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Proposed Medicare Changes to Limit Opioid Prescribing
by Chad KollasOn February 1, 2018, the Centers for Medicare& Medicaid Services (CMS)published its Advance Notice of Methodological Changes for Calendar Year 2019. Included in these proposed rules were several directives intended to reduce" Opioid Overutilization ” (see p. 202), including formal adoption of the “90 morphine milligram equivalent (MME) threshold cited in the CDC Guideline, which was developed by experts as the level that prescribers should generally avoid reaching with their patients (p. 203). ” CMS proposed “adding additional flags for high-risk beneficiaries who use ‘potentiator’ drugs (such...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 4, 2018 Category: Palliative Care Tags: CMS health policy kollas medicare opioids Source Type: blogs

An Impromptu Group Conversation With Women in Hospice and Palliative Medicine
Collectively written by Allison Jordan, Katie Harmoney, SarahScott Dietz, Jeanette Ross, Emily Hahn, Meredith MacMartin, Christian Sinclair, Rachel ThienprayoonWaking up today February 3rd, I (Christian) saw a discussion on our Facebook private messages for the Pallimed page about what we should post for National Women Physician Day (which is held on February 3rd the birthday of Elizabeth Blackwell, the birthday of the first US woman physician.) Jeanette hadfound the 2016 Pallimed post written by Meredith MacMartin and we posted that, but then I thought it would be great to write some fresh content on this new celebration....
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 3, 2018 Category: Palliative Care Tags: dietz hahn harmoney macmartin ross sincliar The profession thienprayoon women Source Type: blogs

Innovation and Design at End of Life: Tea with Ivor Williams
by Lizzy MilesThe day before the inauguralEndwell Conference in San Francisco, I had the opportunity to sit down for tea with Ivor Williams. Ivor ’s Endwell biography listed in the program is what caught my attention.Ivor is Senior Design Associate at theHelix Centre, based in St Mary ’s Hospital in London; founder of the research and consultancy groupBeing and Dying; and co-founder ofHumane Engineering, designing digital products that explore the use of technology for health and social good.Ivor ’s focus at theHelix Centre is on innovation at end of life. I really didn ' t know what that meant, but I wanted to learn...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 31, 2018 Category: Palliative Care Tags: design helix hospice innovation ivor williams lizzy miles social worker tea Source Type: blogs

Exploring Team Composition in Palliative Care
By Brianna Morgan (@BriannaMorganNP) and Elise Tarbi (@EliseConant)Amidst rapid growth in the number of palliative care programs,the December 2017 issue of the Journal of Palliative Medicine calls for a pause to consider the blueprints for how we build moving forward. In the issue,Kousaie and von Gunten (2017) compare two hospitals, one that has an established advanced practice nurse only model of palliative care delivery (APN model), and a second hospital implementing an interdisciplinary team including physicians, APNs, social workers, chaplains, and pharmacists (team model) for the same purpose. Compared to the APN mode...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 27, 2018 Category: Palliative Care Tags: advance apn morgan nurse physician research tarbi team teamwork The profession Source Type: blogs

It ’s Not the Death, It’s the Dying: Moral Distress in Palliative Care
by Vickie LeffEvery day, we get involved in unbelievable and incredible situations. Tragedy, sadness, horrific trauma, despair, and hopelessness all wrap themselves around the cases we drop into. We step onto the stage and become part of the story.Moral distress – the discomfort, angst, and frustration related to situations in which we think we know the “right thing” to do, but cannot due to the situation – is endemic to palliative care and hospice work. Some examples are:Aggressive chemotherapy for a dying cancer patient with days to live.Dumping the truth on a patient overwhelmed and alone.Following the trea...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 19, 2018 Category: Palliative Care Tags: leff moral distress social work social worker Source Type: blogs

Top 10 Pallimed Posts of 2017
by Christian Sinclair (@ctsinclair)Looking back at 2017, we didn ' t publish a ton of posts (only 50!*), but we had some that clearly resonated with people and continue to be popular since we keep seeing them show up on social media. Working closely with her, I already knew the great qualities Lizzy Miles brings to Pallimed as a writer and an editor, but looking at the top 10, her experience as a hospice social worker has led to a knack for insightful and practical posts. Her posts also seem to be meaningful to clinicians in multiple settings in addition to patients and families. So here are the top 10 posts of 2017 based ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 15, 2018 Category: Palliative Care Tags: delirium dignity film hospice LGBTQ meta sinclair The profession Source Type: blogs

Looking Ahead to 2018 for Palliative Care and Hospice
by Christian SinclairIn 2016, I made a list of upcoming events in palliative care and hospice. For some reason, it fell off my list of to-do ' s in 2017, but I wanted to bring it back because it is good to see all the important things happening in our field. Here are some of the things to put on your calendar right now, so you do not miss them! If you want to help out with maintaining this, it would be great to have a colleague and it doesn ' t take that long, please email me (below). We could even go crazy with the Google Calendar and make different ones that are relevant to different disciplines/interests, international ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 8, 2018 Category: Palliative Care Tags: conferences meta Source Type: blogs