means giving up. Increased knowledge of PC might be influenced through targeting educational interventions and educating the general population through social media use.

Palliative ECT for catatonia in a terminal cancer patient: A case reportJournal of the Academy of Consultation-Liaison Psychiatry, by Arushi Mahajan B.S., Thanvi Vatti M.P.H., Andrew Coulter M.D., Elias Khawam M.D., Molly Howland M.D.Common end-of-life illnesses and medications can lead to catatonia. Catatonia can decrease interactivity, which worsens a terminal patient's quality of life. Treatment includes medications and electroconvulsive therapy (ECT). Though treating psychiatric disorders aligns with the palliative care philosophy, end-of-life ECT has been rarely reported. The few case reports on palliative ECT involved continuation of prior ECT courses for chronic psychiatric conditions in psychiatric settings after a terminal diagnosis. No studies have explored palliative ECT for acute catatonia.

Social model hospice: Providing hospice and palliative care for a homeless population in Salt Lake City, UtahJournal of Hospice & Palliative Nursing, by Jensen, Francine Bench, PhD, RN; Thorpe, Deborah PhD, APRN; 4/24Health care for the homeless population is a complex challenge and represents a significant gap in care, particularly for those at the end of life. Hospice care may be desired but is rarely an option for people without residences, social support, and payment sources. Social model hospice is a unique paradigm of care delivery that offers a viable solution to make hospice and palliative care possible for this population.