The NHPCO Updater

Redefining End-of-Life Care: Hospice Savannah’s Approach to Improving the Patient Experience

dcherry@nhpco.org (NHPCO) — Mon, 4 Nov 2024 09:11:00 -0500

The following content is a guest blog authored by CareXM, an NHPCO and Alliance Strategic Partner.

Hospice and palliative care continue to evolve as patient and family expectations shift toward more personalized care based on individual needs and preferences, such as personal values, cultural considerations, and quality-of-life goals. End-of-life care is already complex, and rising patient loads driven by staffing shortages make it even more challenging. To maintain the quality of care patients and families deserve, innovation is no longer optional – it’s essential. Dr. Kathleen Benton, CEO of Hospice Savannah, is redefining what it means to provide patient care by weaving innovation and empathy into every touchpoint.

By blending technologies like CareXM’s patient engagement platform with human compassion, Benton and her team have been able to enhance patient care, streamline communication, and re-engage underutilized staff to increase touchpoints with patients and families. In Benton’s words, “Innovation is not just about being cutting-edge; it’s about being flexible and patient-centric.”

Hospice Savannah: A Legacy of Compassion and Innovation

Hospice Savannah, a non-profit healthcare provider based in Savannah, Georgia, is committed to delivering holistic care to patients with serious and terminal illnesses. With an average daily census (ADC) of 260 hospice patients and 1,700 palliative care patients, Hospice Savannah continues to innovate to meet the growing demands of the communities they serve.

Benton’s leadership has steered Hospice Savannah towards embracing technology that enhances patient care without losing the human touch. A key part of this strategy includes their partnership with CareXM, the industry leader in telehealth, patient engagement, and nurse triage services. This partnership ensures patients and families have 24/7 support, setting a new standard for end-of-life support.

The Role of Technology in Enhancing Patient Care

In hospice and palliative care, every interaction matters. Benton emphasizes the importance of communication: “In hospice, the patient experience IS the outcome. One lost touchpoint can be the difference between life-saving care and a missed opportunity.” Patient engagement solutions like CareXM‘s nurse triage platform help ensure providers stay connected at every step of the patient journey, preventing missed moments that could impact care.

With CareXM’s integrated technology, Hospice Savannah has been able to:

Improve communication with patients and families, ensuring they feel connected to and in control of their care plan through access to their care teams and proactive surveys.
Boost patient and family satisfaction scores through proactive patient engagement.
Enhance continuity of care, particularly for high-need patients who require extra attention but may not always have an assigned care-managing nurse.

Hospice Savannah maintains a human-centered approach while incorporating tools that augment the care team, enhancing access, responsiveness, and care quality.

Four Ways CareXM’s Proactive Patient Engagement Transforms Care

Targeted Care for High-Need Patients
CareXM’s platform is a game changer for patients requiring intensive support. Hospice Savannah began its CareXM implementation by focusing on high-need patients who lacked an assigned nurse due to staffing challenges. By providing consistent, real-time care management, CareXM ensures these patients receive the attention they need when they need it. Benton shares, “We were missing the continuity before, but now we’re not.”
Better Communication with Patients and Families
CareXM’s patient engagement solution provides continuity of care through expanded touchpoints with patients and families, reducing anxiety and preventing communication gaps that can lead to frustration and dissatisfaction. “You are serving people on what may be the worst day of their life,” Benton says. “Over-communication is the best way to serve them.”
A Solution to Overcome Staffing Challenges
Staffing shortages have plagued the healthcare industry, especially home-based care. CareXM offers a flexible, scalable solution that allows providers, including Hospice Savannah, to expand care capacity without overburdening staff. “CareXM is a tool that helps providers weather the storm of staffing shortages,” Benton says.
A Template for Other Departments
The success of integrating CareXM’s technology in hospice care delivery has sparked interest from other departments at Hospice Savannah, including grief support and palliative care. Benton notes, “The data is so powerful that other departments have asked to implement it in their areas to reap the same benefits.”

A Philosophy of Care that Drives Results

Dr. Benton’s personal experiences, including caring for her brother who underwent over 100 surgeries, have deeply influenced her commitment to improving healthcare communication. She believes that technology should enhance, not replace, human interaction. This philosophy allowed her team to focus on what truly matters—the patient—while letting automation handle routine, non-urgent tasks.

The results have been remarkable:

Within two months of implementation, patient and family communication satisfaction scores jumped from 75.2% to 93%.
The ability to get timely help rating saw an even more dramatic improvement, rising from 60.7% to 92.1%.

These scores represent how integrating a technology partner like CareXM can enable real improvements in patient care and family support. Hospice Savannah began responding more quickly to patient needs, increasing meaningful touchpoints with patients, and streamlining internal processes for greater efficiency.

Looking Ahead: A Future Built on Innovation and Guided by Compassion

The future of hospice care lies in the integration of technology with human compassion. With CareXM, Hospice Savannah has developed a “proactive care model” that anticipates patient needs before they arise. Automated patient engagement, real-time triage, and strategic care coordination are helping to reduce nurse burnout, lower costs, and improve patient satisfaction.

But this is just the beginning. Benton’s vision for the future is to continue expanding the use of technologies like CareXM to personalize care even further, ensuring that every patient is treated with dignity, empathy, and respect.

A Call to Action: Embrace Change, Prioritize Service

Dr. Benton’s leadership philosophy is simple but powerful: “Serve.” This principle shapes her approach to navigating the complex landscape of end-of-life care. She challenges her peers to view technology as an ally in their mission to provide an exceptional care experience for patients and families. By adopting solutions like CareXM, providers can do more than just adapt to current challenges – they can position hospice and palliative care for future success.

As Benton notes, “Technology can be the key to unlocking better care—but it will always take compassion and dedication to truly serve our patients.”

Expert Analysis: Allegiance Healthcare’s Approach to Sustained Compliance

dcherry@nhpco.org (NHPCO) — Wed, 30 Oct 2024 16:43:00 -0400

The following guest post is adopted from the blog of NHPCO Strategic Partner, Axxess.

Allegiance Healthcare, operating under the Allegiance Health Management umbrella, is a leading provider of post-acute care in Louisiana, offering home health, hospice, palliative care, and transitional care services to all patients regardless of the complexity or acuity of their diagnosis.

During the Axxess Growth, Innovation and Leadership Experience (AGILE), Allegiance Healthcare received the Compliance Standards of Excellence Award for their demonstrated commitment to surpassing industry survey standards and upholding continued compliance. This award recognizes Allegiance’s successful track record of deficiency-free surveys, reflecting their exceptional dedication to high-quality patient care and rigorous adherence to regulatory requirements.

Axxess interviewed Allegiance Healthcare’s Chief Operating Officer, Brandon Melancon to explore the strategies and tools behind the organization’s success. Read the full interview here. Axxess’ Vice President of Hospice Professional Services, Zaundra Ellis then weighed in on the processes she considers beneficial for other organizations to adopt:

Implement internal auditing and quality assurance processes.

Allegiance’s internal quality assurance processes are deeply ingrained in their organizational DNA. From prebilling audits that ensure claims are clean before submission to yearly mock surveys, monthly QAPI meetings with a medical review auditor, and a compliance hotline where employees can voice concerns anonymously, every aspect of the organization’s operations reflects a commitment to maintaining high standards and regulatory compliance.

“Allegiance’s approach to quality assurance is not only comprehensive but also strategic,” said Ellis. “By embedding these processes into their culture, they’re not just catching issues early – they’re also fostering a shared understanding of quality and compliance among their team. Having a medical auditor as a member of their QAPI team is brilliant. The medical auditor’s participation allows for real-time training that supports quality and compliance, preparing the Allegiance team during each meeting for surveys and audits. The result is deficiency-free surveys.”

Leverage technology for operational visibility and efficiency.

Melancon highlighted that before transitioning their EMR solution to Axxess, Allegiance faced short and long length of stay issues that could have triggered governmental audits. Recognizing this, they invested in an EMR solution to enhance data visibility, enabling close monitoring and proactive resolution of these concerns.

“By adopting an EMR solution tailored to their needs, Allegiance not only resolved potential compliance issues but also gained the ability to continuously monitor other crucial metrics,” said Ellis. “A good EMR solution should empower your team to deeply understand your business and identify and address blind spots, thereby improving overall performance and elevating the quality of care you provide.”

Melancon also noted ease of use and training modules as elements of an EMR solution that not only contribute to compliance efforts but also enhance overall efficiency.

Pivot when areas requiring improvement are identified.

Through their ongoing quality assurance processes and easy-to-use software platform that support real-time data analysis, Allegiance is able to address issues as soon as they arise, initiating a Performance Improvement Project (PIP) immediately when an area requiring improvement is identified.

“By tackling problems head-on, Allegiance minimizes the risk of recurring issues and optimizes overall operational performance, ultimately leading to better outcomes and higher patient satisfaction,” Ellis said. “Both your processes and your technology solutions should support operational agility, ensuring continuous alignment with evolving regulatory requirements and standards.”

Learn more about how Axxess can serve as a partner to your care delivery through integrated technology solutions.

Celebrating Jimmy Carter: A Century of Life and a Legacy of Courageous Conversations

dcherry@nhpco.org (NHPCO) — Tue, 1 Oct 2024 10:28:00 -0400

As the world celebrates former President Jimmy Carter’s 100th birthday on October 1, we reflect on the remarkable impact he has made and continues to make on our country, even through the last phase of his life.

President Carter lives a life of service above self. As a young man, he had a distinguished career as a Naval officer before serving as Governor of Georgia and later, as President of the United States. After his time in office, through the Carter Center, President Carter and Former First Lady Rosalynn Carter led incredible efforts to increase peace and improve health around the world. In this last chapter of his life, his commitment remains steadfast. In February of 2023, President Carter made the courageous decision to publicly share his choice for hospice care. In doing so, President Carter sparked a national conversation about the value of hospice care, one that is reinvigorated even today as we celebrate the momentous milestone of 100 years of life.

To honor the longest living former president’s experience, we have compiled some important articles from the last two years that highlight how his choices now are helping Americans better understand hospice care.

CBS Evening News – Spotlight on home hospice care as Jimmy Carter turns 100

The Atlanta Journal Constitution – Former President Carter’s health journey has raised awareness of hospice care

Axios – Carter's year in hospice sheds light on end-of-life care option

The New York Times – Jimmy Carter’s Long Goodbye

The Atlanta Journal Constitution – Jimmy Carter, one year after entering home hospice, remains resilient

USA Today – Rosalynn and Jimmy Carter bring needed attention to hospice care – and questions

The New York Times – Americans Glimpse Jimmy Carter’s Frailty and His Resolve

The Washington Post – Carters’ journey highlights tough questions about when to choose hospice

NPR Morning Edition – What does it mean to offer compassionate care for people facing the end of life?

The Hill – How Jimmy Carter has changed the conversation around hospice

The Seattle Times – President Jimmy Carter and the benefits of early hospice care

Today, we celebrate former President Jimmy Carter for his meaningful contributions to our country, including his continued commitment to serving his nation even now. Carter and his family have opened the door for many Americans to have important conversations about their own end-of-life wishes.

Happy 100^th birthday, President Carter. We wish you the best in this new century.

Navigating the Future of Advance Care Planning: A Strategic Imperative for Hospice and Palliative Care Leaders

dcherry@nhpco.org (NHPCO) — Wed, 28 Aug 2024 08:35:00 -0400

The following content is a guest blog authored by Maria D. Moen, SVP of Innovation & External Affairs at MyDirectives, an NHPCO Strategic partner.

In a world where we crave and even expect a level of control over every aspect of our lives, it's only natural that this desire includes our healthcare decisions. People want to have a say in their medical journey, not be moved through the healthcare system as a voiceless traveler. Advance care planning (ACP) is an essential process in enabling a person to capture and record their treatment preferences, which can then be used as a guide for healthcare providers, caregivers, family members, and loved ones when it becomes necessary.

Rebecca Sudore, MD, a respected researcher and leader in advance care planning, succinctly defines ACP as "a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care." Seems simple enough and a concept that we can all get behind.

Building and Maintaining Trust in the Patient-Provider Relationship

In hospice and palliative care, trust is the cornerstone of the patient-provider relationship. To maintain and strengthen this trust, it's essential that patients' wishes are not only documented and kept updated, but also readily accessible to others who would treat them during a health crisis or emergency. This requires a seamless availability of ACP documents across the broader care continuum. This kind of access and approach works to build patient trust in their healthcare providers, by instilling confidence that their healthcare providers will respect and honor their wishes.

Leveraging Technology to Streamline Care and Enhance Patient Outcomes

Healthcare is loaded with clinician burden due to repetitive, time-consuming tasks that can interfere with delivering personalized care. By embracing technology throughout the ACP process, providers can automate many time-consuming processes, allowing them to focus on what truly matters to patients: delivering compassionate, personalized care.

