Literature Review

Nurses’ Union reaches labor agreement with PeaceHealth for hospice, home health workers Hospice News; by Jim Parker; 5/14/24 After more than a year of negotiations, the Oregon Nurses Association (ONA) labor union has reached an agreement with PeaceHealth. Priorities among the hospice and home nurses include wage increases, raising safety standards, ensuring affordable and accessible home health care delivery, equitable pay protection and addressing clinical staffing crises by increasing recruitment and retention of skilled caregivers. 

Amazon seeks nonprofit healthcare, EHR expertise Becker's Helath IT; by Laura Dyrda; 5/13/24 Amazon is looking to hire leaders with experience in nonprofit healthcare and EHRs, according to recent job postings on the tech giant's website. Amazon Web Services has a listing for "Senior Solutions Architect, Healthcare, Nonprofit Health, Nonprofit Healthcare" seeking an individual with a passion for helping nonprofit healthcare providers implement cloud computing solutions. ... [Amazon] is also hiring for an account executive focused on nonprofit healthcare and global nonprofit healthcare. The company is searching for a "proven business executive in the NP healthcare sector to lead and continue to expand the business with some of our most important healthcare customers and develop new customers across a targeted greenfield market."

The secret of change is to focus all of your energy not on fighting the old, but on building the new.” — Socrates, philosopher

End of life outcomes following Comfort Care Orders: A single center experience The American Journal of Hospice & Palliative Care; by Matthew Tucker, Dayna Hovern, John Liantonion, Elizabeth Collins, Adam F Binder; 5/13/24 Conclusions: The majority of patients placed on comfort care died during their hospitalization demonstrating a real need for comprehensive end of life care and immediate hospice services. For those discharged with hospice services, they spent an excessive amount of time in the hospital waiting for services to be arranged.

When families fight over a relative with dementia, it’s time to call in the mediator The New York Times; by Paula Span; 5/13/24 Trained negotiators can help families struggling with vexing elder-care issues.  The four adult children were in agreement. Their father, William Curry, a retired electrical engineer and business executive, was sinking deeper into dementia. ... [But their mother] remained determined to continue caring for her 81-year-old husband at home, despite the increasing toll on her own health. ... As the weeks passed, “we were really at an impasse,” [a daughter] said. “Do you override your mother?” ...  [Increasingly,] families seek elder mediation privately, before disputes land in court and imperil or destroy family relationships. [Continue reading for descriptions of how mediation differs from arbitration, from family therapy, and for cautions about this being "a fairly new field with no nationwide certification or licensing requirements."]Editor's Notes: Executive leaders, what community education and resources are you providing for Advance Directives? What family systems education and and problem-solving are you providing for your interdisciplinary team members and grief counselors? Family conflicts are inherent--in some form or fashion--with almost anyone needing dementia care, especially when paired with palliative or hospice care. (If in doubt, ask your seasoned, front-line professionals.)

California to redirect more than $7B in healthcare funding Becker's Hospital CFO Report; by Mackenzie Bean; 5/13/24 California is seeking to divert more than $7 billion in funding from the healthcare sector to address a major funding deficit, according to a revised budget proposal released May 10. Gov. Gavin Newsom has proposed reallocating $6.7 billion from Medi-Cal provider rate increases planned for Jan. 1, 2025, to balance the state budget. This funding was generated by the managed care organization tax created last year. ... The proposed budget would also cut funding for healthcare workforce initiatives by $854.6 million through 2028. Funding for public health and various behavioral health programs would also be reduced. 

Hospital CEOs ask patients to receive care at home Becker's Hospital Review; by Madeline Ashley; 5/14/24 Hospital executives are making the push to move more care, specifically recovery rooms and exams, out of the hospital and into patient homes, to potentially save money and improve finances as the country continues to move out of the pandemic, Politico reported May 11. And Congress is supporting these efforts by introducing legislation that would expand at-home care and to allow Medicare to continue funding telehealth. Here are five findings from the report: ... [Click on the title's link to read more.]

Nurse practitioners improve skilled nursing's dementia care outcomes, but regulatory barriers remain: studyMcKnights Long-Term Care News; by Josh Henreckson; 5/13/24[Nurse pracitioners'] NPs’ involvement can significantly improve end-of-life care outcomes for residents with Alzheimer’s disease and related dementias (ADRD), according to the results of a new study in JAMA Health Forum. ... Those benefits, however, were shrunk by state regulations on the scope of care NPs are allowed to provide. ...  Elizabeth White, PhD, assistant professor of health services, policy and practice at Brown University [describes,] “For example, when a state restricts NPs from signing Do Not Resuscitate orders, that can serve as a barrier to advance care planning and could contribute to unnecessary hospitalizations at the end of life.” Editor's Note: We posted this JAMA Health Forum article on : Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia. 

Hospice remains underserved by Medicare Advantage, data showsBioMedWire; 5/13/24 While the Medicare Advantage space grows bigger, it is difficult for regulators and the medical industry to decide how best to integrate hospice into MA programs. This is a major concern because hospice care is the only segment of the healthcare sector that isn’t catered for in Medicare Advantage (MA). ... Almost 50% of all individuals (1.7 million) on MA programs that succumbed to their terminal illnesses in 2022 were recipients of hospice services. ... 

Beyond medicine: 'Being Mortal' challenges healthcare's approach to death and dying SwiftTelecast; by Shawn Butlere; 5/11/24 This video from the “Frontline” series, titled “Being Mortal,” follows Dr. Atul Gawande as he explores the complex relationships between doctors, patients, and end-of-life decisions. Based on his best-selling book “Being Mortal,” Gawande discusses how medical training often falls short in preparing doctors for the realities of death and dying. The documentary highlights personal stories, including Gawande’s own experiences with his father’s illness and death, to illustrate the challenges in balancing hope with realistic outcomes and the importance of quality life in the face of terminal illness. 

“Mental wellbeing is as important as physical wellbeing – both are interconnected” Marie Curie Hospice; by Anne Finucane, Marie Curie Senior Research Fellow, and David Gillanders, Senior Lecturer, Clinical Psychology, The University of Edinburgh, United Kingdom; 5/13/24 At least one in every four people living with a terminal diagnosis will experience depression, anxiety, adjustment disorder or low mood. Many more will experience distress because of deteriorating health and related uncertainty. Feelings of hopelessness, discouragement and even a desire for hastened death can occur. People have reported that psychological support helps them develop better coping strategies, helps them be more open to their situation and improves communication with their families and those involved in their care.Editor's Note: Executive leaders, what value do you give to your interdisciplinary team members and their contributions to patients' mental/emotional care? What advocacy, support and recognition do you have for your social workers, chaplains, counselors? What mental wellbeing measures do your employees experiences throughout your organization--and more directly--from your leadership with them? Perhaps it's time to "take the pulse" of your culture's mental wellbeing.

AHA, H-ISAC warn hospitals about Black Basta following Ascension cyberattack Healthcare IT News; by Andrea Fox; 5/13/24 Meanwhile, staff at the health system say they don't have paitent orders and can't page doctors. As it works to restore clinical systems, Ascension says it's working with law enforcement and sharing threat intelligence to help prevent similar attacks. The Health Information Sharing and Analysis Center issued a threat alert Friday about the Russia-backed ransomware group Black Basta, warning of its accelerated attempted attacks against the healthcare sector. Prompted by H-ISAC, the American Hospital Association also sent a cybersecurity advisory with technical mitigation recommendations to its members. ... 

Failure is not the opposite of success: it’s part of success. — Arianna Huffington, businesswoman