Literature Review

Largest health care strike in Oregon history begins as thousands picket Providence Hospitals FM News 101 KXL, Portland, OR; 1/10/25 Some 5,000 hospital health care workers walked off the job Friday as they picketed all eight Providence hospitals in Oregon, in what the state health workers union described as the largest health care strike in Oregon history — and the first to involve doctors. Most of those participating in the open-ended strike are nurses. But in a rare move, dozens of doctors at a Portland hospital and at six women’s health clinics are also partaking, making it the state’s first physicians strike, according to the Oregon Nurses Association union.

How agilon health trains primary care physicians to provide palliative care Hospice News; by Jim Parker; 1/8/25 The senior care company agilon health (NYSE: AGL) has scaled a palliative care education model for its physician partners throughout most of the markets they serve. ... A 2023 study published in the Journal of Pain and Symptom Management found that the primary care-led, integrated approach to palliative care that agilon employs were two-thirds less likely to die in a hospital and on average spent five more days at home near the end of life. Hospice News sat down with agilon’s CMO, Dr. Karthik Rao, to talk about the ways the company prepares physicians to provide palliative care to their most seriously ill patients. [Key goals include:]

Managing clinical care after M&AHealthleaders; by Christopher Cheney; 1/6/25Coping with the challenges of mergers and acquisitions has become an essential responsibility for CMOs.

Hospice workers share the foods that bring patients comfort till the end: Plus, they reveal how families can support their loved ones with scents, small bites and shared memories HuffPost; by Julie Kendrick; 12/30/24... We all live, we all die and we all enjoy food along the way. The memory and meaning of food, along with the bliss of being able to savor a cherished flavor, are still present in our lives, even as we head toward a last meal, a soothing sip of water or a final bit of sustenance. “Food often plays an emotional role in the last stages of life,” said Dr. Kurt Merkelz, the chief medical officer at Compassus, a home-based care company. “Some patients may reminisce about favorite meals or foods that connect them to fond memories and loved ones. There are instances where patients crave a specific dish that reminds them of their family or heritage, even if they can’t eat much.” ... People often ask for things like mashed potatoes, ice cream and chicken soup, according to Gail Inderwies, the founder and president of KeystoneCare, a hospice and home health provider in Pennsylvania. ... Sometimes, those comforts are part of a culinary heritage.

As a hospice nurse, Jaffrey's Nancy Folsom helps make the journey easier The Keene Sentinel, Keene, NH; by Elijah de Castro; 12/28/24 Nancy Folsom has been working around death since she was a teenager in her family’s funeral home, where she was an embalmer apprentice. From there, she took a step back, pursuing a career as a home hospice nurse in the Monadnock Region, where she helps those who are dying confront death. “Death is never easy, at any age or any time,” Folsom said. “We want to make it as human as possible. I’ve always been comfortable with death.” ... Folsom, 62, of Jaffrey, “has never had a boring day” on the job. When she’s not out in the community working, she’s in the Peterborough office of Home Healthcare, Hospice and Community Services, a local nonprofit provider of home health services that also has offices in Keene and Charlestown. ... Over the years, Folsom has gained experience in how to best read a situation when she gets a new patient. Building trust between a hospice nurse and a patient, Folsom said, takes time, something many of her patients don’t have. Folsom resolves this dilemma by first making sure she is comfortable herself and cultivating a calm, abiding presence. ...

Physician union drives skyrocketed in 2023 and 2024, data show MDedge - Cardiology; by Randy Dotinga; 12/20/24 While fewer than 10% of US physicians are unionized, the number of official union drives among private-sector doctors have skyrocketed in the last 2 years, compared with 2 decades prior, according to a new study.  Researchers counted 21 union drives in 2023 and 12 in the first 5 months of 2024, compared with 0-6 drives each year between 2000 and 2022. If the 2023 and 2024 drives succeed, unions will represent 3523 new physicians — nearly equal to the 3541 doctors who sought unionization between 2000 and 2022. “We were able to document a significant uptick in union petitions and success in certification drives,” said corresponding author Hayden Rooke-Ley, JD, of the Center for Advancing Health Policy Through Research, Brown University School of Public Health, Providence, Rhode Island. “We were surprised to see such a marked shift in 2023.” ... The study authors launched their research to better understand trends in physician unionization in light of high-profile union drives, especially among residents. Rooke-Ley said: “We suspected that declining morale and increased corporate employment for physicians were leading them to consider unionization.”

Palliative care, mental health services underutilized in pancreatic cancer Healio; by Jennifer Byrne; 12/19/24 Individuals with pancreatic cancer underutilized palliative care and mental health services, according to a retrospective analysis. ... Researchers from Saint Louis University used electronic health record data from Optum’s Integrated Claims-Clinical Data set to identify 4,029 patients with newly diagnosed pancreatic cancer. The investigators then used ICD-9/10 codes to identify subsequent diagnoses of anxiety and depression, as well as palliative care consultations. ... Results showed higher prevalence of anxiety (33.9% vs. 22.8%) and depression (36.2% vs. 23.2%) among patients who had palliative care consultations than those who did not have documented consultations. ... Healio: Did any of your findings surprise you? Divya S. Subramaniam, PhD, MPH: It was unexpected to see that palliative care consultations, despite identifying higher levels of anxiety and depression, did not increase treatment rates for these mental health conditions. This suggests mental health might not yet be a central focus in palliative consultations, which often concentrate on managing physical symptoms.