A well-structured ACP process should include:

Comprehensive Documentation – At the time of intake or admission, inquire whether the patient has existing ACP documents. If they do, be sure to collect them and review them carefully with the patient and/or their healthcare agent to ensure they align with the patient’s current values and goals of care. It’s crucial to keep these documents current, reflecting any changes in the patient's wishes or preferences for the care they want to receive.
Accurate Record Keeping – The patient’s chart or electronic health record should include copies of their ACP documents with key elements highlighted in the record that can become time-sensitive such as CPR status, designated healthcare agents and their contact information, and any specific treatment preferences.
Visibility Across the Care Team – It’s essential that this information be easily accessible to every member of the care team. Digital systems are particularly effective at providing quick reference points, as well as more detailed information, when it is urgently needed.
Broad Access and Sharing – Solidify the trust patients have placed in your team by ensuring that their ACP documents are available not only to the immediate care team but also to others those patients will encounter during their healthcare journey. This might be family members and friends but should also include other healthcare providers across the care continuum. Go beyond your own specific care location to ensure ACP forms can be easily found by medical teams. This may include uploading documents to state health information exchanges, their patient portal, or any other secure digital platforms, such as personal health record systems or large-scale registries of ACP documents.

The Imperative of Digital Advance Care Planning

Given the complexity of today’s healthcare and the mounting pressures to maximize reimbursement, quality, and outcomes all while minimizing risk, the shift to digital ACP document creation and access is not just a convenience — it’s a necessity. Here’s why digital ACP systems are especially critical for hospice and palliative care providers:

Portability and Accessibility – Digital ACP documents can seamlessly follow the patient across different care settings, ensuring their wishes are respected no matter where they receive care. This eliminates the risks associated with paper forms, which can be misplaced or inaccessible in a crisis, and tangibly demonstrates commitment to the patient even when they are being treated by other medical teams.
Verification and Authentication – Digital systems provide a clear audit trail that reduces risk by verifying who created the document, when it was signed, which version is current, and who has accessed it. This enhances the authenticity and reliability of the documents and increases the confidence of the provider using them to inform treatment.
Interoperability and Integration – Digital ACP documents can be securely yet easily made available across different providers, healthcare systems, health information networks, and with trusted individuals, ensuring that everyone connected is working from the most current information. This is particularly important in complex care environments where multiple providers may be involved in a patient’s care.

Creating a Personalized Healthcare Experience

Hospice and palliative providers must deliver care that is not only clinically sound but also deeply personalized. Modernizing advance care planning through digital solutions to honor the patient voice as part of a larger ecosystem of care is a crucial step in achieving this goal. By ensuring that every patient’s healthcare journey is guided by their values, preferences, and goals of care, providers can create a more compassionate, patient-centered care journey that fulfills the expectations of both patients and partners in care.

Shaping the Future of Care

Embracing digital ACP document options reflects a foundational shift towards patient-centered care, where individuals are empowered to shape their healthcare journey. For hospice and palliative care providers, it’s not just about keeping pace with technology; it’s about ensuring that every patient’s voice is heard and respected, especially in their most vulnerable moments. By integrating these modernized approaches to personalized care into your organization, you can build stronger patient and family member relationships, improve the outcomes of the care your patients receive, and fulfill your commitment to providing the highest standard of compassionate care to those you serve.

About the Author

Maria D. Moen is the Senior Vice President of Innovation & External Affairs at MyDirectives and a seasoned advocate for leveraging technology to enhance patient outcomes and streamline healthcare operations.

About MyDirectives®

MyDirectives is the premier provider of digital advance care planning (ACP) solutions and the only national registry and repository for highly secure, cloud-based storage for anytime, anywhere access across the healthcare continuum.

Hospice Helpers: Volunteer Recruitment and Engagement Tips

dcherry@nhpco.org (NHPCO) — Wed, 3 Apr 2024 09:29:00 -0400

The following guest post is adopted from the blog of Glatfelter Healthcare, NHPCO Strategic Partner.

With the hospice volunteer requirement of five percent returning in January of 2024, now is a great time for hospice professionals to put on their volunteer recruiter hats.

Many hospices have found it challenging to keep volunteers engaged post-pandemic. National averages show that hospices lost between 30 to 50 percent of the volunteers they had before COVID-19 hit. Some hospices adapted by offering virtual volunteer opportunities, while others asked volunteers to perform hands-off duties such as writing notes or making items for patients from home. Now, many hospices need to do extra work to not only gain new volunteers, but to regain previous volunteers whose support slowed during the pandemic.

This blog walks hospice professionals through recruiting and retaining hospice volunteers, from hanging flyers to volunteer skill-building.

Targeting Potential Volunteers

Hospice volunteers span all ages, but one-third of hospice volunteers are between 41 and 64 years of age. Hospice providers have a significant opportunity in recruiting volunteers of younger generations to join their teams.

Below are 12 viable strategies for recruiting the next generation of volunteers:

Ask young volunteers to recruit their friends and celebrate those volunteers who bring in others with special recognition.
Offer a variety of schedules and volunteer options to accommodate the often-busy lives of young people.
Reach out to leaders of local church youth groups, school clubs, and sports teams to generate interest.
Meet the audience where they are—on social media. Keep an active profile(s), highlighting volunteer successes and advantages to generate interest. Ask volunteers to repost your content.
Make it a mutually beneficial experience for volunteers by offering position titles, letters of recommendation, and development opportunities.
Focus on the cause AND what’s in it for volunteers. Gen Z, in particular, is a passionate generation and will likely respond to calls of helping others. However, it’s still important to remind volunteers how service can benefit them—such as resume building, career education, and meeting new people.
Things move fast in today’s world. Return prospective volunteer calls and emails within 24 hours so you don’t lose them to another organization.
60 percent of volunteers are moved to volunteer because of personal experiences. When marketing your volunteer opportunities, try to highlight the personal connections and rewards.
Participate in job fairs.
Hang flyers with QR codes at youth-centered community organizations and high schools.
Present to nursing, social work, and other healthcare-related classes at nearby colleges and universities, as well as local youth groups and organizations.
List your volunteer opportunities on volunteermatch.com.

Screening Volunteers

Once you get interested volunteers and begin screening, consider the following about them:

Relevant skills
Degree of sensitivity
Level of comfort with the topics of death, dying, and loss
Willingness to complete required training
Time available
Ability to adjust to significant losses

Background Checks

Once you’re ready to bring someone on board, don’t forget that they are unpaid employees and will need a background check. Criminal background checks must be obtained for volunteers in accordance with state requirements. In the absence of state requirements, criminal background checks must be obtained within three months of the date of hire for all states that the prospective volunteer has lived or worked in over the past three years. In addition to a criminal background check, it’s a good idea to have your own system of checks and balances, including:

Ensure volunteers who drive as part of their volunteer description have an acceptable driving record and adequate auto insurance coverage (review your state limits and follow internal policies).
Complete repeat background checks as per state guidelines. Adhere to a follow-up background check schedule. Some checks may need to be repeated after a certain number of years.
Create volunteer position “profiles” to map the skills needed for each position, as well as the risks each pose, to inform training needs.
Ensure volunteers are properly supervised, when appropriate.
Revisit the onboarding process from time-to-time to make sure you’re keeping up with best practices.

Nine Ways to Retain Volunteers

In addition to documenting your recruitment strategy, hospices should review and maintain a volunteer retention strategy.

Here are nine tips to keep your volunteers interested and engaged:

Offer continual and flexible training and growth opportunities through additional responsibilities, where applicable.
Appoint volunteer leaders and trainers.
Encourage volunteers to keep sharing new skills with patients, such as writing poetry, learning an instrument, or reading a book.
Show your volunteers some appreciation by sharing the value they bring patients and their loves ones.
Emphasize the personal and professional growth volunteers often undergo.
Remind volunteers that they’re needed. Being needed is a human instinct and something that makes everyone feel good.
Ensure volunteers feel supported—personally and professionally—by checking on them if they suffer a patient loss and throughout the year.
Encourage volunteers to take ownership of their work, such as offering new ideas for patient engagement activities.
Highlight volunteers and their work in local newspapers or on local tv news, encouraging them to continue and inspiring new volunteers through storytelling.

Volunteer Accident Coverage

It’s important to think about the risks associated with having volunteers serve your patients and their loved ones. Having insurance coverage, like Glatfelter’s Volunteer Accident coverage, can help cover providers in the event of volunteer accidents or injuries. Volunteer accident coverage also covers unexpected and unreimbursed medical expenses that occur from an accident while volunteering and provides a lump sum benefit when a volunteer suffers a serious injury.

Hospice began as a community initiative and remains a community initiative. Through smart recruiting and retention, hospices can keep their volunteers’ attention, ensuring they’ll have, and help create, life-changing memories for years to come.

One Year in Hospice Care: What Jimmy Carter is Showing Us

dcherry@nhpco.org (NHPCO) — Fri, 16 Feb 2024 18:22:00 -0500

By Ben Marcantonio, NHPCO COO and Interim CEO

February 18, 2024 marks one year since President Jimmy Carter began receiving hospice care at home and generously shared that information with the American public. In that year, President Carter and his family have continued to share pieces of their experience with us, helping to shape the public’s understanding of what hospice care can offer patients and families. They have brought hospice care into the public eye and into our national conversation to a degree that rarely happens.

The Carters spearheading this change in awareness aligns with the many ways in which they have impacted public health throughout their lives. Rosalynn Carter’s focus on mental health shifted the dialogue in the United States, and the positive ripples of her work continue to inform our approach to mental health today. The Carter Center has led the global effort to fight Guinea worm disease, and it is now on the cusp of being the second-ever disease to be eradicated. And, it was under President Carter’s leadership that the idea of government-supported hospice care was first tested. That demonstration project led to legislation, passed by Congress and signed into law by President Reagan, that formalized the Medicare Hospice Benefit. In other words, with hospice care, President Carter is living the last stage of his life in a way that matches his values. As President Carter’s grandson, Jason Carter, recently said about his grandfather’s end-of-life journey: “He is living this part of his life, as part of that same faith journey that he’s been on for his whole life.”

The hospice structure President Carter helped create has enabled about 30 million Americans over four decades to choose the support of hospice at the end of life. Of course, not everyone who receives hospice lives for a year. Six percent of patients are in hospice care for 365 days or more, while 10% receive up to two days of care and 25% receive up to five days of care. Hospices help patients at any length of stay, but President Carter’s story reinforces something we hear so often from patients’ families and from hospice providers: the wish that more people found hospice earlier, so they could benefit from more care and support.

Over the years, Americans’ awareness of hospice has grown, and more people have chosen hospice care. Today, about 1.5 million Americans make that choice each year. It’s reasonable to assume that the Carters’ choices to receive hospice care and to share that information with all of us will mean that more people consider and choose hospice as an option for their own end-of-life journeys.

What will it mean if more people choose hospice? Let’s look to the Carters as a guide. We know some of what President Carter’s life has been like over the last year. At the beginning of his care, he would have had conversations with members of the hospice interdisciplinary team (including medical, social, and spiritual care professionals) about his values and goals for his care. The hospice team would have developed a care plan tailored to the patient based on those conversations. If he is experiencing pain or discomfort, we know the hospice team would be working to minimize the pain or discomfort, and to make him as comfortable as possible. His care would be overseen by a physician specializing in hospice care, and he would be visited and checked on regularly by hospice nurses, aides, and volunteers, and very likely by social workers and spiritual caregivers (if that was part of his individualized care plan), and possibly by specialized therapists such as massage or music therapists.

From stories members of the Carter family and friends have shared with the press, we know President Carter, the longest-living president in American history, has been enjoying his favorite treat: peanut butter ice cream. During baseball season he watched his beloved Braves on TV. He watches the livestream of his niece teaching the Sunday school class that he used to teach. We know he has had visits, calls, and prayers with friends, including Ambassador Andrew Young, and several-times-per-week visits from Jill Stuckey, the superintendent of the Jimmy Carter National Historic Park. President Carter’s children have a rotation for spending time with him.

He has continued following the news and current events, and has even thought about ways he might be helpful to advancing peace, something he has done throughout his life. In October, President Carter celebrated his 99th birthday. Tributes, well-wishes, and accolades poured in from around the world, and we know he was able to enjoy those. Similarly, President and Rosalynn Carter celebrated their 77th wedding anniversary in July. We know that while she was still living, the two of them spent much of their time sitting next to each other in the living room of their longtime home in Plains, GA, holding hands. When Rosalynn Carter died in November, we all watched as President Carter traveled and attended services to celebrate the love of his life and honor her memory. Those photos and videos were a testament to an incredible love story and to the inner strength of Jimmy Carter. They were also a powerful visual of what is possible when someone has the right care model, including the support of hospice.

President Carter is showing us an amazing example of what it means to live out the end of one’s life in a way that is in keeping with the entirety of one’s life, and to experience life to the fullest, even as you prepare to die. What that means is different for everyone, as we are all unique individuals, but we should each have the opportunity to create the end-of-life journey that is right for us. Hospice care does that for millions of Americans.

