Literature Review

The hurdles providers may face when setting up a palliative care program Hospice News; by Jim Parker; 10/30/24 Health care providers can have a bumpy road ahead of them when it comes to launching a new service like palliative care, in part due to complex legal and regulatory requirements. Before they launch a new program, operators must have a clear picture of their target population and the structure they want to build, according to Rachel Carey, counsel with the Virginia-based law firm Whiteford. Carey advises hospices establishing new services, pursuing acquisitions and other issues. Hospice News spoke with Carey about the regulatory and legal obstacles that health care providers may encounter when setting out to build a new program and what they should do to prepare. 

The case for stronger caregiver vetting in home care Home Health Care News; by Audrie Martin; 10/24/24 Direct care workers are, in many ways, the collective face of home-based care organizations. They are who clients and patients interact with. Therefore, regulators and providers are increasingly taking a closer look at who they’re hiring in the first place. While it is shocking to see caregivers commit crimes against clients, it does happen. About one in six people aged 60 and older experienced some form of abuse during 2023, according to the World Health Organization. Rates of abuse against older people have increased since the COVID-19 pandemic and are predicted to continue rising as many countries experience rapidly aging populations. To combat this trend, increased vetting is essential when hiring individuals to care for seniors in their homes. Editor's note: Related, disturbing articles we posted recently include ...

Diagnosed with disease he studied, Stanford doctor puts his personal story at center of new class. NBC Bay Area; 10/24/24 Stanford Medicine physician Dr. Bryant Lin is the perfect professor to teach the course “From Diagnosis to Dialogue: A Doctor's Real-Time Battle with Cancer” at Stanford. And that’s not necessarily a good thing. The class focuses on the cancer journey of a non-smoking patient diagnosed with lung cancer. Dr. Lin is that patient. “I want to take something that is obviously very negative to me personally and get some benefit out of it for at least for other people,” Dr. Lin said. 20 years ago, Dr. Lin chose a career in medicine for a simple reason. “I wanted that personal connection and that satisfaction from helping people on a day-to-day basis,” Dr, Lin said. This same motivation led Dr. Lin to co-found Stanford’s Center for Asian Health Research and Education in 2018, with a particular focus on lung cancer in non-smokers. This is why Dr. Lin was (and in a way was not) surprised when earlier this year he found himself part of the 20% of lung cancer patients who have never smoked. ...  [Click on the title's link to continue reading this inspirational story.]

Safety first: How to ward off health care facility violence SmartBrief; by Julia M. Johnson; 10/23/24Panelists on an American Hospital Association webinar highlight ways in which hospitals and practices can protect their patients and themselves. ... The American Hospital Association recently hosted a webinar about what hospitals and practices need to know to protect themselves, staff members and patients. “Understanding Origins of Violence in Health Care Facilities” featured Jason Grellner of Evolv Technology and Drew Neckar of Cosecure. Both panelists spoke candidly about technology, terminology and steps that can be taken to dial down the danger at health care facilities.  

State association launches support program for home, hospice, personal care workers The Journal Gazette, Fort Wayne, IN; by Lisa Green; 10/15/24 A statewide association for home and hospice care professionals is launching a support program today with features including training and one-on-one counseling to help with workforce retention. The CARE (Creating Action and Resources for Employees) Connect program is billed as the first of its kind in the U.S., a news release said. A recent report released by MissionCare Collective indicates that caregivers are three times more likely to suffer from anxiety and depression, and 21% of caregivers nationwide self-report poor mental health. And 55% of those workers receive some form of federal or state assistance, the Indiana Association for Home and Hospice Care said in a news release announcing the new support program.

Exploding physician union membership signals a significant labor market shift NJToday.net; 10/16/24 As of 2022, about 70,000 medical doctors in the United States, or about 8% of the physician workforce, belonged to a union—a notable increase of 26.8% since 2014. This shift reflects significant changes in the employment landscape for doctors, with nearly half of all physicians now working for health systems or large medical groups. The rise in union membership comes amidst broader labor movements in healthcare, highlighted by the 2023 Kaiser Permanente strike, recognized as the largest healthcare worker strike in U.S. history. While nurses have typically led these efforts, physicians and residents are increasingly exploring unionization as a means to advocate for improved pay, benefits, and working conditions. 

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.