States ranked by nurse communication Becker's Hospital Review; by Mackenzie Bean; updated 12/13/24 Hospitals in Louisiana, Minnesota, North Dakota, Nebraska and South Dakota have the highest nurse communication scores, while hospitals in the District of Columbia have the lowest, CMS data shows. CMS collects and publicly reports data on nurse communication as part of its HCAHPS survey data. The nurse communication measure assesses the percentage of patients who reported that their nurses "always" communicated well. The data was collected in 2023 and published in CMS' Provider Data Catalog Oct. 30. Nationwide, 80% of patients reported nurses always communicated well, up one percentage point from the year prior, according to CMS data. [Click on the title's link for this ranked list.]

Palliative medicine for the community paramedic Journal of Emergency Medical Services (JEMS) - The Conscience of EMS; by Maurice Paquette; 12/17/24 The role of the paramedic is evolving. ... EMS has become a catch-all, a gateway into a somewhat—if not totally—fractured healthcare system. ... The landscape of healthcare is shifting as well. The pandemic, coupled with the realization of self-care, well-being, and mental health struggles has caused drastic reduction in the number of healthcare workers, and the amount of experience in skills that those healthcare workers carried with them. ... Over the past many years, we’ve seen a push for the idea of the community paramedic, as well as mobile healthcare. The establishment of a community paramedic program, especially in rural areas of the United States, would provide non-emergent care, under expanded scope and under the direction of a physician in the patient’s home.  According to a literature review in the International Journal of Paramedicine, the most common community paramedic program goals are to “aid patients in chronic disease management, reduce emergency department visits, reduce hospital admissions/readmissions, and reduce Healthcare costs.” Editor's note: Pair this with the article we posted yesterday, Characteristics of patients enrolled in hospice presenting to the emergency department.

Palliative care may improve quality of life for stroke survivors and their family members American Heart Association - Stroke News & Brain Health; by Newsroom; 12/16/24 Palliative care ... can help improve quality of life for stroke survivors as well as their family members, according to “Palliative and End-of-Life Care in Stroke,” a new scientific statement published today in the Association’s peer-reviewed scientific journal Stroke. ... The new statement complements the Association’s 2014 Scientific Statement on Palliative and End-of-Life Care in Stroke, which covered core palliative care competencies and skills for health care professionals who treat stroke patients. The statement includes strategies to improve communication about prognosis and goals-of-care, address psychosocial needs such as coping with loss, navigate complex health care systems and prepare for death with end-of-life care when necessary. It also highlights the substantial inequities that exist in palliative care after stroke across sociodemographic and regional characteristics and the need to reduce those disparities.

University of Michigan Health-Sparrow nurses authorize strike as contract negotiations continue CBS News, Detroit, MI; by Elle Meyers; 12/12/24 Union officials representing the University of Michigan Health-Sparrow nursing staff have been working for months for an improved contract, but leaders say they're not close to a deal. "The hospital so far is not making offers that are going to keep up competitive. It's not going to allow us to make sure we maintain our level of care or quality of care," said Jeff Breslin, a registered nurse and the president of the Professional Employees Council of Sparrow Hospital. The University of Michigan bought Sparrow last April. Bresil says he was hopeful for positive change. "They had promised to come in and build new facilities, improve other facilities that we have, which is great, but you've got to take care of the people as well, and frankly, I'm disappointed that this is the direction things are taking," he said. Breslin said contract negotiations between the nurse's union and the hospital began last August. Their contract expired in October, and they still haven't reached a deal. He says nurses want to see more competitive pay, better staffing levels and an improved health plan. 

Northern Colorado cancer palliative care nurse leans on patients as she battles her own diagnosis ABC KJCT News 8, Fort Collins, CO; by Dillon Thomas; 12/11/24 A Northern Colorado woman who has spent years of her career helping patients navigate their cancer diagnosis says she leaned on her own patients for encouragement as she battled cancer herself. Riley Mulligan, a palliative care nurse navigator for UCHealth in Fort Collins, said she was able to battle her diagnosis of breast cancer by leaning into the courage of her patients while also taking lessons from herself. Mulligan’s journey battling cancer started nearly a decade ago, but the cancer she was helping battle wasn’t her own at the time. As a palliative care nurse, her job was to help some of the most ill patients that UCHealth treats. ... “I’m trying to take my own advice, I am trying to remember how to live. On the days I felt the worst, the most nauseous and tired, I still tried to get out and do things because I knew it would help me feel better,” Mulligan said.

Early successes, untapped potential, lingering questions: AI Adoption in Healthcare Report 2024 Medscape; by Jon McKenna; 12/6/24 ... For this report, Medscape partnered with Healthcare Information and Management Systems Society (HIMSS), a global professional society that includes an interest group focused on AI-related issues. ... Data came from a jointly managed survey to practicing physicians and other clinicians, practicing nurses, IT professionals, clinical leadership, and executive leadership at medical organizations. All respondents were in the U.S.