Today’s hospice leaders need a creative and innovative approach to sustainability and growth as evolutionary trends occur in end-of-life care delivery.

This is according to Beth Klint, executive director at Goodwin Hospice. The Alexandria, Virginia-based hospice is part of the nonprofit Goodwin Living and Goodwin Living Health.

Founded in 1998, Goodwin Hospice provides palliative care and hospice across 10 regions in northern Virginia. The hospice also provides end-of-life doula services, massage and pet therapy, and offers a Full Circle Aftercare bereavement program.

Hospice News recently sat down with Klint to discuss some of the most significant trends impacting end-of-life care delivery, including staff retention initiatives, service diversification and expanding community education opportunities.

What are some of the strategies that Goodwin Hospice has found successful for recruitment and retention?

We try our best to always be aware of the balance between being present and the work of the job.

Using technology has allowed us to be able to use our time in a more structured way, and that has really been important to staff. Technology at the bedside can help with anything like ordering medication, durable medical equipment and help find resources for family needs. It has really helped to use our time more efficiently. The feedback from our staff has been that it’s a game changer in the ability to be more present with a patient and their family and helps ensure everything is completed before moving forward with another patient visit from an assessment standpoint.

We also look at things like health and wellness in everything we do organizationally and in our individual operations. We’re looking at ways to support our staff as well as care for our patients. We have a standing time frame with our volunteers and staff for reflection and time for themselves to process supporting patients and families.

We have a career ladder program with Goodwin Living. One of the things we’re also looking at is a hospice academy as a way to develop leaders. That’s something we’re looking at for next year and may be something through our Goodwin Living Foundation. It will allow staff to apply if they’re interested and get more hospice business training.

We genuinely want to be the best place to work and receive care.

Can you walk me through the scope of your hospice’s current services and others in consideration?

We offer all the required elements of hospice care and we also do other things.

Our massage therapy program, like many of our services, was made possible by generous donations. We have offered therapeutic massages to both the patient and family caregivers. The patient is always most worried about their loved one and vice versa, so you have to take care of both to really provide comfort.

We have an end-of-life doula program that came from recognizing the need of families in the community and how few resources there are. We spent a lot of time wanting to make sure that our staff had resources to offer people who needed more than what’s provided within hospice itself. End-of-life doulas are a creative way to that and have been really helpful

Our Full Circle Aftercare program offers help with a loved one’s affairs such as bank accounts, death certificate requests, social security details and handling their estate. It can be helpful through what is a really confusing process for people.

We have a social worker-driven palliative care model, Care Connections. It focuses on advance care planning, resource management and goals of care. We offer it to all of our senior living residents, to anyone on home health with a serious illness and also have support in the hospital. The goal is to provide some guidance and support people navigating a serious illness journey.

Our Threshold Choir volunteer program is a singing group that provides quiet, powerful music at the end of life. We’ve worked with them for a long time, and their songs really make a difference.

How would you describe the current state of hospice care delivery? What are some important evolutions that have taken shape in the field?

One of the things that has made hospice more accessible is technology. There isn’t anything that can make up for the actual person-to-person interaction, but technology has given us more virtual accessibility and new ways to get information. We have a more even playing field of using technology to complement and not replace a human at the bedside.

It’s trying to find a balance between those technologies and human opportunities. That’s a dance that every provider is trying to figure out and learning to balance in a way that’s additive and not taking away from the human interaction and humanity of hospice.

Right now, we’re mostly using artificial intelligence (AI) for [electronic health record (EHR)] auditing. The AI-based components can let us know through data our highest risk, and that has been hugely helpful.

How do envision the future of hospice care delivery?

The future is idea-driven. When you look at the hospice industry and at health care, there is a lot of good and bad that we’re up against. At the root of all of it is that people still need care and that this work actually makes a difference. There’s humanity and education in our work, but putting the patient first is still the most important thing in our ideas.

Hospice also still requires reimbursement, and the reimbursement really is going to determine what you can offer. We’ve spent our careers being creative and trying to find ways to put all the pieces together to meet an individuals’ needs. It comes down to your staff and taking care of them. They are your greatest asset. You can’t do anything without the people doing this work. It’s hugely important to invest in staff well-being, in their growth, job satisfaction and mental health. We have strong partnerships and collaborate with other organizations that allow us to do that.

Hospice [leaders] also have to recognize that there’s going to be more patients who need care than there are people to provide it. We can’t do this by ourselves and we need to look at our community of caregivers to make sure we’re all in this together, whether that’s in senior living all the way through acute care and hospice.

It’s also about learning from one another as an industry. Hospice has always been a tight knit industry, but there’s been more competition that is changing things. How do we work and learn together so that we can move more mountains as a team and have much more effective health care?

What are your hospice’s key priorities in 2026?

We’re always trying to find ways to streamline according to regulatory requirements. Our big focus is quality scores. We have the Hospice Outcomes and Patient Evaluation (HOPE) tool that’s going live in October, and we’re still trying to learn it and figure it out. We have put a lot of energy and effort into trying to support our staff to document bedside and offline.

We’ve also really looked at being able to provide more support to people throughout their journey, not just at one particular point. So it’s education, support with informed decision making and identifying what’s most important and what they’re hoping for. That’s true patient-centered care and we do a lot to accomplish that.

We also need to better identify the barriers to hospice care. It’s developing partnerships with other organizations, with community-oriented groups and providing more education and places to reach people.

What we’ve learned from the pandemic is that everything is uncertain, and you have to be able to pivot. You need to build stability into your operations, your patient care and with your staff.

Our patients are living longer, our aging population needs are different and we need to better identify the needs of the people we serve. It’s trying to get ahead of that, because there will be a lot of change in health care in the next year and coming years, and we have to always be thinking about ways to meet actual needs in our care models. Are there ways we could support people more upstream? How do we meet those needs?