Ellen McGirt on supporting caregivers at work Great Place to Work; by Roula Amire with Ellen McGirt; 10/8/24 This episode of Better features journalist, speaker, and podcast host Ellen McGirt. In this deeply personal conversation, we dive into the challenges of caregiving while balancing a career.  ...On how managers can better support caregivers at work: Flexible time off, no questions asked. A flexible schedule can change everything for people. ...On the impact a senior leader can have by talking about caregiving and grief: If a very senior person triggers this conversation in the workplace with a disclosure or concern, you're going to see new training, new conversations, new talking points, and new volunteers, and maybe even new staff positions around this. ...On how colleagues can support coworkers who are caretakers, or members of the sandwich generation: Kindness and compassion go a long way. ...

University of Maryland bolstering palliative care workforce via master’s degree, certification program Hospice News; by Molly Bookner; 10/7/24 The University of Maryland, Baltimore (UMB) School of Pharmacy is seeking to address the dearth of palliative care-trained clinicians and improve care among seriously ill patients. By 2060, the demand for palliative care is expected to nearly double, according to the World Health Organization. Yet, despite this need, significant gaps in training remain, with many professionals lacking exposure to hospice or palliative care during their schooling. UMB seeks to bolster the palliative care workforce through its online Graduate Studies in Palliative Care program, launched in 2017. While most palliative care clinical education programs see small cohorts of five or fewer students, UMB is seeing a larger crowd of professionals enter the workforce. Of the Class of 2024, 36 students received their Master of Science degree and seven received a graduate certificate. “We have an amazing diversity of students,” Mary Lynn McPherson, professor in the Department of Practice, Sciences, and Health Outcomes Research at the School of Pharmacy and executive program director of Graduate Studies in Palliative Care, told Palliative Care News. 

EEOC sues AccentCare Home Health Care company for pay discrimination and retaliation U.S. Equal Employment Opportunity Commission; Press Release; 9/27/24 AccentCare, a nationwide home health care service company headquartered in Dallas, Texas, violated federal civil rights laws by paying female employees less than a male colleague because of their sex and retaliating against a female employee who repeatedly complained, the U.S. Equal Employment Opportunity Commission (EEOC) charged in a lawsuit filed today. According to the EEOC’s lawsuit, female Licensed Practical Nurses (LPNs) working out of AccentCare’s Pottsville, Pennsylvania, location were paid less than their male colleague for performing equal work, despite their superior qualifications. After a female LPN repeatedly complained about the gender-based pay disparity and requested a raise, AccentCare retaliated against her, and ultimately fired her. Such alleged conduct violates Title VII of the Civil Rights Act of 1964 and the Equal Pay Act of 1963, which prohibits pay discrimination based on sex and retaliation for opposing sex discrimination.

NY home care agency pays $400K in racial prejudice lawsuit A home care agency in Brooklyn, NY, was ordered to pay $400,000 to settle a race and national origin discrimination lawsuit filed by the US Equal Employment Opportunity Commission. ACARE HHC Inc., doing business as Four Seasons Licensed Home Health Care Agency, routinely assigned home health aides based on clients’ racial preferences, according to a consent order filed with the US District Court for the Eastern District of New York. These workers, which included Black and Hispanic aides, would either be transferred to new client assignments based on clients’ wishes or lose their employment entirely, EEOC found. These practices were a violation of the Civil Rights Act, which prohibits employers from making job assignments based on workers’ race or national origin. Four Seasons will pay $400,000 in monetary relief for the home health aides affected, according to the consent order. It will also update its internal policies and training processes related to Civil Rights Act requirements, cease making home health aide assignments based on clients’ race or nationality preferences, and provide semi-annual reports to the EEOC regarding any reports or complaints surrounding race discrimination.

The growing, troublesome issues around non-solicitation agreements in home care Home Health Care News; by Audrie Martin; 9/23/24 In August, Comfort Keepers was fined $500,000 and forced to remove language from its contracts restricting caregivers from accepting positions with home care clients up to one year after terminating employment. That contract language, dubbed a non-solicitation agreement, is a widely used clause in home care contracts to protect providers’ businesses. On its end, the Irvine, California-based Comfort Keepers is a large franchise that offers non-medical in-home support, including meal preparation, companionship and personal assistance. The company required each client to execute a care agreement containing this language before receiving services. California Attorney General Rob Bonta concluded that this agreement violated California law by restraining worker mobility, as caregivers could not be hired by any Comfort Keepers client, not just the client to whom they were assigned to provide services. ...