Literature Review

Hospice social worker and nurse perceptions of the usability of a hospice live discharge protocol (LDP)American Journal of Hospice & Palliative Medicine; by Stephanie P. Wladkowski, Susan Enguídanos, Tracy A. Schroepfer; 9/25Live discharges from hospice are often distressing for patients, caregivers, and hospice providers alike, disrupting care continuity and leading to emotional and logistical challenges. Despite Medicare’s discharge planning requirement, no standardized process currently exists for hospice-initiated discharges, resulting in variable quality of care transitions.  An explicit Live Discharge Protocol has strong potential to enhance the quality and consistency of a live discharge from hospice care. The LDP provides a framework to help smooth the transition from hospice care and provides patients and families with post-discharge support. Feedback from hospice professionals affirmed the relevance and usability of each step within the LDP, while also identifying opportunities for refinement for future implementation.

Nonprofits can profit from customer experience practices Evolve-Success; by Rick de Yampert; 10/14/25 Becca Gatian is grateful for each of the gifts she receives as executive director of Halifax Health – Hospice.“When we notice a gap in service or someone has a concern, we don’t call it a complaint,” said Gatian. “We see it as a gift, an opportunity to improve.” For Halifax Health – Hospice, a nonprofit that services Volusia, Flagler, Orange and Osceola counties, “We always focus on the patient and family – they are our customers,” Gatian said. “‘Client’ seems like a clinical term. It’s really about meeting the customer where they’re at versus having a product that we sell. When you think about a customer and a great experience, it’s because that organization individualized that experience for that particular patient and family.”

Evaluation of a flexible artist-facilitated storytelling intervention on a palliative care unitJournal of Pain and Symptom Management; by Kyle J. Drouillard, Regine Krechowicz, Kim Kilpatrick, Shirley H. Bush, Cory J. Ingram, Kaitlyn Boese, Jaya Rastogi, Jessica Roy, Carol Wiebe, Jenny McMaster, Claudia Hampel, Sarina Isenberg; 9/25A professional storyteller facilitated sessions with patients, caregivers, and healthcare professionals on a palliative care unit, starting with an open-ended question (e.g., “What story do you want to tell?”). From 18 sessions, patients (n=6), caregivers (n=8), and healthcare professionals (n=6), found the storytelling session acceptable, appropriate, feasible, meaningful and worthwhile. The storyteller perceived participants as enthusiastic and appreciative. Patient and caregiver stories described the palliative care unit as a calm site of reflection, and framed illness as a journey. Healthcare professionals’ stories reflected pride in and gratitude for their work.

Emergency Department care coordination program for assisted living residents with dementia-A qualitative studyJAMA Network Open; Grace F. Wittenberg, Peter T. Serina, Nichole E. Stetten, Ann Reddy, Ellen McCreedy; 8/25Care transitions to the emergency department (ED) from assisted living centers (ALCs) for residents may include incomplete or inaccurate information during transfer. These transitions can be especially difficult for vulnerable populations, including persons living with dementia (PLWD). In this qualitative study of a care coordination intervention, CCMs [complex care managers] advocated for their patients remotely by filling information gaps, particularly for PLWD and patients in hospice, and perceived that the intervention was associated with improved patient care. CCMs also identified key areas for improvement, such as to increase ED staff awareness of the program and to expand program hours.

Associations of patient experience with doctor-patient communication and patient-reported physical and mental health in seriously ill adultsJournal of Patient Experience; by Sarah F. D’Ambruoso, Anne M. Walling, Neil S. Wenger, Rebecca L. Sudore, Lisa Gibbs, Maryam Rahimi, Ron D. Hays; 8/25We administered the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) communication scale, Patient-Reported Outcomes Measurement and Information System (PROMIS®) global health items, and the PROMIS-29 depression and anxiety scales. Better global health (PROMIS) at baseline was associated with better doctor-patient communication (CAHPS) at 12 months ... and better doctor-patient communication at baseline was related to better mental health at follow-up ...The results suggest that patients’ overall health may influence doctor-patient communication, and this communication may impact patients’ mental health over time.

Understanding trauma in the context of direct care work in nursing homesJournal of Applied Gerontology; by Alfred Boakye, Jennifer Craft Morgan, Candace L. Kemp, Antonius D. Skipper; 8/25Direct care workers (DCWs) experience job quality challenges such as heavy workload, low pay, and few benefits. Layered risks such as the COVID-19 pandemic and systemic racism have impacted DCWs, made them more vulnerable, and increased turnover and the precarity of the long-term care system and residents’ care. Findings suggest that DCWs are often crippled with challenges stemming from the impact of COVID-19, work-related factors, and personal factors. Understanding the intersection of trauma provides a detailed contextual description of care work, which is important for developing practical coping strategies, either at the personal or organizational levels, and developing more refined trauma-informed initiatives to build resilience and support DCWs.

