Consider the ethical dilemma the health care professional faces in the selected case study

Ethical case studies | Nursing homework help

elected case study: Reducing Hospital Readmissions

Summary: Caleb Powell, CEO of Virginia County Regional Hospital (VCRH), wants to reduce the readmission rates across the board to avoid penalties from the Centers for Medicare and Medicaid Services (CMS) under the Affordable Care Act. He believes that reducing readmissions will improve patient satisfaction, and a focused approach can help them succeed. He has identified themes that have emerged from initial research, including establishing partnerships with physicians and clear discharge planning. Caleb is concerned that an aggressive policy could be seen as too focused on the hospital’s bottom line and not patient needs. Caleb is considering profiling healthcare providers whose patients have high readmission rates.

Problem: The problem in the case study is to reduce readmission rates at VCRH to avoid penalties under the Affordable Care Act without being too focused on the hospital’s bottom line and indifferent to patient needs. The ethical dilemma is to find a balance between reducing readmissions and providing adequate care to patients without preventing them from seeking care.

Ethical Decision-Making Model:

Moral Awareness: Caleb is aware of the potential conflict between reducing readmission rates and providing adequate care to patients. He wants to avoid a policy that prevents patients from seeking or receiving care, which is the ethical obligation of a healthcare provider.

Moral Judgment: Caleb has identified themes that have emerged from initial research, including establishing partnerships with physicians and clear discharge planning. He is considering profiling healthcare providers whose patients have high readmission rates. This action could lead to an ethical issue, as it could be seen as blaming healthcare providers for patients’ readmissions.

Ethical Behavior: Caleb needs to find a balance between reducing readmissions and providing adequate care to patients. He should focus on establishing partnerships with physicians and other local hospitals to develop a patient-centered approach to care. He can also implement a clear discharge planning process and nurse-driven medication reconciliation to reduce the risk of readmissions. Caleb should avoid profiling healthcare providers and blaming them for patients’ readmissions, as it could lead to a toxic work environment and undermine the trust and confidence of patients.

Factors that contributed to the problem: The primary factor that contributed to the problem is the penalty imposed by CMS under the Affordable Care Act for hospitals with higher than expected 30-day readmission rates for heart failure, heart attack, and pneumonia. This penalty creates financial pressure on hospitals, leading them to focus on reducing readmissions to avoid penalties. However, an aggressive policy to reduce readmissions could be seen as too focused on the hospital’s bottom line and indifferent to patient needs.

Individuals involved or affected by the problem: The individuals involved or affected by the problem are the healthcare providers, patients, hospital administration, and CMS. Healthcare providers may feel pressured to reduce readmissions, which could lead to conflicts between patient care and hospital goals. Patients may receive inadequate care or feel prevented from seeking care. Hospital administration may face financial penalties for higher than expected readmission rates. CMS may impose penalties on hospitals that do not meet the readmission rate standards.

Communication approach: Caleb communicated his concerns and goals with his executive leadership team via email. He emphasized the need to reduce readmissions without hindering patients from seeking care. He also asked for his team’s input about whether they should create a system to profile healthcare providers whose patients have high readmission rates. The communication approach was effective in conveying his goals and concerns to his team, but the question about profiling healthcare providers could lead to a toxic work environment and affect patient care negatively.

Effectiveness of the approach: The approach used by Caleb to reduce readmissions was focused on establishing partnerships with physicians and local hospitals, implementing clear discharge planning, and nurse-driven medication reconciliation. This approach is patient-centered and addresses the ethical obligation of healthcare providers to provide adequate care to patients. The approach to profiling healthcare providers could