Please join NHPCO in thanking President Carter for lighting the way for all of us. Learn more here and share your thoughts on social media using the hashtag #CandlesforCarter.

The National Hospice and Palliative Care Organization’s 2023 In Review

dcherry@nhpco.org (NHPCO) — Thu, 21 Dec 2023 15:52:00 -0500

The year is coming to a close and it’s been a busy one for NHPCO staff and members across the nation. While the NHPCO team is proud of the 2023 accomplishments outlined below, we didn’t achieve them on our own. Our work is made possible by our members, through support in the form of belonging to NHPCO, direct service on NHPCO committees, councils, and boards, and via ongoing feedback and participation in our various requests for input, networking calls, office hours, and online courses. While there is far more to reflect on than can be captured in a short blog post, here are twelve standout accomplishments from the year.

Value of Hospice in Medicare Report

In March of 2023, NHPCO, in collaboration with NAHC, released research conducted by NORC at the University of Chicago which demonstrates patients’ use of hospice care contributed to $3.5 billion in savings for Medicare in 2019, while providing multiple benefits to patients, families, and caregivers. Access the report on this NHPCO webpage, read the press release, or learn about the congressional briefing on the value of the benefit held in July of this year.

Former President Jimmy Carter’s Courageous Choice to Share His Hospice Election Publicly

In February, Former President Jimmy Carter and his family chose hospice care for his end-of-life journey and announced this decision to the world. By sharing that choice publicly, the Carters have sparked a national conversation and countless private ones about the value of hospice. Read more about NHPCO’s NYC August event to acknowledge six months since former President Jimmy Carter entered hospice care and the most recent NHPCO Updater blog post by NHPCO’s Interim CEO, The Carters Are Showing Us What Hospice Means.

Rosalynn and Jimmy Carter have captured the hearts and mind of a nation and as a result, dozens of articles and episodes have been written and released addressing the myths and misconceptions of hospice care which have been invaluable in educating the public about the hospice benefit. A few standout examples include:

NPR Morning Edition – What does it mean to offer compassionate care for people facing the end of life?
The Washington Post – Carters’ journey highlights tough questions about when to choose hospice
USA Today – Rosalynn and Jimmy Carter bring needed attention to hospice care – and questions
The New York Times – Americans Glimpse Jimmy Carter’s Frailty and His Resolve
The Hill – How Jimmy Carter has changed the conversation around hospice
The Seattle Times – President Jimmy Carter and the benefits of early hospice care

Program Integrity

The Department of Health and Human Services (HHS) acted on 17 of the 34 hospice program integrity recommendations NHPCO and other leading organizations made earlier this year to protect the integrity of the hospice community. NHPCO celebrated success on behalf of the ideals at the heart of the hospice—high quality, person-centered, interdisciplinary care.

1. 2023 NHPCO Annual Leadership Conference

As the first in-person conference NHPCO hosted since the COVID-19 pandemic began, the rebranded 2023 NHPCO Annual Leadership Conference (ALC2023) brought together over 900 hospice and palliative care leaders and aspiring leaders working to advance the field of hospice and palliative care. Read a summary of the conference’s events or learn about what ALC2024 has in store.

1. Hospice Action Network’s Hospice Action Week

In June, more than 70 hospice and palliative care advocates from across the country met with over 130 congressional offices to discuss key legislative and regulatory priorities for ensuring and expanding access to hospice and palliative care. The meetings were part of Hospice Action Week, hosted in Washington, DC by NHPCO and its advocacy affiliate, the Hospice Action Network (HAN).

1. Quality and Innovation Network Launch

In 2023, NHPCO launched a new quality program, the Quality and Innovation Network. This program brings together a community of providers committed to establishing a culture of quality within their organizations and facilitates collaboration across providers nationwide through monthly virtual working sessions and NHPCO’s expert support.

1. CaringInfo.org Launches in Spanish

CaringInfo.org is a program of NHPCO that provides free resources to educate and empower patients and caregivers to make decisions about serious illness and end-of-life care and services. In October, NHPCO announced the launch of the CaringInfo.org website in Spanish. All pages and advance directives on the website are available in translation and NHPCO will continue to translate any new site additions.

We Honor Veterans Launches New Resource Webpages

In 2023, the We Honor Veterans launched two new website sections, Psychedelic-Assisted Therapy and Caring for Veterans and Women Veterans and End-of-Life Care. The psychedelic-assisted therapy page defines the practice, covers studies and emerging organizations in the field, catalogs other sites with additional information, and discusses some of the policy efforts currently underway. The women Veterans page, created in collaboration with Dr. Qwynn Galloway-Salazar – a U.S. Army Veteran – outlines the unique experiences and needs of women Veterans at the end of life, including unique risk factors, circumstances, and strategies for appropriately engaging these Veterans.

1. Project ECHO 2023 Series: Equity Where It Matters

Project ECHO is an innovative program designed to create virtual groups of learners by bringing together healthcare providers, subject matter experts, and the wider community using case-based learning and fostering an “all teach, all learn” approach. The 2023 NHPCO Project ECHO curriculum focused on inclusive topics addressing various aspects of diversity and cultural competence in healthcare. Individuals who completed the curriculum earned a certificate in diversity, equity, and inclusion for hospice and palliative care.

1. National Hospice and Palliative Care Month – Courageous Conversations

The 2023 NHPCO theme for National Hospice and Palliative Care Month (HAPCM) was Courageous Conversations. The campaign encouraged everyone to engage in Courageous Conversations to start a meaningful dialogue on dying a good death, and NHPCO offered an extensive resource library to members who wanted to participate in the campaign. NHPCO enjoyed wide participation from members across social media and through local events.

1. New NHPCO Quality Member Resources

Throughout 2023, the NHPCO Quality and Regulatory teams were hard at work creating valuable, members-only resources on a wide variety of topics from workforce training to enable high-quality care to comprehensive guides that help your organization navigate reporting requirements. Review the list of top resources below and access all of these materials on the NHPCO Quality Resources webpage.

NHPCO Care Planning Primer and Tip Sheet
Telehealth Toolkit – best practices for Administrators and Clinicians
Interdisciplinary Hospice Onboarding and Orientation Guide
Charting a Course to Quality – A Consumer Guide to Publicly Reported Quality Measures
Charting a Course to Quality – HQRP Comprehensive Resource Guide
Measures of Excellence National Report
STAR National Report

1. 2023 Facts & Figures Report

In December, NHPCO published its 2023 edition of Facts and Figures, an annual report on key data points related to the delivery of hospice care, including information on patient characteristics, location and level of care, Medicare hospice spending, and hospice providers. NHPCO Facts and Figures is the leading resource for hospice providers and others interested in understanding the work of the community.

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Looking to 2024, we are excited about expanding the resources and advocacy we provide the serious-illness home care community. In August of 2023, the NHPCO and National Association for Home Care & Hospice (NAHC) boards agreed to pursue a new, combined organization. All updates about the merger have been and will continue to be included on this webpage about the new organization. The webpage also includes a list of notable press.

As a united organization and community, we will be even better equipped to fulfill our mission of leading and mobilizing the transformation of care delivery to ensure equitable access to high-quality, interdisciplinary, person-centered care for those living with serious illness. In the meantime, as we work toward this future organization, NHPCO will continue to deliver expert resources, guidance, education, and advocacy on behalf of our members nationwide. We’re glad to have you along for the journey.

Ten Years Later, Am I Still Grieving Appropriately?

dcherry@nhpco.org (NHPCO) — Mon, 18 Dec 2023 11:16:00 -0500

A personal mediation on the role of hospice care in a daughter’s grief

By Elyssa Katz, NHPCO Marketing and Communications Specialist

December 2013

I sat on the footstool. It was nestled so close to the reclining chair that my knees were pushing into the soft, black leather, forcing a dent. Both of my hands cupped his. I was on his right side and had pulled his left arm over his body to feel both of his hands at once. Every few minutes I would interlace my fingers between his and squeeze my fingertips against the back of his hand, but most of the time, his were just resting in mine. I was perched forward, my back unsupported, my elbows leaning on the armrest. My head was hovering over his. I couldn’t get as close as I wanted. His eyes were three-quarters shut and I couldn’t change that, but they were facing mine, and I know he was looking at me. He wasn’t able to do what he wanted to do, but he was looking at me, and sometimes, he would even have these moments when he could see me. That usually happened after I interlaced my fingers between his.

I smiled the whole time. Not my usual big-toothy-happy smile, but a special one, just for this time, right now. I had never used it before, and I was never going to use it again. I smiled the whole time and he smiled sometimes, when he had those moments of being able to see me, because I had interlaced my fingers between his. He was trying to see me the whole time and smile the whole time that type of smile that I was doing, but he wasn’t able to. I saw when he saw me though, and we smiled. His smile wasn’t his usual because he couldn’t form that one, but the corners of his mouth would turn upwards a bit, and his lips would part just enough for me to tell that they were parted.

I didn’t know what he would have said if he had been able to say anything. He had left me a collection of voice memos so that he didn’t have to say anything after he couldn’t say anything. Since he couldn’t say anything, I thought I should say something. I said that I loved him. I didn’t have anything else to say. I interlaced my fingers between his; he saw me for a moment, and I smiled at him, “I love you.”

I sat on that footstool with my knees all smushed and my body perched forward with my back unsupported and my elbows leaning on the armrest for a really long time. We kept doing all those things until he couldn’t do any of those things anymore, and then I kept doing all those things. Except now I kept my fingers interlaced and I kept my smile steady and I kept repeating the same three words without any pauses. I kept doing that until his hands got colder. His hands got colder and colder and then it got a little harder for me to keep them curled within mine and then I couldn’t keep them curled within mine. His hands lay open, and his hands were really cold. I laid the right side of my head against the left side of his chest. I pressed my ear deeper and deeper into the gray cotton of his shirt as I reached down for the cold, stubborn hands, and then I began to cry.

I wrote this passage when I was sixteen, days after I watched my father die in his bedroom at 3:08 a.m. on December 8, 2013. My father, Jerry Paul Katz, battled metastatic colon cancer for six years. I don’t encourage the use of the word “battle” in clinical contexts, but I use it deliberately here.

My parents were honest about his diagnosis, but only as much as was appropriate for an eleven-year-old, and looking back, only as much as would allow them to pretend that everything was, in fact, going to be just fine. My father’s first few years of treatment were characterized by language like “when I beat this thing…”. He said it to me, to his partners at his law firm where he continued to work, to our extended family, and to himself. I believed him as we made plans to take another trip to the go-karts or to get A&W root beer floats.

He was proven right, for a while, but after five years of efficacy, the chemotherapy failed, and even his own belief in his maxim became tenuous. When the experimental trial drug he qualified for proved ineffective, we were left with no curative treatment options. The once meaningful, then hopeful repetition ceased. He came home with the help of hospice for whatever time he had left. That time turned out to be three months, and our care team helped him live these months as well as possible.

Beyond attending to my father’s physical health, hospice gave us the time together that we both needed. My father had repeatedly expressed, above all else, a desire to participate as actively in my life as possible, and in addition to critical pain management, this is exactly what hospice enabled him to do. While he was lucid, hospice meant that when I returned from school each day, I could sit next to him no matter his condition. He loved to quiz me on vocabulary for tests. He loved his blended-up distortion of my Nana’s homemade pecan pie that he ate with the rest of our family on Thanksgiving. Most importantly, though, we both loved that I was there at the end. I came home from a cross country race one Saturday, and upon seeing his decline, sat by his side until I was sure I had gotten every last smile and every last hand squeeze.

It is almost unimaginable for me to now face the fact that it has been ten years since my father’s death. When he was first diagnosed, I was beginning seventh grade at a new school. My personal identity was malleable, so my role as the daughter of a sick man, and later, as the girl with the dead dad, became core to my self-conception.

Years later when I began my first professional role at a hospice organization, I learned about the terms “complicated grief” and “grieving appropriately.” As time passed and my loss wasn’t so heavy, I developed an insatiable desire to know everything about the type of care my dad received, and to help make sure others received it too.

Whether or not clinicians would classify my actions as symptoms of complicated grief or not, they have served me. Ten years later, I am still working in hospice care, this time for an organization that has the honor of supporting and representing hospice and palliative care providers of all kinds from across the nation.

The younger version of my grief would be terrified by the lack of power it has over me now, the way I allow myself to experience joy, and to speak of my memories with ease. I would like to say that I no longer live in fear that I will forget, but I cannot. I can say, however, that despite the fear I face, especially as December rolls around each year, I know that I will not forget. I choose to carry my father’s memory and legacy forward by helping support the critical interdisciplinary care team members that work each day to serve all eligible Americans. That’s the “appropriate” grief response for me.

Leveraging Telehealth to Enhance the Patient and Clinician Experience

dcherry@nhpco.org (NHPCO) — Thu, 7 Dec 2023 13:50:00 -0500

The following guest post is adopted from the blog of CareXM, NHPCO Strategic Partner.

Providing exceptional care to patients while improving the clinician experience can be challenging. Goshen Health, a 3,000-employee Magnet Hospital, proved that through effective experience management, hospice programs can not only survive but even thrive during intensive situations.

Before the emergence of the COVID pandemic, Goshen Health recognized the importance of leveraging technology, restructuring processes, and focusing on its people. This approach successfully saw them through this chaotic period. Their team spearheaded an innovative approach that combined technology, a dedicated triage system, and workforce restructuring to drive positive changes. Here’s a closer look at Goshen Health’s action plan and the results they achieved within the first year:

The Action Plan

People, Processes, and Technology

Goshen Health’s journey to improve the patient and clinician experience began with a holistic approach. They recognized that success would depend on addressing multiple parts of their operations. To achieve this balance, they prioritized three key areas: people, processes, and technology.

People are at the heart of healthcare. Goshen became dedicated to supporting both patients and clinicians throughout this growth process, leaving no one behind.
Processes show who you are. Goshen left no stone unturned, dedicating time to transform their administrative processes throughout every part of their healthcare routines.
Technology transforms quality of care. Goshen elevated their procedures with triage and telehealth which supported, maintained, and engaged the healthcare journey for all.

Restructure Employment

Goshen Health recognized they needed a dedicated workforce committed to their mission of quality care. They undertook a significant restructuring effort and converted part-time employees into salaried full-time equivalents (FTEs). This change created opportunities for staff, but more importantly, it led to clear productivity expectations for everyone. It not only created a stable workforce, but also allowed for greater patient engagement opportunities and accountability efforts overall.

Engage Triage Technology

One of the pivotal steps in Goshen Health’s transformation was their commitment to partnering with a provider offering a care coordination platform with business intelligence for healthcare–CareXM. This collaboration allowed Goshen to streamline after-hours triage and leverage technology to enhance patient care and clinician support. With a robust triage system in place, the hospital staff could focus on proactive case management and improving patient outcomes.

Goshen’s Results

The changes implemented within Goshen Health yielded results within just one year. These outcomes highlighted the success of their strategic approach and the positive impact on both patients and clinicians in many different aspects:

70% Reduction in Overtime Expenses: By optimizing their workforce, Goshen Health reduced overtime expenses. The considerate amount of savings allowed the hospital to invest in other areas that needed support. They were able to hire full-time case managers, as well as dedicated evening and weekend staff that ensured around-the-clock patient support.
Significant Reduction in After-Hours Calls: With a streamlined triage system, Goshen Health experienced a significant decrease in after-hours calls. This allowed for proactive patient management, ensuring that each patient received timely care and support–even over the phone.
Drastic Reduction in Call Times: Goshen found a clinician-backed and solution-based partner for telehealth services. Shorter call times translated to improved patient satisfaction overall as complaints dwindled.
Clinician Peace of Mind: The restructuring efforts and improved triage system provided clinicians with the peace of mind needed to tackle the overwhelming number of patients. Best of all, they could “unplug” and disconnect from work, still confident that their patients were receiving quality care during non-office hours.
Leadership in Employee Engagement: Goshen’s dedication to improving the clinician experience had a profound impact on employee engagement across the board. Their home health and hospice sector set the standard for emotional commitment, inspiring other departments to follow suit and work on behalf of Goshen’s other goals.
Enhanced Documentation and Virtual Mentoring: Accreditation reviewers noted significant improvements in clinician documentation and virtual mentoring.

With the Right Partnership, Providers Can Overcome Any Outcome

Goshen Health’s journey to enhance the patient and clinician experience serves as an inspiring example of what can be achieved through innovation, commitment, and strategic thinking. By focusing on people, processes, technology, and a triage solution, they achieved remarkable results within a short timeframe. This success story underscores the profound impact that a patient-centered approach can have on both clinician and patient satisfaction, ultimately making healthcare a better experience for everyone involved.

Learn more about the CareXM mission to help partners effortlessly anticipate and respond to patient needs with triage technology backed by our on-demand triage team.

The Carters Are Showing Us What Hospice Means

dcherry@nhpco.org (NHPCO) — Tue, 5 Dec 2023 15:33:00 -0500

By Ben Marcantonio, NHPCO COO and Interim CEO

Former President Jimmy Carter and his family are showing us what it means to live fully and meaningfully at the end of life. For more than nine months, the family has generously shared parts of their experience with us, the American public, and by doing so have painted a new picture of hospice care for millions of Americans.

The photos and videos from the Rosalynn Carter memorial celebrations last week are the latest, and perhaps the most potent, examples of the Carters helping to reframe how people think about the end of life. Many people think of hospice care as giving up, or as something that is only available for a few days. The choice for hospice care has grown consistently to the point where today about half of Medicare beneficiaries select hospice for their end-of-life care. Even so, many still speak the word only in a whisper. Last week, we saw with our own eyes that hospice care can help patients achieve their most important goals even when their time to do so is limited. As New York Times reporters Rick Rojas and Jacey Fortin pointed out “Americans Glimpse Jimmy Carter’s Frailty and His Resolve,” it took incredible personal strength and fortitude, as well as the support of his family, for Jimmy Carter to travel and take part in these celebrations of his wife’s incredible life. It also took hospice care, with a team of hospice workers working with and supporting the family to help the patient – who happens to be a former President of the United States – meet his goals for the time he has left. That is exactly what hospices do, and I could not be more grateful to the Carters for showing it to their fellow Americans in real time.

Throughout last week, news apps, television screens, social media feeds, and newspapers brought us images of the oldest former President in American history celebrating the life of former First Lady Rosalynn Carter, his beloved wife of 77 years. First, at a tribute service in Atlanta – more than 150 miles away from the Carters’ home in Plains, GA – and later at the memorial service in Plains.

In some ways, the images were striking. We saw Jimmy Carter looking thin and pale, in a wheelchair, with a blanket covering his legs. His mouth was sometimes open, and his eyes – which have always been so bright – seemed sunken. We are not accustomed to seeing former US Presidents this way.

Yet in other ways, the images are very familiar, even ordinary. Rosalyn Carter famously said, “There are only four kinds of people in the world – those that have been caregivers, those that are caregivers, those who will be caregivers, and those who will need caregivers.” Many of us have personally witnessed – and often provided care for – family members, friends, or neighbors in times of declining health and frailty at the end of life. We have all been part of commemorations celebrating the life of loved ones after death, and we know how important these moments are. The images we saw of Jimmy Carter this week remind us of our own parents, grandparents, and friends.

Jimmy Carter entered hospice care in mid-February of this year and has been receiving care at home, as the majority of American hospice patients do. It’s a fitting next chapter for the President whose administration first tested the hospice model as a national program – a test that led to the Medicare Hospice Benefit available to all Americans today. By publicly sharing the choice for hospice, the Carters sparked a national dialogue surrounding the myths and misconceptions often associated with hospice. Since then, the news about President Carter’s life have helped demonstrate the many benefits of hospice care, which go beyond pain management. In fact, studies show that at any length of stay, hospice benefits patients, family members, and caregivers, including increased satisfaction and quality of life, improved pain control, reduced physical and emotional distress, and reduced prolonged grief and other emotional distress.

In the nearly 300 days since President Carter first elected hospice, the family has continued to share glimpses of the former President’s day-to-day life. We know he has had opportunities to visit and pray with family and friends, and has continued to follow world news, as well as his favorite baseball team, the Atlanta Braves. We know he has enjoyed peanut butter ice cream, one of his favorite treats, and that he and Rosalynn saw Fourth of July fireworks. When President Carter celebrated his 99^th birthday on October 1, we learned that he enjoyed receiving well-wishes from everyday citizens and celebrities alike. We know that Jimmy and Rosalynn spent most of their time together, often sitting in their living room holding hands. Hospice care is designed to support exactly these types of activities and experiences. Hospice care teams work with patients to understand their goals and provide care that enables them to meet those goals to the best of their abilities.

We also know that Rosalynn Carter, a preeminent mental health advocate, was living with dementia. The family made that announcement in May. In mid-November, the family shared the news that Rosalynn Carter had also entered hospice care. She died two days later, at home.

By offering these important details – big and small – the Carters have graciously let the public into their lives. They have sparked untold numbers of conversations across the country about how we each want to live our own lives at the end, about hospice and other care options – what these choices mean, and how they align to our values. In the news, on social media, and at kitchen tables across the country, the Carters’ unfolding story has created opportunities for people to educate themselves and each other, to have courageous conversations with loved ones about their own values and how they would want to live those values if they face serious illness or death, and even to reframe what dying means – it can, and often does, mean ice cream, baseball, fireworks, and quietly holding hands with the people we love.

Adapting Palliative Care to New Models - What's in a Name?

dcherry@nhpco.org (NHPCO) — Thu, 19 Oct 2023 12:28:00 -0400

The following guest post is adopted from the blog of Acclivity Health Solutions, NHPCO Strategic Partner.

Written by: Robin Stawasz, Program Development Executive

When is palliative care not palliative care? How vital is nomenclature? As the healthcare continuum and payment reform evolves, palliative care providers must re-evaluate what constitutes the essence of palliative care and how the care model can best adapt. Without a federal benefit currently defining palliative care, as it does for hospice, there is great variation in care models which causes many disadvantages. However, it also creates opportunities. Providers can hold on to the core of palliative care while specializing the services to best meet the needs of their stakeholders, including their patients, families, partnered providers, and payers.

The Guiding an Improved Dementia Experience (GUIDE) Model from CMMI is one such opportunity. GUIDE is not technically palliative care. But it calls for many of the core services that palliative care provides. Specifically, it calls for meeting the holistic needs of the patient through an interdisciplinary team, providing education and respite for the caregivers, keeping the loci of care in the home, aiding in transitions, being available 24/7, and addressing social, behavioral, and functional needs through community support. Who better than palliative care providers to deliver such services? Given the payment structure, providers will need to adapt to keep services efficient and sustainable, such as adopting technology and data capabilities to manage this population effectively. But it will create continuity of care for this seriously ill population, as well as build the relevance and networking opportunities for provider organizations. Whether palliative care providers enroll in GUIDE directly or through contracts with other GUIDE providers, there is opportunity here to build service lines, diversify revenue streams, and build costumer pipelines. Being able to apply the strengths of palliative care to new care models, no matter how they are labeled, will empower providers to take advantage of new payment models, especially within value-based care. The palliative care field needs to move into innovation, adaptation, specialization, and collaboration. If not palliative care, other providers will move into this space and the opportunity will be lost.

Interpersonal Skills Crucial to Nurse Retention and Cultural Competency

dcherry@nhpco.org (NHPCO) — Tue, 5 Sep 2023 11:39:00 -0400

The following guest post from Enclara Pharmacia is adapted from their recent ebook, Cultivating Care: Prioritizing Hospice Nurse Learning and Development, which is available as a free download on the Enclara website.

Two of the top priorities for hospice providers today are improving nurse retention and advancing health equity. While these are both complicated issues that call for a variety of interventions, there is at least one area where they intersect: interpersonal communication.

Perhaps because nursing is a “caring profession,” we tend to assume interpersonal communication comes naturally to nurses. However, research suggests that nurses are more or less in line with the general public when it comes to overall emotional intelligence, including social skills.

Hospice nurses are well aware that they have room for improvement. In a 2019 survey, 70 percent desired more communication training. Self-perceived deficits in navigating difficult topics with patients and caregivers were associated with stress and burnout, which can in turn increase staff turnover.

Interestingly, two of the communication areas palliative nurses find most difficult are directly related to cultural competency: talking with patients or families from different cultures and responding to spiritual concerns. This suggests that incorporating interpersonal communication training alongside diversity and inclusion initiatives can improve the nurse experience while also reducing disparities in care for minority communities with historically lower hospice participation.

For more insights, download Cultivating Care: Prioritizing Hospice Nurse Learning and Development.

Explore the benefits of nurse education for both quality of care and staff retention
Prioritize subject matter in technical, operational, interpersonal and clinical domains
Leverage resources you may already have available to provide maximum value

Using Data to Manage the Hospice Cap

dcherry@nhpco.org (NHPCO) — Tue, 25 Jul 2023 08:33:00 -0400

Janice Mitchell, Communications Specialist at Axxess

Hospice leaders are responsible for the health and well-being of both their patients and their organization. From a financial perspective, this includes minimizing risk by managing spending and the hospice cap.

Defining the Hospice Cap

The cap is designed to ensure that hospice care does not exceed the cost of conventional medical care at the end of life. The allowable amounts are limited by two things: an annual limit per beneficiary and the number of beneficiaries served. Any amount paid to a hospice for its claims that exceeds the cap is considered an overpayment and must be repaid to Medicare.

The fiscal year 2023 hospice cap amount increased by 3.8% from the prior year. The recommendation from the June 2023 MedPAC report is for Congress to update the Medicare base payment rates by the amount specified in current law with a wage adjustment, in addition to reducing the hospice aggregate cap by 20%.

Minimize the Risk of Overpayment

“I was thinking specifically about the Medicare payment and cap rate, and [these are] some of my favorite hospice solution features that I wish I would have had as an operator to minimize my risk – outside of spiral bound notebooks,” said Christina Andrews, Senior Director of Professional Services at Axxess.

Reports on the topics outlined below can help organizations minimize their risk of overpayment:

Cap Statistics Report: This type of report calculates allowable Medicare payments, estimates how much revenue is under or over the cap, estimates Medicare beneficiaries and provides the total number of Medicare inpatient days and the maximum inpatient days.
Median and Average Length of Stay Reports: These reports generate the median and average length of stay for the specified date range. This information helps organizations determine if there is an opportunity to create a balanced length of stay.
Referral Report: This type of report generates a list of all patients and referrals entered into the system, which also helps balance the length of stay.

How to Balance Length of Stay

Andrews encourages hospice organizations to develop a strategy to balance the average length of stay for their patients. Hospices above the cap admit fewer patients per year and have significantly longer stays and higher discharge rates than hospices below the cap. The following activities can be included in the plan.

Have daily cap calls to report on daily activity toward goals.
Assess community needs on an ongoing basis to grow market share and penetration.
Create a brand and identify key messages to convey based on community needs and how your organization solves them.
Develop marketing and sales strategies based on referral and admission data.
Establish weekly admission goals by referral partner.
Use needs-based selling that highlights the value proposition of the services provided.
Create a diversification strategy to impact the referral mix and stay within national benchmarks.

Using Business Intelligence

Andrews also recommends the use of business intelligence dashboards to create a road map to success. Useful key performance indicators include:

Medicare Beneficiaries
Average Length of Stay
Media Length of Stay
Referrals by Referral Partner
Inpatient Days as a Percentage of Total
Admissions by Benefit Period
Admissions by Primary Diagnosis
Live Discharges by Reason
Benchmark Against Self
Benchmark Against National

“Be very cautious of information overload,” Andrews said. “This is the excess of information available to a person aiming to complete a task or make a choice. Managing cap risk is a daily task driven by strategy and the metrics that matter.”

Axxess Hospice, a cloud-based hospice software, includes tools such as intuitive medication management and real-time plan of care updates as outlined above to help keep organizations compliant.

Disclaimer: Axxess is a 2023 Strategic Partner of NHPCO. All views expressed in this blog are the author’s own and do not represent the view of NHPCO.

Life, Liberty, and the Pursuit of Equitable Access to Healthcare for All

dcherry@nhpco.org (NHPCO) — Mon, 3 Jul 2023 14:18:00 -0400

By Ben Marcantonio

COO and interim CEO of the National Hospice and Palliative Care Organization (NHPCO)

The Fourth of July is a time to celebrate the United States’ independence, but it is also an opportunity to reflect on our nation’s founding principles, and how we can live by those ideals today and into the future. The Declaration of Independence tells us: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” The first sentence of the U.S. Constitution sets out the purpose of that founding document and our purpose as a country: “We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

As I think about our work in hospice and palliative care, and the broader healthcare community, I see our purpose reflected in these founding documents. Providers certainly are foundational to quality of life and the pursuit of happiness. By supporting patients, families, and the community, we are helping form a more perfect union. Delivering equitable access to healthcare for all is an important part of justice.

Last week, the news was dominated by headlines about recent Supreme Court decisions on affirmative action and LGBTQ+ rights. Regardless of whether you think the court made the right or wrong decisions in these cases, we can all recognize that these rulings will affect the everyday lives of people, particularly Black and Hispanic individuals, and members of the LGBTQ+ community. We also know that these decisions have an influence that is broader and deeper than meets the eye.

These court decisions have multi-directional impact because they are connected to healthcare. Every day, in communities across America, there are people who have inequitable access to healthcare. It’s clear that access to care is impacted by factors such as wealth, where people live, and what insurance they have or are lacking. It may be less obvious on the surface, but it is no less true that race, ethnicity, language, gender, sexual orientation, and religion can impact access to and/or delivery of care as well. If you can’t get care in a language you understand, is that full access to care? If treatment of pain is likely to vary based on a patient’s race, is our health system equitable? If our Hispanic and Latino neighbors know less about hospice than their Black or White counterparts, as shown in a recent report, can we say we are delivering on the promise of equal access? These issues are often compounded by lack of trust and dedicating the time it takes to build rapport and meaningful relationships. The Hospice through the DEI Lens report shows that nearly 1/3 of LGBTQ+ respondents either doubt or are unsure that hospice care providers would respect their sexuality. With that level of doubt, LGBTQ+ people are less likely to access care. Decades of mistreatment of African American/Black and Native American communities by the medical establishment has led to mistrust of doctors and health facilities, creating significant barriers to access for many Americans today.

As a longtime hospice provider, and now a champion for hospices across the country, I am proud of the many ways in which our members have been at the forefront of making care accessible to more people. One of the most prominent examples is the way that hospices stepped up during the AIDS crisis to care for patients who were largely ignored by the rest of the health system. Today, we have incredible and inspiring examples of hospices reaching people where they are. There are hospices in prisons, with care provided by prisoners. There are hospices delivering care to people who are unhoused. There are hospices established recently with the express goal of reaching underserved communities, in both rural and urban settings, as well as hospices focused on connecting with African American and Black communities. Let’s take that further. Our charge to support equitable and accessible care for ALL at the end of life, includes caring for those who are on the unpredictable and often precarious trajectory of serious illness and co-morbid conditions.

This imperative and unwavering commitment to equity and justice is foundational to our country and to the hospice movement and should be our guide to creating a better future for all. But equity does not exist in a vacuum. It is found through embracing diversity of thought, words, and actions as well as a curiosity for learning with an open mind. As our nation continues to wrestle with inequities that prevent certain groups of people from pursing life, liberty, and happiness, we can strive for an even more perfect union to become a part of the solution. I believe the hospice and palliative care community has an important role to play. It’s our job to meet people where they are, to provide the care they need at the right time and in the right manner. Our job as healthcare providers is to recognize and celebrate the differences that make each person unique, and to deliver care that meets their individual needs. I’m proud to be part of this community; I’m proud of NHPCO’s work to support hospices in advancing equity and providing inclusive care; I’m proud that the hospice movement is helping advance freedom and justice. As we look to the future of our country and of the hospice movement, we must remain committed to freedom, justice, and equality for all.

Note: NHPCO offers a wealth of hospice and palliative care access and inclusion resources at www.nhpco.org/diversity

Hospice Action Week 2023: Advocates Unite on Capitol Hill

dcherry@nhpco.org (NHPCO) — Thu, 29 Jun 2023 11:04:00 -0400

On Wednesday, June 7 hospice and palliative care advocates from across the nation made a difference and presented a united voice in Washington, DC.

As a part of the annual Hospice Action Hill Day, over 70 NHPCO and HAN advocates gathered to make legislative visits on Capitol Hill in support of key policy priorities impacting hospices of all shapes and sizes. This was the first completely in-person Hospice Action Hill Day since 2020. Participants were excited to come together and have face-to-face congressional meetings for the first time in years.

Participants included members of the board of directors for both organizations, state leaders, MyHospice Ambassadors, and grassroots advocates. There were representatives from every piece of the hospice and palliative care system, from CEOs to clinicians and nurses, from administrators to volunteers. NHPCO and HAN staff also joined groups of advocates for meetings, including five NHPCO summer interns. Advocates’ previous experience on the Hill ranged from decades of visits to the Capitol to this event being their first-ever opportunity to meet with legislators.

Over 130 Congressional offices in the House and Senate took time to speak with advocates representing providers, patients, and families from more than half the total states in the US.

Advocates spoke with legislative offices about five key policy issues: community-based palliative care, program integrity, payment policy, the future of the hospice workforce, and the results of the recent NORC study on annual hospice cost savings to Medicare. Through a series of trainings and resources, advocates were introduced to recent developments on these issues and key asks for legislators.

One key ask was for legislators to support the Expanding Access to Palliative Cart Act (S. 1845), which was introduced on June 7 during Hospice Action Hill Day. This bill would authorize the Centers for Medicare & Medicaid Services (CMS) to test a demonstration model of providing palliative care to Medicare beneficiaries outside of the hospice benefit and in community settings. On the workforce front, legislative offices were also asked to support the Palliative Care and Hospice Education and Training Act (PCHETA), which is expected to be reintroduced before the end of June.

On program integrity asks, advocates informed legislative offices of NHPCO and partners’ 34 recommendations to CMS, and that a bipartisan sign-on letter to CMS on the issue from Representatives Earl Blumenauer (OR) and Beth Van Duyne (TX) would soon be circulating.

Advocates have shared that legislative offices were engaged with policy issues and asks, expressing enthusiasm for the latest NORC research, interest in exploring paths forward for workforce and program integrity issues, and in expanding access to palliative care. Offices also reportedly expressed interest in being involved in the We Honor Veterans program.

At the pre-Hill Day training on June 6, Hill staffer Sarah Gilbert of Representative Neal Dunn’s office (R-FL) stopped by for a conversation about what advocates could expect when meeting with a Congressional office.

The training also included recognition for leaders and advocates who made a special difference in the last year for hospice and palliative care.

The 2022 Hospice Angel Awards for members of Congress were shared. Advocates meeting with some offices the following day were able to personally deliver these awards. Honorees who met with advocates during the Hospice Action Hill Day included Senator Shelley Capito (R-WV) and Congressman Joe Morelle (D-NY).

Winners of the 2022 MyHospice Ambassador Awards were also formally announced at the pre-Hill Day event. MyHospice Ambassadors is an advocacy program for those who are particularly committed to advancing hospice and palliative care through their demonstrated passion, dedication, and leadership. These award winners stood out through their efforts in the previous year:

Rookie of the Year: Angela LaBarca, Business Development Specialist with Caring Circle Hospice, Michigan
Impactful Voice: Sandy Kuhlman, Executive Director of Hospice Services of Northwest Kansas, Inc., Kansas
Ambassador of the Year: Demetress Harrell, CEO of Hospice in the Pines, Texas

The event also briefly recognized Mackenzie Daniek, co-director of Providence Hospice in Seattle and first-time Hospice Action Hill Day attendee. Daniek co-wrote an impactful op-ed on hospice care in the Seattle Times this past April, and organizers wanted to recognize the piece as an ideal example of advocates effectively raising the profile of hospice and palliative care issues.

Overall, the Hospice Action Hill Day and the training that preceded it have already proven to be a seminal moment in NHPCO and HAN advocacy for 2023. With the start of a new Congress and the resolution of outstanding issues like the debt ceiling, it was vital for hospice and palliative care advocates to come together and raise a collective voice for the cause. After years of being separate-but-together, an in-person advocacy event provided opportunities for renewed energy among advocates from across the country.

Learn more about how YOU can be part of changing hospice care policy for the better by signing up with the Hospice Action Network today!

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How Death Doulas Help Those Who Have Decided to Use Medical Aid in Dying

dcherry@nhpco.org (NHPCO) — Wed, 31 May 2023 08:52:00 -0400

Arlene Radasky | 25-Year Hospice Volunteer and Certified Death Doula/Death Midwife

Disclaimer: All views expressed in this blog are the author’s own and do not represent the view of NHPCO or affiliated organizations.

Virginia grew up on a small farm and was fiercely independent. She worked extremely hard, juggling two jobs to raise her sons after her beloved young husband passed from a heart attack. The youngest of her two sons had an intellectual disability and required much of Virginia’s spare time.

As the boys grew into men, her youngest son, wanting independence for himself, chose to live in a group home. Her eldest son became a dentist and moved across the country.

As Virginia approached 68, she was diagnosed with myositis after several, injury-causing falls. Following two years of treatment, she could not live independently anymore. Additionally, her eldest son had a stroke and was living in a brain injury facility.

Virginia was on Medicaid and was moved to a nursing facility that had a bed available. She eventually declined to the point that she and her doctor decided hospice was the right next step for her wishes.

She chose a local hospice, was evaluated and accepted, and her care team began caring for her. The hospice death doula volunteer on the team, Mary, made her first visit with Virginia to get to know her. Mary visited once a week for one hour, during which time Virginia became very comfortable with her.

At her visits, Mary helped Virginia fine tune her advance directives, talked about vigils, and planned what Virginia would like to have at hers. Mary also discussed the different options for burials or cremations after Virginia’s death and when Virginia decided on one, Mary made sure it was noted in her advance directives. The hospice team was notified and given copies of the edited advance directives, and Mary made sure a POLST was also completed.

In their many conversations, Mary learned details that Virginia had not felt comfortable talking to the doctor and nurses about. Mary made note of these concerns, such as a suspected bladder infection, in her weekly reports and team meetings. If needed, the subjects were discussed between Mary’s medical team, counselors, and Virginia in more detail.