Conversational AI in hospice care: risks and benefits Hospice News; by Jim Parker; 8/29/25 Numerous types of artificial intelligence (AI) have gained a substantial foothold in health care, including hospices, with conversational AI among them. Conversational AI uses natural language processing and machine learning to develop virtual assistants and chatbots that can automate certain functions. ... The use of conversational AI in health care for the most part falls into two categories — delivery of remote health services and administrative assistance to health care providers, according to 2024 research published in the Journal of Medical Internet Research. ... However, the technology has limitations, the study found. These include ethical challenges, legal and safety concerns, technical difficulties, user experience issues and societal and economic impacts.

Why physician strikes are a form of hospiceKevinMD; by Patrick Hudson; 8/24/25I have only recently started thinking about strikes. They seemed like something other people did: railway workers, bus drivers, teachers, dockworkers. People with contracts. People who clocked in and out. Not doctors. Not surgeons. Certainly not me. You and I were supposed to absorb and adapt. To advocate from within. And we did, for a long time. We bent ourselves into shapes that did not fit. Worked around all the broken processes. Made phone calls after hours. Took the extra shift. Rewrote the notes to satisfy a system that did not understand the work. Until, eventually, some of us stopped. Not because we wanted to burn it all down, but because we could not keep pretending. And that is what a strike is, sometimes. Not rebellion. Not rage. Just a line and a refusal. And an end to the performance. Is it not strange how long you can work inside a system that is eating itself? ... You do not strike because you have stopped caring. You strike because you remember when it mattered.Publisher's note: An interesting analogy for our fractured healthcare system...

The future of work: Prioritizing human connection with Ryan Jenkins Teleios Collaborative Network (TCN) - Anatomy of Leadership; podcast/video by Chris Comeaux with Ryan Jenkins; 8/13/25 "Connection isn't new, it's just neglected. And it's neglected now more than ever." These powerful words from Wall Street Journal bestselling author Ryan Jenkins set the stage for a transformative conversation about what might be our most critical yet overlooked human need. Despite our hyperconnected world of social media, texting, and endless digital communication, genuine connection continues to slip through our fingers. Jenkins reveals the crucial distinction between mere communication and true connection – explaining how our brains process these experiences differently and why it matters so profoundly.

Simulation, flipped classroom, and reflective dialogue in socioemotional training in end-of-life care: Perspectives of nursing students Journal of Hospice & Palliative Nursing (HPNA); by María Lanza, Rebeca Abajas, Mar Aparicio Aparicio, Ángeles Melero, Carmen Ortego; 8/1/25The implementation of active methodologies in end-of-life education can play a crucial role in stimulating participatory learning and facilitating the acquisition of socioemotional competencies. ... From the students’ perspective, simulation, reflective dialogue, and flipped classroom enhance the conceptual learning process and facilitate students’ socioemotional preparation to face this complex and challenging professional situation. Editor's Note: Today’s tech-savvy nursing students show that simulation, reflective dialogue, and flipped classrooms build the person-centered qualities hospice and palliative care need. Use these methods—inside and outside the classroom—to improve patient/family care, teamwork, and self-care. For more information: 

Combining clinical insight and data-driven expertise: The case for morning huddles in primary care HEAL Security; by Becky Trotter and Aliya Ali; 7/1/25 The daily huddle, also called a morning huddle, is a brief standup meeting commonly associated with inpatient and surgical care. In these settings, safety is the predominant focus of the meeting. However, the same idea can be used in primary care settings to get care teams ready for the patients scheduled for that day. Morning huddles are an opportunity to merge clinical knowledge with data and analytics to help ensure primary care teams are aligned and specific care needs are recognized before patients walk into the practice. Editor's Note: Is this practice so new? Back in the 1990's at Hospice & Palliative Care of Louisville, each morning began with going through my hospice voicemail box for our well-oiled system of receiving and replying to voicemails for the whole team or individual members, from on-call staff, from leaders from throughout our organization, or other voicemails. These first-thing-in-the-morning communication/tech "huddles" were so crucial then--and are important today (with better tech and data)--because our patients often die during the night. Or, a new patient must be assessed. Or, the patient was transferred from home to an inpatient unit. Or, you know the common, literally life-changing needs. Is your hospice behind the times or leading the way with today's clinical communications and data?

The hidden leadership threat draining workplace productivity Forbes; by Julian Hayes II; 7/27/25 If speed is a premium currency in modern business, friction is the hidden tax. It doesn't appear on your balance sheet or get highlighted on the org chart. Yet, it compounds daily through missed deadlines, disengaged employees, decision bottlenecks, various leadership issues, and a tech stack that overwhelms more than it empowers. ... Perhaps the most revealing (and to some surprising) insight: executives reported the highest levels of friction. The very individuals tasked with solving complexity are often the most affected by it. This discovery underscores a deeper truth: friction isn't merely an operational issue. It's also a leadership issue. ... [The] following four categories of friction offer a diagnostic window into the health of an organization's leadership infrastructure. ...