Voices clamor to be heard in the discussion about end-of-life care. Patients prefer to die at home and in comfort. Physicians struggle to speak to patients they have been trying to save but worry about legal issues. Politicians debate the best way to curb rising health care costs and shun "death panels." Amid this fervor, researchers in Sweden found last year that conversations about imminent death are associated with improved care and less pain and suffering. Now, a team at Harvard Medical School reveals more detail about the social and psychological factors that affect quality of death.
In January, Nationwide Children's Hospital began requiring new nursing hires to have a bachelor's degree or earn one within five years. Nurses already employed were grandfathered. Research suggests nurses with more advanced degrees are associated "with better rescue of patients who are deteriorating," said Linda Stoverock, Nationwide Children's chief nursing officer. Mount Carmel, OhioHealth and Ohio State University's Wexner Medical Center are setting timetables to reach an Institute of Medicine goal that 80 percent of nurses have a bachelor's degree by 2020. That goal won't be reached through hiring practices alone, said Gingy Harshey-Meade, CEO of the Ohio Nurses Association. Working nurses would have to return to school.
Although some industries still struggle to find their footing, healthcare providers are moving ahead with new and expanded West Valley facilities—welcome news for the region. From Goodyear to north Peoria, heavy hitters in the healthcare industry are boosting facilities in anticipation of resumed growth the West Valley. For too long, many West Valley cities have lacked necessary healthcare services. As growth returns to Arizona, it's critical that facilities are in place to serve the current and expected population. The addition of new and expanded facilities is needed to address that deficiency.
Sinai Hospital, which opened its milk bank in May, is part of a growing movement in the Maryland health community to make breast milk donated by other mothers more available in hospitals. So far only three hospitals—Sinai, Johns Hopkins and Saint Agnes—are licensed by the state to use donated milk. In 2010, Maryland hospitals provided donor milk to just nine babies. A state legislative work group recently presented recommendations to the General Assembly on ways to increase those numbers. Supporters of its use say donor milk can help save dozens of babies' lives.
U.S. women may be the big winners when it comes to healthcare reform, not only those who are uninsured, but those with insurance, researchers say. The report by the Commonwealth Fund, a U.S. non-profit group that conducts independent research on health policy, estimated once fully implemented, the Affordable Care Act would cover nearly all women, reducing the uninsured rate among women from 20 percent to 8 percent. Twenty percent of U.S. women—18.7 million—ages 19-64 were uninsured in 2010, up from 15 percent—12.8 million—in 2000, the report found.
One in five patients in Massachusetts is now under some kind of global payment. Blue Cross Blue Shield launched this experiment in Massachusetts in 2009. Michael Chernew, and a team of researchers at Harvard Medical School, recently took a look at what happened in the first two years. The 11 physician groups and hospitals that joined in 2009 and 2010 did a better job than physicians in traditional medical contracts of making sure that patients received standard check-ups, cancer screening tests and other preventive care. Overall they trimmed spending by just under 3 percent.