Virginia continued living in the facility for eight months while she was under hospice care. Her falling risk was high during the last six months of her stay there and she was not let out of bed without supervision. These restrictions cause some toilet accidents that were mortifying to Virginia. Swallowing became more difficult, and the facility tried to compensate by changing her diet, making sure everything was cut into bite-sized pieces and eventually, blending some meals.

At the six month point of Virginia’s hospice care, she began asking about medical aid in dying (MAID). Mary made note of her questions and told Virginia’s team about their conversations. Virginia’s hospice counselor talked to her and together, they made the decision to start the process for Virginia so she would be able to use the option if she wanted to. Virginia asked Mary to transport her and attend the required appointments.

Virginia received the prescription and was told at that time by the facility she was in that she could not be a resident there when she decided to use the option. Virginia became anxious and despondent.

Mary reported this to the hospice team and asked if the hospice facility allowed the option. It did not, and neither did another facility in town. The only option left was to find a bed in a private home.

Mary asked Virginia about her friends with homes who lived nearby. There were very few, but Virginia and Mary contacted one who, after talking to Virginia on the phone, asked to meet with her. Mary picked up her friend, Theresa, and took her to meet with Virginia. They talked for an hour about the past, Virginia’s disease, and her decision. Mary then took Theresa home. One week later, she called Virginia and said she had an extra room where she could come stay for a while.

Mary told the hospice team a bed had been found. Together, Mary and a hospice nurse went to visit Theresa and look at the room. It was found appropriate, and a hospital bed was ordered for Virginia to be able to be in.

Mary was with Virginia during her transport to Theresa’s home and was able to make her comfortable, reporting back to the hospice team that Virginia was laughing with Theresa when she left.

Mary continued her weekly visits with Virginia, who had been on a liquid diet for two weeks when she said she was done and wanted to take the medicine. Mary discussed this decision with Theresa and with her hospice team, and the date Virginia had requested was assigned.

On the day Virginia chose, Mary arrived early so Virginia’s requested vigil space could be set up. A small fountain bubbled in the corner of the room. Virginia was changed into her requested night gown and made comfortable. Large scarves were draped around the windows to create a softer atmosphere, and over Virginia as she lay in the bed. Virginia’s chosen music was playing on Mary’s phone lying next to Virginia. Theresa came in to say goodbye but said she could not stay in the room while Virginia was dying. Mary said she would come tell her when it was over.

The nurse came and helped Virginia mix the medication with her choice of fruit juice. Virginia drank it when it was time. Mary sat next to Virginia, holding her hand at Virginia’s request the entire time.

Virginia continued breathing for longer than expected and the nurse left to attend to other patients while Mary stayed with Virginia during her vigil. After Virginia’s last breath, Mary called the hospice, reported that she needed a nurse to come to declare death, and went to tell Theresa that Virginia had died.

Mary sat with Theresa until Virginia’s body was removed. Mary made one more visit with Theresa a week later to talk about her grief, and to let her know about grief resources in the community.

Mary, the volunteer Death Doula, added many hours of compassionate discussion and attending to personal details for Virginia while she was a hospice patient.

A Conversation with Dr. Aditi Nerurkar, Leading Stress and Resilience Expert

dcherry@nhpco.org (NHPCO) — Wed, 17 May 2023 10:29:00 -0400

Dr. Aditi Nerurkar, MD, MPH

Dr. Aditi Nerurkar is a Harvard physician, Forbes contributor, and an NBC News medical commentator. Her expertise is in the science of stress, resilience, and burnout. She offers insights in optimizing mental health, wellbeing, and productivity during the Covid-19 pandemic and beyond.

Dr. Nerurkar is on faculty at Harvard Medical School in the Division of Global Health & Social Medicine and serves as the Co-Director of the Harvard Clinical Clerkship in Community Engagement. Prior, she worked in global public health in Geneva, Switzerland with a World Health Organization collaborating center.

NHPCO had the opportunity to sit down with Dr. Nerurkar and ask her a few questions about leading high-quality programs in the healthcare sector, and her lessons learned over the years. NHPCO questions are italicized for clarity.

How will we know when the pandemic is over? Will we know when we have reached the “new normal?”

We are officially in the post-pandemic era from the policy perspective. On May 5, the World Health Organization (WHO) declared the end of the global health emergency but still said that COVID continues to be a global health threat. We are at present entering the new normal. That doesn’t mean that people won’t continue to get COVID or to be hospitalized and potentially die from the infection, it simply means we don’t have the policy guardrails, funding, and coordination we once did when it was considered a global health emergency. There are many downstream implications of this, many of which we cannot understand or begin to perceive now.

Why should hospice and palliative care teams enhance their focus on burnout and mental health? Where should they begin?

Every industry should be focused on mental health at this time because we are seeing unprecedented levels of mental health issues among employees across sectors. We’ve endured a major global event with broad ramifications on mental health, stress, and burnout. Particularly for those in the healthcare sector, this is especially marked. Prior to the pandemic, we were already noticing a rise in burnout among healthcare staff.

However, the pandemic exponentially accelerated this rise. We now have an epidemic of burnout among healthcare workers. We need to heal the healers

There are so many ways to begin to focus on protecting healthcare workers mental health and burnout. The first is to remove the burden of responsibility off the individual healthcare workers. This is a system-wide issue that needs systemic solutions. Broader institutional approaches to protect burnout must be instated. The American Medical Association has a wide array of resources and data on how to do this within an institution.

At the same time, we can support our healthcare workers by normalizing and validating this experience for them. Data shows that 60-72% of healthcare workers have at least one feature of burnout. We must do more to aid in burnout recovery for these individuals, who are now the majority.

You note that the pandemic has created an “occupational health crisis.” What does that mean?

We refer to the pandemic as a public health crisis, which it has been. But it’s also been an occupational health crisis and a mental health crisis. Mental health has been the shadow pandemic. We’ve seen an unprecedented rise in stress and burnout during the pandemic as well as a rise in stress-related conditions like anxiety, depression, and insomnia. The focus on recovery should include both individual and institutional factors. We must help individual healthcare workers recover from their burnout, but we also must focus on systemic solutions to help create more sustainable working conditions and an environment that supports the mental health needs of the individual workers. When an organization’s culture and an employee’s experience can align, that’s when mental health is optimized.

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If you’re interested in learning more from Dr. Nerurkar, she was a keynote speaker at the NHPCO 2023 Virtual Interdisciplinary Conference. Her session recording, The Reentry Phenomenon: A Blueprint to Navigate the New Normal, is now available in the conference portal for attendees. If you are not yet registered for the conference, register now and access the recording along with an extensive on-demand content library offering 22+ hours of CE/CME-eligible education.

NHPCO members can also find more resources on the end of the PHE through the NHPCO Regulatory and Policy Alerts webpage, under Updates and Alerts and titled “Final CMS Guidance for the Expiration of the COVID-19 Public Health Emergency (5/2/23).”

A Conversation with Dr. Ted James of Harvard Healthcare System

dcherry@nhpco.org (NHPCO) — Thu, 4 May 2023 10:04:00 -0400

NHPCO had the opportunity to sit down with Dr. James and ask him a few questions about leading high-quality programs in the healthcare sector.

Ted James, MD, MHCM, FACS
Medical Director and Vice Chair, Beth Israel Deaconess Medical Center
Associate Professor of Surgery, Harvard Medical School

Dr. Ted James is a medical director and lecturer within the Harvard Healthcare System with extensive experience in efforts to advance healthcare. He leads international programs focused on digital health, clinician engagement, and patient experience, and collaborates with healthcare executives and industry experts from around the world.

He is an author who writes about the trends shaping the future of medicine and strategies for transforming the healthcare ecosystem. Dr. James has received numerous awards for his contributions to teaching, leadership, and quality. One of his greatest professional satisfactions comes from partnering with others to reimagine healthcare in ways that improve organizational performance and the wellbeing of patients, care teams, and communities.

NHPCO had the opportunity to sit down with Dr. James and ask him a few questions about leading high-quality programs in the healthcare sector, and his lessons learned over the years. NHPCO questions are italicized for clarity.

Why should hospice and palliative care teams enhance their focus on quality?

Focusing on quality improves patient outcomes and enhances the patient and family experience, which results in greater confidence in the care team. These have been shown to improve pain and symptom management. Essentially, the quality focus improves the patient's overall quality of life. Quality also leads to more efficient and less costly care, which is critical in the era of value-based care. Lastly, focusing on quality is a source of professional satisfaction

Where should hospice and palliative care teams begin in their quality improvement process? What does an organization focused on quality look like?

Start with a comprehensive assessment of current performance and then identify areas for improvement. This should be a leadership-supported, team-based approach with measurable goals and action plans to address identified gaps in care. Regular monitoring and measurement of outcomes with a constructive, not punitive, focus should be done to track progress and make necessary adjustments. The organization should be focused on continuous quality improvement, always seeking to elevate the next level.

What advice do you have for hospice and palliative care teams focusing on clinical innovation and leadership development?

Embrace change. Foster a culture where change is welcomed and seen as necessary to meet the future needs of patients. Leaders should promote psychological safety where people feel safe to ask questions, admit mistakes, challenge norms, and provide new ideas. Create venues for brainstorming and collaboration. Having opportunities for individual growth and professional development are also critical. Finally, realize that we can all be leaders and take ownership in making things better.

How can hospice and palliative care teams overcome resistance to new ideas?

People are not so much resistant to change as they are resistant to uncertainty. Conveying the "why" behind change, the purpose, can be a powerful way to motivate others. Involving people in the change process is also crucial to getting by in and overcoming resistance to new ideas.

What are some organizational best practices to encourage leadership at every level?

One of the best ways to foster leadership is simply to provide leadership opportunities. Make sure people have opportunities to initiate and lead projects. Seek out people who show potential and give them a chance to shine. Make certain to encourage autonomy and ownership; nothing will stifle leadership development like micromanagement. It also helps to recognize and reward good leadership.

How do you become a high-performing team? How do you know if you are a high-performing team?

High-performing teams need open communication, shared goals, structured processes, and, most importantly, mutual respect and mutual support. Great teams also have high expectations for the team and for individual members. They regularly evaluate their performance, deal with conflicts effectively, and celebrate wins collectively.

What advice can you share on how to enact transformation at different scales (i.e., system/organization-wide versus departmental)?

It requires tailoring the approach to the specific context. Organization-wide transformation needs centralized leadership, extensive strategic planning, and strong communication channels. Departmental transformation needs engaged champions who can spearhead targeted interventions. Well performed departmental initiatives that align to the goals of the organization will often scale to system wide. programs.

What are some steps hospice and palliative care leaders can take to develop leaders at all levels of an organization? What mistakes are healthcare leaders currently making when it comes to leadership development?

Mistakes in leadership development include neglecting to offer adequate resources and support, not recognizing and rewarding leadership behaviors, and not promoting a culture of inclusivity and diversity.

What are some tips that care team members can use to center their focus on the greatest priority of healthcare (and often, the reason for their connection to their work) – the patient?

Prioritize meeting the needs of our patients. We can understand their needs by actively listening to patients and families. Other key approaches are to communicate with empathy, strive to meet patient's physical, emotional, cultural and spiritual needs, convey respect, and empower patients through education and shared decision-making.

What’s the best piece of advice you’ve ever received?

That's a difficult one. I've received good advice from many mentors over the years. I think we should all view patient care as a calling. Also, we should remain curious and never stop learning. Healthcare is constantly evolving and being open to new ideas is essential for quality improvement.

What are some leaders doing that other leaders should be doing?

Leaders should think about how healthcare can innovate to improve the patient experience, including leveraging technology to improve care coordination and patient outcomes. We've seen great advances in other industries that are meeting user needs through technology and innovation. By embracing change and learning lessons from outside healthcare, leaders can drive positive changes.

Are there any other questions that we should have asked you that you’d like to ask and answer yourself?

Clinical teams are under a great deal of stress. Burnout is a serious threat. We should be asking how to use the power of teams and teamwork to support and revitalize the clinical workforce. Leaders and individual team members can take steps to promote mutual support, psychological safety, and a sense of inclusiveness and belonging that helps to address these challenges and allows teams to thrive.

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If you’re interested in hearing more from Dr. James, he was a keynote speaker at the NHPCO 2023 Virtual Interdisciplinary Conference. His session recording, Revitalizing Your Healthcare Teams Through Action-Based Leadership, is available in the conference portal until May 24. Attendees can watch and re-watch the presentation to glean takeaways for them and their teams.

Patient Safety Awareness Week March 2023

dcherry@nhpco.org (NHPCO) — Fri, 17 Mar 2023 16:00:00 -0400

Why Safety?

By Aparna Gupta, DNP, FACHE, CPHQ, CRNP

Safety in healthcare is a cure-all – yet how many of us put safety front and center? From wearing seat belts, to washing hands, to crossing the street, the mechanism of safety is (mostly) well entrenched in all of us. Yet when it comes to identifying safety risks, reporting adverse events, or keeping patients and clinicians safe, we are prone to miss the point. The Institute of Medicine has established six domains of healthcare quality – safe, effective, patient centered, timely, efficient, and equitable care .

The first domain is safety. Delivering safe care means that adequate assessments have been done in a consistent, efficient, and equitable manner and that the right patient is receiving care in the right way, at the right time. Which also means that medical waste (unnecessary intervention) is avoided and patient outcomes including the experience of care are optimized. In other words, we accomplish the triple aim – maximize the patient experience of care, quality, reduce cost and enhance outcomes.

But wait, there’s more. What about clinician safety? Our interdisciplinary team members that are in the patients’ homes are exposed to a plethora of risk, the most recent being demonstrated during the COVID pandemic. While these are unsung superheroes, we need to focus on the safety of our staff. Not only physical safety, but psychological safety as well. As much as we need to ensure our staff are protected and feel safe to report any security incidents for their selves, we also need to ensure that the organization nurtures a just culture, whereby staff can “say something” when they “see something”.

It is well known that organizations that focus on a just culture see higher rates of “near miss” reporting – events that could have harmed the patient but didn’t reach the patient just yet. When these organizations make it safe and non-punitive for staff to report near misses, we see better workflows, higher standards of care and better communication between the interdisciplinary team (IDT).

Communication plays a big role in ensuring safety both for staff and patients. When the IDT talks to each other and shares important information at the right time and in the right way, the coordination of care reaches a new horizon. Safety tools like SBAR become the language that keeps care focused on the patient and the family.

As we celebrate Patient Safety Awareness Week, I cannot help but think of James Reasons Swiss Cheese Model (BMC Health Serv Res. 2005; 5: 71.) which explains how complex functions like taking care of a human being can be simplified when the whole team gets a say, has input, and works together to put patients’ safety first. Let’s keep our patients, our communities and ourselves safe by working together, trusting each other, and leaning on one another. Happy Patient Safety Awareness Week 2023!

About the author:

Aparna Gupta is the Vice President of Quality with National Hospice and Palliative Care Organization. Aparna is a board-certified adult nurse practitioner and has served in various roles ranging from executive leadership, operations, and clinical care delivery across healthcare. She holds a national certification in healthcare quality and is a Fellow with the American College of Healthcare Executives.

To learn more from NHPCO about improving your organization's quality and safety, register for the upcoming 2023 Virtual Interdisciplinary Conference.

A Letter to Grief - Part Two

dcherry@nhpco.org (NHPCO) — Mon, 12 Dec 2022 09:16:00 -0500

By Emily Marge, MPS, NHPCO Veterans Services Specialist

Last year, I ventured into sharing my experience with my uncle's death due to suicide. I wrote my first NHPCO Updater blog post five months after his passing. I was afraid to be vulnerable but hoped that sharing my feelings might help me. The experience allowed me to be comfortable sharing something personal while examining how my professional life intertwines with my grief. The anniversary of his transition into the afterlife was in August. Our family laid him to rest in the National Veterans Cemetery in New York where he always wanted to be, alongside his fellow sisters and brothers who served. To this day, I can hear the echo of “Taps” playing at his funeral and think of him when I feel the stitches on the folded flag in his honor. The death of my uncle is a moment in my life which will forever be part of me, but it does not define me.

I know I'm not alone as someone who experienced grief from the passing of a loved one due to delayed internments, travel plans, and mandates from the pandemic. I suspect some of you have experienced this in your personal or professional life. If you have, know that you are not alone. While painful, grief can also bring us peace, but it can take years for us to accept that—I know I have yet to. However, I hope one day to be comfortable again around Veterans, who so often remind me of my uncle, without fear of emotions rising up like a tidal wave. Instead, I want to ride the wave with balance; even if I fall a few times, I will get back up again.

Many in the hospice community including patients, caregivers, staff, and family members, experience these waves of grief, getting back up only to soon be knocked down again by the next wave. When I find myself trying to get up—reaching for air—I work to remember positive moments and realize my uncle’s impact on this world. He may not have had children or married his sweetheart, but he created communities that still benefit from his actions today, even if they do not know his name. His legacy lives on not just through the work he did for fellow Veterans and friends, helping them back up when they got knocked down, but also through my sister and me. We both strive to honor his legacy by continuing to give back; even if we can impact just one person, we never know if or how the resulting ripple effect may touch others. This is how I will get back up from the wave that crashes down on the not-so-good days, knowing that I'm continuing his legacy of kindness.

If you’re looking for additional support, I recommend checking out the information on bereavement care offered by CaringInfo.org, a program of NHPCO. You might also check out NHPCO’s Facebook, Twitter, and LinkedIn pages for an ongoing conversation about TV series, podcasts, books, and movies that may help you talk about death and grief more openly in tandem with professional support. NHPCO has shared a variety of lists on death-or-grief related resources to consider engaging with, and our community members have left many more in the comments that have helped them and their loved ones.

If you’d like to take action to advance the crucial, ongoing work of bereavement care providers, and expand access to grief support across the nation, urge your Member of Congress to support the Grief Resilience Investment and Education Fund Act. I’ve done so and encourage you to do the same.

I want to be kind to myself and honor all forms of the word grief this holiday season. I hope you’ll join me.

dcherry@nhpco.org (NHPCO) — Wed, 19 Oct 2022 10:14:00 -0400

How Doulas Help Hospices Meet Their Mission

By Beth A. Eck, PhD

In June of 2019, I began my quest to become a hospice death doula volunteer. For those who may not be familiar, an end-of-life doula guides individuals transitioning to death and their loved ones through the dying process. After a heady turn of events, I recently completed my first year as the Director of End-of-Life Doula Services for Hospice of the Piedmont in Charlottesville, Virginia. I am a practicing doula for hospice and palliative patients, but in my unanticipated “encore career,” I also train and supervise new hospice doulas, communicate with the interdisciplinary team (IDT), and run consultation groups. My job is a full-time, salaried position; I’ll share a little about that journey below, but more importantly, offer practical steps for hospice agencies to incorporate the end-of-life doula role.

After I returned from my first end-of-life (EOL) doula training in May of 2019, I knocked on the door of my non-profit hospice where I had been volunteering for the previous six months. I asked the volunteer department for supervisory hours (required for the training organization’s certification process) and was told they would need to know more about doulas and what I was requesting. I wrote up a five-page single-spaced proposal replete with footnotes—the occupational hazard of an academic. I covered the support a doula offers; I stated why the work did not require a particular degree or professional background; I offered how doulas offer complementary supports and not duplicative ones (i.e., they did not take the place of social workers or volunteers), and I argued that exploring the proposition was mutually beneficial—I would find out if I was suited to doula work, and they could find out if it was the kind of discipline they wanted to invest in. Because the number of doula training organizations seemed to be proliferating, I knew doulas were becoming more mainstream, and I argued that our hospice could be a leader in working with doulas rather than dismissing their potential impact. I knew I would not be the last to knock on the door.

Bureaucracy is bureaucracy and so the process was not as straightforward as I assumed, but after many internal discussions, my proposal made it up the chain of command for approval. Even so, there was an overriding concern about structure. To have a doula, even a volunteer one, seemed to require some rethinking of the organizational chart as well as a clear delineation between existing volunteers and doula volunteers.

If doulas are volunteers, will all patients have equal access to their services? If we have many doulas, who will supervise them? What if we train them and they decide not to volunteer for us and are privately hired by families instead? What if patients don’t want ‘just’ a volunteer anymore and only want doulas? These are legitimate concerns, and the answer for your organization may be different than it was for mine. Instituting an in-house doula program, or incorporating trained doulas into your fold, is not without its hiccups, but my organization and I would argue that it is well worth the effort.

If you are not ready to hire a Director of End-of-Life Doula Services or have an in-house training program, I want to share what I have learned about how a doula can gain legitimacy within hospice teams and bring value to the organization. Some of these suggestions assume the doulas have a flexible schedule. If they do not, it will require some creative substitutes.

1. Embed your doulas within an interdisciplinary team. During the orientation period, they can introduce themselves and learn faces, names, and roles without a patient assignment, and can comment on cases where a doula would be helpful.

2. Arrange for the doulas to shadow team members. This is something a typical volunteer does not do. Shadowing a social worker and chaplain is likely enough, and these disciplines are good choices because doulas will work closely with them while supporting the patient. The “ride-along” will provide an opportunity to dispel concerns about overlapping roles and help to build bridges.

3. Discuss and decide on patients for the doulas to serve. Generally, patients who make a good fit are those who are interested in doing life review or legacy work, practical planning, or storytelling. They are patients who wish to plan their own active dying period and/or would like more presence at their bedside. They are also patients whose families welcome this kind of support.

Another barrier hospices may face when first integrating doulas into their programs is that doulas generally work with only one to two patients at a time to ensure those patients and their loved ones have the best experience possible. Doula work is intimate; they can spend hours with patients at any given visit, prohibiting a large caseload. From an administrative viewpoint, this may not sound good. Why is it worth having doulas if they cannot see very many patients?

· Medicare regulations can make it difficult for dedicated clinical care team members to spend the amount of time they would like with patients; doulas can fill in that space, deepening relationships.

· Because of this relationship, doulas help hospices achieve the desired continuity of care. We are with patients through each transition in their death journey.

· Hospices are evaluated on their ability to provide a good patient care experience. Doulas are a bridge to comprehensive team communication as they fill in gaps about patients and their families. Their ability to spend long periods of time with patients means they can provide an intensive layer of emotional support.

· An in-house doula program need not cost much. Thus far, our program is staffed by volunteers, and we offer the training for free. All costs associated with the doula program are covered by philanthropic dollars. There is some cost to market the program, but death doulas may present a very attractive donor opportunity. If you bring on board doulas trained outside your organization, they need only be trained as volunteers by your hospice to participate.

Having doulas work with your hospice is a win-win, though the road to victory is not necessarily easy. You cannot anticipate every question, scenario, or challenge, and it will take patience to make it work. Hospices were the first iteration of the “death positive movement.” Doulas are the newest. Let’s work together to make sure everyone has their good death.

Beth A. Eck, PhD, is a practicing death doula and the Director of End-of-Life Doula Services at Hospice of the Piedmont (HOP) in Charlottesville, Virginia. Beth started at HOP on August 1, 2021, where she was hired to develop an in-house death doula training program. Beth did her own training with the International End-of-Life Doula Association and Going with Grace. She is National End-of-Life Doula Alliance (NEDA) proficient and a member of the NHPCO’s End-of-Life Doula Council. She earned her PhD in 1996 from the University of Virginia and is an Emeritus Professor of Sociology at James Madison University where she taught for 25 years, most recently in the area of death and dying.

NHPCO’s End-of-Life Doula Council promotes awareness and understanding of the end-of-life doula role. The council is currently seeking feedback on the role of end-of-life doulas in hospice; share your perspective now. To learn more about end-of-life doulas, register for the 2022 Virtual Interdisciplinary Conference to access the on-demand content library through December 31, 2022 and view the session: “Workforce Shortage is REAL…Doulas Offer Real Options.”

Three Things You Can Expect After Integrating Empathy into Your Communication

dcherry@nhpco.org (NHPCO) — Thu, 29 Sep 2022 07:59:00 -0400

By Erin Whalen

Empathy is a buzzword these days. It seems to be everywhere from publications such as Forbes and The New York Times to countless LinkedIn articles mentioning empathy’s power and effectiveness.

But in the real world--in the hard work you do helping people die with dignity — is empathy something that fits? And at what cost? What makes it worth the effort? In other words, what’s in it for you?

Empathy does have power; it can help ease your day, as well as those of your patients’ and their loved ones. It’s a shortcut to connection, and if people feel connected to you, they are more likely to listen to your recommendations and trust you as the expert on the death process.

Before we dive into the three things you can expect after integrating empathy into your communication, let’s first define empathy. The research team at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia provides the following definition of empathy: “a predominantly cognitive — as opposed to affective or emotional — attribute that involves an understanding — as opposed to feeling — of patients’ concerns, combined with a capacity to communicate this understanding and an intention to help by preventing or alleviating pain and suffering.” Simplified, empathy is the ability to understand another’s perspective and communicate this understanding with the intention of alleviating suffering.

1. Empathy will save you time.

If empathy requires extra work on your part--recognizing and expressing how others feel--how can it possibly save you time?

For one thing, empathy helps someone feel seen and heard. Have you ever been in a conversation where a person kept bringing up the same point, or returning to the same part of the story and couldn’t seem to move on from it? It’s possible that their behavior was driven by their desire to feel seen or heard. As humans, one of our strongest wants is to be understood. If someone feels understood because you have empathized with them, they won’t harp on the same point. They will relax, knowing that you “get it.” On the other hand, not empathizing can lead to the broken record phenomenon we all want to avoid.

