Literature Review

Compliance 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.

End-of-life doulas’ growing value proposition in hospice Hospice News; by Holly Vossel; 5/14/24 Hospices and other health care providers are increasingly recognizing the value proposition of end-of-life doulas. Organizations are taking varied routes to leverage doula’s skills to improve quality. End-of-life doulas support patients and their families in a number of broad and diverse ways, according to Erin Collins, program director of The Peaceful Presence Project. Collins is also a certified hospice and palliative care nurse and end-of-life doula. She serves as vice-chair of the National Hospice and Palliative Care Organization’s (NHPCO) End-of-Life Doula Advisory Council. Editor's Note: Caution. What training, professional experience, credentials, referrals, and other qualifications does the individual, end-of-life care doula bring? Not bring? What gaps in your services (for which a doula might be called) indicate that your organization needs to "step up" your community education, caregiver/family resources, psychosocial support, and volunteer presence?

Terminal cancer: What matters to patients and caregivers Medscape Medical News; by Megan Brooks; 5/6/24 What's most important to patients with terminal cancer and their caregivers? New research found that patients and caregivers both tend to prioritize symptom control over life extension but often preferring a balance. Patients and caregivers, however, are less aligned on decisions about cost containment, with patients more likely to prioritize cost containment. ... As patients approached the end of life, neither patients nor caregivers shifted their priorities from life extension to symptom management.

Breaking the silence: The mounting need for trauma-informed hospice care Hospice News; by Holly Vossel; 5/3/24Traumatized and abused hospice patients and providers often experience an array of lingering physical, emotional and psychological effects that can fall into a silent abyss of unmet needs. ... Many seniors have experienced some form of trauma or abuse in their lifetime. ... More data has become available in recent years around the prevalence of different types of abuse and trauma. Roughly 10% of seniors 65 and older nationwide are victims of some type of abuse each year, the U.S. Department of Justice (DOJ) reported. Caregiver neglect represents 5.1% of these cases, with psychological and physical abuse impacting 4.6% and 1.6% of seniors, respectively. ...Editor's Note: This article highights interviews with Dr. Ashwin Kotwal, assistant professor at the University California San Francisco; Carole Fisher, president, National Partnership for Healthcare and Hospice Innovation (NPHI); Dr. Cameron Muir, chief innovation officer, NPHI; Andrea Devoti, executive vice president at the National Association for Home Care & Hospice (NAHC); Lindsey Owen, executive director of Disability Rights Vermont.

How Avow Hospice used triage to boost quality, reduce turnoverHospice News; by Jim Parker; 4/26/24Avow Hospice has implemented a triage system that has resulted in improved quality scores and reduced turnover. The Florida-based provider uses an acuity system that draws data from its electronic medical record (EMR) system to help stratify patients based on their most likely immediate needs. To complement these efforts, Avow also revamped its approach to night time and weekend visits, Rebecca Gatian, COO of Avow Hospice, said at the National Hospice and Palliative Care Organization’s Virtual Interdisciplinary Conference. 

Quality in Motion: Acting on the CMS National Quality Strategy CMS - Centers for Medicare & Medicaid Services; 4/22/24In 2022, the Centers for Medicare & Medicaid Services (CMS) launched the CMS National Quality Strategy (NQS), a plan aimed at improving the quality and safety of health care for everyone, with a special focus on people from underserved and under-resourced communities. ... The CMS National Quality Strategy has four priority areas, each with two goals. This action plan provides details on how CMS is putting these eight goals into action.

Potential CMS measure shows divide over quality training standards Modern Healthcare, by Mari Devereaux; 4/12/24 Hospitals may soon be required to provide set quality training to staff as part of a Medicare reporting program, but health systems and advocacy organizations are split on whether the standardization of quality-related skill sets is necessary to improve patient care.

Medicine—Both a Science (Care) and an Art (CARE) JAMA Network - Viewpoint; by Theodore J. Strange, MD and Mario R. Castellanos, MD; 4/3/24In the current era, health care is increasingly characterized by the integration of big data, predictive analytics, medical devices, and artificial intelligence. These technological advancements have undoubtedly transformed the landscape of medical care, offering unprecedented precision and efficiency in diagnosis and treatment. Yet, amidst this surge of scientific innovation, the timeless art of medicine (compassion and caring) remains a foundational aspect of patient-centered health care ... The acronym CARE (compassion, assistance, respect, and empathy) encapsulates these enduring values. ... In a world increasingly driven by data and algorithms, these qualities foster a trusting and supportive relationship between health care professionals and patients, thereby enhancing the healing process and enriching the overall health care experience.

Elevating quality, outcomes, and patient experience through Value-Based Care: CMS Innovation Center’s Quality PathwayNEJM Catalyst; by Susannah M. Bernheim, MD, MHS; Noemi Rudolph, MPH; Jacob K. Quinton, MD, MPH; Julia Driessen, PhD; Purva Rawal, PhD; and Elizabeth Fowler, PhD, JD; 4/3/24The U.S. Center for Medicare and Medicaid Innovation is launching a new Quality Pathway to elevate patient-centered quality goals in the design and evaluation of alternative payment models. The Quality Pathway will align model design around quality goals; elevate outcomes and experience measures, particularly patient-reported outcomes; and ensure that evaluations have the ability to assess the impact of models on primary quality goals. These determinations will help the Innovation Center make critical decisions about which models to scale or expand in the pursuit of improving the quality of care for people with Medicare and Medicaid.

Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner

Improving the Quality Of Quality Metrics Health Affairs; by Aditya Narayan, Bob Kocher, and Nirav R. Shah; 3/19/24... The landscape of health care quality measures is dynamic, reflecting efforts to enhance patient care, safety, and outcomes. These measures are developed and reimbursed by a variety of stakeholders, including government agencies such as the Centers for Medicare and Medicaid Services (CMS), health care organizations, and independent bodies such as the National Quality Forum and the Agency for Healthcare Research and Quality (AHRQ). The development process involves rigorous research, stakeholder engagement, and consensus-building to ensure measures are evidence-based, applicable across different health care settings, and meaningful to patient care.Editor's Note: Read and share this informative, big-picture article about the evolution of healthcare's quality metrics, its tools, and best practices. 

Top 10 patient safety threats of 2024: Helping new clinicians, maternal care barriers, AI, and more Chief Healthcare Executive, by Ron Southwick; 3/21/24 When ECRI unveiled its list of the leading threats to patient safety for 2024, some items are likely to be expected, such as physician burnout, delays in care due to drug shortages or falls in the hospital. However, ECRI, a nonprofit group focused on patient safety, placed one item atop all others: the challenges in helping new clinicians move from training to caring for patients. ... ECRI’s top 10 threats to patient safety for 2024: