Literature Review

Calvary Hospital doubles down on palliative care and hospice expansion Becker's Hospital Review; by Kelly Gooch; 3/24/25 Michael Fosina began serving as president of Calvary Hospital in New York City in January, bringing decades of healthcare experience to the role. ... Mr. Forsina told Becker’s he’s excited about Calvary’s mission as the organization celebrates its 125th anniversary. Recently, the hospital integrated services with its parent organization, ArchCare, the healthcare ministry of the Archdiocese of New York. Mr. Fosina shared his perspective on Calvary’s role in New York and its future in meeting patient needs. ... [Michael Fosina described:] "ArchCare has all of the components of post-acute care when you include our end-of-life hospital and our hospice program. The integration allows us to accept patients, move patients around, have them stay connected with the physician — the team physician. So the transitions of care are not as dramatic as if you’re going from one organization to the next organization." [Continue reading ...]

Inpatient use of valproic acid in agitated delirium by palliative medicineAmerican Journal of Hospice and Palliative Medicine; Sarah Jacobs, DO; Leah Herbst, DO; Carlos Fernandez, MD; Zankhana Y. Mehta, MD; Amanda Young, MS; Mellar P. Davis, MD; 2/25Valproic acid (VPA), an anti-epileptic medication available in intravenous and parenteral forms, has recently been used to treat agitation associated with delirium. VPA as an adjunct in treating delirium has been reported to be opioid, antipsychotic and benzodiazepine sparing. ... this study did show that 50% of patients did not require benzodiazepines or antipsychotics at all, and that VPA might have a role in sparing the use of medications such as antipsychotics and benzodiazepines which have poor evidence in the management of agitation in delirium.

The biggest lessons of the last 12 months, according to 36 C-suite execs Becker's Hospital Review; by Mariah Muhammad; 3/19/25 Becker’s asked C-suite executives from hospitals and health systems across the U.S. to share their biggest lesson from the past year. Question: What is the biggest lesson you learned in the last year, and why?

Oz does not rule out Medicaid cuts during Senate confirmation hearing McKnights Home Care; by Adam Healy; 3/14/25 Mehmet Oz, MD, President Donald Trump’s pick to lead the Centers for Medicare & Medicaid Services, did not give a direct answer when asked whether he was for or against Medicaid cuts Friday during a Senate Finance Committee hearing. “I cherish Medicaid and I’ve worked within the Medicaid environment quite extensively practicing at Columbia University,” Oz said when asked by Sen. Ron Wyden (D-OR) if he would oppose cuts to Medicaid. “I want to make sure that patients today and in the future have resources to protect them if they get ill. The way you protect Medicaid is by making sure it’s viable at every level, which includes having enough practitioners to afford the services, paying them enough to do what you request of them, and making sure that patients are able to actually use Medicaid.”

Revamped tool can reliably assess pain symptoms in dementia patients: researchers McKnights Long-Term Care News; by Zee Johnson; 3/17/25 ... A team of researchers reconstructed the End-of-Life Dementia-Comfort Assessment in Dying, or EOLD-CAD, after a multifacility study showed that caregivers could adequately and reliably address a host of pain symptoms seen in end-of-life dementia patients. ... When clinicians working in the SNFs that were part of the trials used the EOLD-CAD, they were able to detect patterns in more than 600 residents that fell into four categories: physical distress, symptoms of dying, emotional distress, and well-being. Common symptoms observed across these categories were restlessness, shortness of breath, choking, gurgling, difficulty in swallowing, fear and anxiety. ...

2010 to 2019 saw early palliative care billing up for advanced cancer HealthDay News; by Elana Gotkine; 3/17/25 For patients with distant-stage cancers, there was an increase in early palliative care (PC) billing from 2010 to 2019, but the level remained low, according to a study published online March 7 in the Journal of Clinical Oncology. ... The researchers found that in 2010 to 2019, there was an increase in the percentage with early PC billing among 102,032 patients treated by 18,908 unique physicians, from 1.44 to 10.36 percent. The likelihood of early PC billing was increased in association with treating physician's early PC referrals in the previous year and organizations' employment of any HPM specialist (3.01 and 4.54 percentage points, respectively). 

Is Medicare ready for an aging america? Home-based care offers hope RealClear Health; by Jonathan Fleece, JD (President and CEO of Empath Health) and Dr. Steve Landers (CEO of the National Alliance for Care at Home); 3/12/25Too often, families face an impossible situation: a loved one is ready to leave the hospital, but no home health provider is available. Or they’re told hospice is the best option, but administrative red tape delays access to comfort and support. These failures put patients at risk. ... This experience underscores why policymakers must protect and expand access to home-based care—before more patients fall through the cracks. ... According to one analysis, in a recent three year period, hospital stays for patients waiting to be discharged to post-acute care providers increased by 24 percent, deteriorating health outcomes and quality of life. Discharge delays – caused by hospital capacity issues and workforce shortages – not only cause harm to patients; they also add unnecessary strain and costs on our healthcare system.

[Canada] Use of feeding tubes among hospitalized older adults with dementiaJAMA Network Open; Anne-Marie Hartford, MSc; Wenshan Li, PhD; Danial Qureshi, MSc; Robert Talarico, MSc; Stephen G. Fung, MPH; Shirley H. Bush, MBBS; Genevieve Casey, MSc, MBBS; Sarina R. Isenberg, MA, PhD; Colleen Webber, PhD; Peter Tanuseputro, MHSc, MD; 2/25In this cohort study of hospitalized individuals with dementia, feeding tube insertion was not associated with improved survival or postdischarge outcomes. Being male or younger and having swallowing problems and greater functional impairments were associated with increased odds of feeding tube use, while having a do-not-resuscitate directive and living in rural settings were associated with reduced odds. Factors that were (or were not) associated with feeding tube placement were sometimes misaligned with best practice guidelines. Goals of care conversations, alternative intervention options, and improved clinical protocols are recommended. 

Healing spaces: The art of hospital architecture The Daily Utah Chronicle; by Isra Habib; 3/13/25 In the 20th century, architects designed hospitals as stark and functional structures with long hallways, sterile walls and fluorescent lighting that prioritized efficiency yet provided little comfort. These spaces, designed for practicality, often neglected the emotional and psychological needs of patients and their families. Today, however, architects are redesigning hospitals to heal both body and mind. They aim to transform the intimidating experience of being in a hospital into one that is comforting and supportive.

How hospital merger oversight is shifting deal-making Modern Healthcare; by Alex Kacik; 3/12/25 Health systems are increasingly pursuing mergers and acquisitions in the South, a region where demand for care is growing and there are fewer regulatory barriers. More than a dozen states have passed laws over the past several years designed to increase oversight of healthcare transactions, but Southern states have largely stayed on the sidelines. As a result, deals involving hospitals are expected to pick up in the South, particularly in markets that feature growing populations, a high number of Medicaid patients and less stringent merger reviews, merger and acquisition advisers said. Potential Medicaid cuts could also drive up deal-making in the 16-state region spanning from West Virginia to Texas, as well as Washington, D.C., advisers said. 

Mass General Brigham begins 2nd round of layoffs Becker's Hospital CFO Report; by Alan Condon; 3/10/25 The second of two rounds of layoffs at Mass General Brigham began March 10, with about 1,500 employees reportedly affected by the overall workforce reductions, according to The Boston Globe. The layoffs, the largest in the Somerville, Mass.-based health system's history, were announced in early February. The workforce cuts stem from "the same unrelenting pressures affecting many healthcare systems across the country," as the system faces a projected budget gap of $250 million within two years, a spokesperson told Becker's. Mass General Brigham, the largest health system in the state, said the layoffs primarily affect nonclinical and nonpatient-facing roles to "enhance efficiency, reduce costs and maximize support for front-line clinicians." 

Intervention increases palliative cancer care consultations/lowers EOL care CancerNetwork.com; by Roman Fabbricatore; 3/11/25A palliative care (PC) intervention combining algorithm-based automated identification of patients eligible for PC led to an increase in PC visits and a decrease in end-of-life systemic therapy among patients with cancer, according to a randomized clinical study (NCT05590962) published in JAMA Network Open. ... "...  Prior efficacy trials in oncology have tested early PC in controlled, primarily academic settings.2To our knowledge, this is the first effectiveness randomized clinical trial of algorithm-driven default specialty PC in community oncology.”

Assessing pain, anxiety and other symptoms of nursing home residents unable to speak for themselves Regenstrief Institute, Indianapolis, IN; by Kathleen T. Unroe, MD, MHA; 3/10/25 Revamped tool reliably addresses physical and emotional distress, well-being and end-of-life symptoms. As many as half of nursing home residents are cognitively impaired and may be unable to communicate symptoms such as pain or anxiety to the staff and clinicians caring for them. Therefore, information needed for the evaluation of symptoms and subsequent treatment decisions typically does not reliably exist in nursing home electronic health records (EHRs). A new paper reports on the novel adaptation of a commonly used symptom assessment instrument to more comprehensively acquire this difficult-to-obtain data with the ultimate goal of enabling knowledge-based expansion of palliative care services in nursing homes to address residents’ symptoms.