Empathy is also a shortcut to the heart of the matter. When you are working with those who are dying and their loved ones, sometimes empathy can get people to a sense of understanding and peace much sooner by helping to gently reveal the essence of a person’s situation or story. For example, knowing the end is near, a son might be incredibly afraid of watching his mom die. He might show this fear by asking many questions, wringing his hands, and shaking his head as he hears your answers. By gently and compassionately providing some empathy, you can take the edge off his fear and help him work towards next steps. Something like this might do the trick: “Listen, I know this isn’t easy to hear. You love your mom so much. You’re afraid of watching her die, and you might even feel some guilt about being afraid in the first place. I’m here for you, and I am happy to answer any questions you have.” This can help ease his mind a little and he will be more open to continuing the conversation.

2. Empathy will form stronger connections.

When you empathize with another person and really see where they are coming from, your connection will naturally deepen. Connection leads to trust. People who trust their medical providers are more likely to be compliant.

Imagine that your patient’s daughter is in denial about her dad’s need to be on hospice and she also insists he shouldn’t be given pain killers, fearing that he will become addicted. You have the medical knowledge and experience to recognize that her worries are not cause for concern, but you just can't seem to convince her of that.

Empathizing with the daughter by naming her emotions and sharing that you want to alleviate her father’s suffering can help her trust you more. You might try something like this: “You’ve had a lifetime with your dad, and you know him best. You’re worried about his tendency towards addiction, and you’re very hesitant about morphine.” (Pro tip: pausing at this point and allowing her to react is one of the most empathetic things you can do). After hearing more of her perspective, you can proceed with additional empathy and a permission statement: “I can see how much you love your dad and want what’s best for him. In my professional opinion, morphine will actually help not harm him at this point. Would you like to hear more about my thinking?”

Empathy creates the opportunity for a dialogue to occur and for common ground to be found. You both want what’s best for the patient, her father, but it may take a bit of empathetic conversation to get there. Once you do, however, it will not be time wasted. When she trusts you, she will be more willing to listen to your expertise and follow the plan.

3. Empathy can help your days be filled with less stress and more fulfillment.

Dr. Dan Siegel, a clinical professor of psychiatry at UCLA’s School of Medicine, uses a hand model of the brain to talk about emotional regulation. When we are in a heightened emotional state, our prefrontal cortex, where rational thought occurs, is not easily accessible to us. How do we get back to our rational selves? With empathy.

Let’s face it-in the field of death and dying, emotions can get very raw, very quickly. If a patient or family member is agitated, your mirror neurons may be firing, and your stress level can increase as a result. Using empathy can help you and your patient to de-escalate. It might take multiple empathy statements before someone can calm down, so be prepared to provide the compassionate, calming presence they need. Sometimes, the most powerful empathy you can offer is silence.

A word of caution: empathy is not a limitless asset. We all can give only what we are capable of giving. Empathy fatigue is a real phenomenon, and it’s important to know when you need to step back and prioritize self-care.

When you think about some of the benefits of empathy—closer connection, recognition of another person’s humanity, deepened levels of trust—you can’t help but see that your days will be more fulfilling. You’ll be reminded of why you pursued this field in the first place, most likely some version of “to help people.” By incorporating empathy into conversations with your patients, their families, and your colleagues, you will most definitely be “helping people,” yourself included.

Interested in learning more about how to infuse empathy into your communication, including in the workplace, and the impact of doing so? If you haven’t already, register for NHPCO’s 2022 Virtual Interdisciplinary Conference to view “Ready! Set! Role Play! Infusing Empathy into Your Work” along with an array of other on-demand sessions in the conference platform. Educational content is available through December 31, 2022. Register here.

Erin Whalen is a Communication Coach and founder of Compassionate Coaching. Her company’s mission is to restore dignity to the grieving and the dying, and to help them feel seen and heard, by helping others to communicate effectively and compassionately with them. Erin has 15 years’ experience as a professional role-player for health care workers, nine years’ experience as a Playback Theatre practitioner, and five years’ experience in training and development in the healthcare field.

Staff Retention and Workplace Satisfaction in Hospice and Palliative Care

dcherry@nhpco.org (NHPCO) — Thu, 21 Jul 2022 11:49:00 -0400

By Ross Hoffman, MBA

“Always treat your employees
exactly as you want them
to treat your best customers.”
–Stephen Covey

Covey was on to something. In hospice and palliative care, our patients are important to us and our company. We also know that our employees drive the measure of success regarding the care each patient receives. So how do we increase the care we show our employees to help them be successful? With increases in the cost of living, a changing pandemic environment, and growing tensions regarding social and political issues, staff retention and employee satisfaction deserves more attention than ever before. The way we did things ten years ago just doesn’t work, and a dollar raise with a pat on the back isn’t enough. We are finding that employees are looking for more than a job; they want to know that they are working for a company that cares about its employees, their families, and about the concerns of the public. They are looking for purpose in what they do, and they want to know that they’re with a company that will keep up with their needs during these challenging times.

How do we approach this shift? Well, we need to get to the bottom of what goes on in our organization. Having 100+ employees with different needs is a lot to tackle, but it can be done. How can we find out the root cause, or causes, of our current situation on a large scale? And how can we do so anonymously, so that employees can tell it like it truly is? We may not always like what we find out, but it’s the only way to get on the path to retaining great, hard-working team members, keeping them not just satisfied, but hungry for more.

Can a survey help with this? Yes, it can. Surveys have helped world-class organizations steer in the right direction to remain the very best. But they did so through intentional action, considering and implementing their employees’ suggestions and ideas, and swallowing their pride by getting rid of unwanted, outdated practices. Surveys can transform raw feedback into actionable data.

What can we measure with surveys? One of the biggest online survey companies, Survey Monkey, states: “[Companies] can measure satisfaction with benefits, compensation, work environment, opportunities for growth, and other topics related to employee morale. By using a survey and guaranteeing anonymity, employees are empowered to answer truthfully. Feedback obtained from an employee satisfaction survey can be used to improve conditions in the workplace, shape policies, and provide a benchmark for future satisfaction surveys.”

In hospice and palliative care, our employees work in sensitive situations with patients and their families. The greater the employee satisfaction, the more our teams will be able to focus on the things that matter most. They’ll know they work for a company that cares about them as individuals. This, in turn, will drive them to provide the best possible experience, with a positive attitude that patients can see and feel.

The words of Stephen Covey above mean more to us because we know that every single one of our patients deserves the very best palliative and end-of-life care. That means that every one of our employees must be heard. Gathering real feedback so we can make better strategic decisions will ultimately translate into the world class medical care we promise our patients.

The Next Generation Leadership Council’s intergenerational sub-committee has created this survey to gather valuable feedback to help strengthen relationships within the hospice and palliative care workforce. The sub-committee will be using the data collected here in many ways and plans to present some of its findings at NHPCO’s 2022 Interdisciplinary Conference.

Please take two minutes to complete this survey.

Once you’ve completed the survey, check out NHPCO’s lineup for the 2022 Interdisciplinary Conference, and be sure to register if you want to learn even more strategies for employee recruitment and retention.

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Ross Hoffman, MBA is the Director of Operations at Hoffmann Hospice, Bakersfield, CA and serves on NHPCO’s Next Generation Leadership Council.

The Tulsa Shooting: What it Means for Hospice

dcherry@nhpco.org (NHPCO) — Fri, 3 Jun 2022 10:00:00 -0400

By Edo Banach

Yesterday, I had the opportunity to correspond with Kyle Terry, Director of Saint Francis Hospice in Tulsa. The hospice is part of the same health system as Saint Francis Hospital, where this week a gunman murdered four people, injured others, and then took his own life.

The staff at Saint Francis Hospice is providing grief support to their colleagues in the health system and to the broader community in the wake of this horrific act of violence. This is what hospice staff do, all too often—they quietly step in following a tragedy to help those who find themselves suddenly grieving.

Whether in Buffalo, Uvalde, Tulsa, or the countless other communities that have been impacted by senseless gun violence, hospice staff are unsung heroes who step up to provide expert support, to help people get through the initial phase of shock and grief, and to begin the long journey of individual and community healing. In this instance, the staff at Saint Francis Hospice is working in a particularly trying situation, as the shooting not only happened in their community, it happened a block away, in the same health system, to colleagues. It is hard to imagine how they are simultaneously managing their own shock, fear, and grief, and providing support to others in need. My heart goes out to them, and I let Mr. Terry know that NHPCO is here to provide any support that we can.

In my five years with NHPCO, I have shared my thoughts about a few mass shootings. Of course, there have been dozens and dozens of other shootings that I have not written about. Over those years, some things have remained consistent, and others have changed. What has remained consistent is that these tragedies continue to happen, with no end in sight. The political discourse around how to reduce gun violence remains at stalemate. And hospices continue to be resources for their communities in times of tragedy, over and over.

What has changed is that the COVID pandemic has shifted the discourse on grief in the wake of tragedy. It has become glaringly clear that our country does not have the right resources to support communities in grief, which opens an opportunity for change. NHPCO is leading the charge in calling for a National Strategy on Grief. A National Grief Strategy that shapes policy would help build capacity in communities and direct resources where needed, including for natural disasters, violent tragedies, and deaths from illness. It would help families impacted by the next pandemic, the next deadly tornado, the next shooting, and the next cancer death. It would help the unsung hospice heroes who step up in times of tragedy.

While we continue to advocate for national policy change, NHPCO has also begun an internal conversation about the role of our organization and the hospice community in the cycles violence. Hospice providers have the deepest understanding of the importance of a good death—how we support the dignity of a person experiencing the end of life and care for their loved ones. Our work is about the value of life, all the way through death. So when we see lives cut short by senseless violence, it affects us deeply. Perhaps we have a bigger role to play.

Gun violence is the manifestation of a complicated set of factors. As policymakers grapple with gun control measures, waiting periods, background checks, mental health resources, and more, what we can do is stand together as a hospice and palliative care community to demonstrate what an interdisciplinary approach to illness can do to heal.

There is one small thing you can do today, June 3. In Tulsa, Saint Francis is known as the Pink Palace, and they have asked people wear pink to show that good can overcome evil. So, let’s all wear pink and post pictures using the hashtag #SaintFrancisStrong.

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Edo Banach, JD, is the President and CEO of the National Hospice and Palliative Care Organization. NHPCO is the leading organization representing integrated, person-centered healthcare, NHPCO gives ongoing inspiration, practical guidance, and legislative representation to hospice and palliative care providers so they can enrich experiences for patients and ease caregiving responsibilities and emotional stress for families. Visit www.nhpco.org.

Inspired by Hospice Volunteers

dcherry@nhpco.org (NHPCO) — Mon, 18 Apr 2022 08:15:00 -0400

By Ben Marcantonio

As a former hospice executive, I can tell you that volunteers are, and always have been, the heart of hospice. It’s important to remember that historically, hospice in the United States started as a volunteer-led grassroots movement. Later, the hospice Medicare benefit was enacted into law, formalizing the hospice system and minimum standards of care. Volunteer support for patients is quite literally a requirement of the Medicare regulations governing hospice care.

This week, the country celebrates National Volunteer Week. NHPCO and our member hospices nationwide send a heartfelt “thank you” to hospice volunteers. Without you, hospices could not deliver the quality of care that end-of-life patients deserve.

As part of our National Volunteer Week celebration, I want to share a few resources with you:

The first is a video – “The Gift of Volunteering” – in which Mercedes Ibarra, a volunteer with Silverado Hospice in Irvine, CA, shares her experience as a hospice volunteer.

The second is a video – "Nikita’s Mission" – about a pet therapy dog who volunteers with Heartland Hospice in the We Honor Veterans program.

The third is a list of five inspiring hospice volunteers who were recently honored as at the recipients of NHPCO’s 2022 Volunteers are the Foundation of Hospice Awards. Each honoree’s name links to a write-up about their service.

In the first video above, hospice volunteer Mercedes Ibarra talks about her patients, saying: “I never knew I could love someone I didn’t know, that wholeheartedly.” That type of connection, that inspiration, that love – I saw that over and over as a hospice leader. That’s why I say that hospice volunteers are the embodiment of the theme of this year’s National Volunteer Week – “Volunteer Faces of Caring.” I hope you are as inspired by hospice volunteers as I am…not only this week, but all year round.

P.S. If you are a hospice looking for communications resources to support your National Volunteer Week efforts, NHPCO is pleased to offer this NVW toolkit to our members.

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Ben Marcantonio, MS, MEd, LMFT, is the Chief Operating Officer at the National Hospice and Palliative Care Organization (NHPCO). He joined NHPCO in October 2020, bringing 30 years of leadership experience in educational, healthcare, and social service settings. Prior to joining the NHPCO senior leadership team, he was with Hospice of the Chesapeake where he served as President and Chief Executive Officer (2015-2020) and Chief Operating Officer (2013-2015). Prior to relocating to Maryland in 2013, he served as Chief Administrative Officer at San Diego Hospice and The Institute for Palliative Medicine.