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

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Case study selected: Reducing Hospital Readmissions

Summary: Caleb Powell (CEO of Virginia County Regional Hospital) wants to decrease readmissions to all levels to avoid any penalties under the Affordable Care Act. His belief is that patients will be happier if readmissions are reduced. A focussed approach may help him achieve this goal. From his initial research, he has identified key themes such as forming partnerships with doctors and clearly planning for discharge. Caleb is concerned that an aggressive policy could be seen as too focused on the hospital’s bottom line and not patient needs. Caleb will be profiling those healthcare professionals whose readmissions are high.

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. This ethical dilemma requires that we find the right balance between readmissions reduction and adequate patient care without hindering patients from seeking treatment.

The Ethical Decision Making Model

Moral Awareness: Caleb knows that there is a conflict between the reduction of readmissions rates and adequate patient care. Caleb wants to prevent patients from seeking and receiving healthcare, as that is an ethical duty of a provider.

Moral Judgment. Caleb has identified the themes emerging from initial research. This includes establishing partnerships and clear discharge planning. Caleb is looking into profiling those healthcare providers who have high rates of readmissions. This action could lead to an ethical issue, as it could be seen as blaming healthcare providers for patients’ readmissions.

Ethical behavior: Caleb must find the right balance between decreasing readmissions while still providing quality care for patients. Caleb should work with doctors and local hospitals to establish relationships that will allow him to provide patient-centered care. To reduce readmissions, he can implement clear discharge planning and nurse-driven medication reconciliation. 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 led to the problem The penalty puts hospitals under severe financial pressure. To avoid the penalties, they must focus their efforts on decreasing readmissions. However, an aggressive policy to reduce readmissions could be seen as too focused on the hospital’s bottom line and indifferent to patient needs.

Problem-affected or involved individuals: These are patients, healthcare professionals, hospitals administration and CMS. Patients and hospitals may be pressured by healthcare providers to cut readmissions. Inadequate care may be provided to patients, and they may not have the right to seek treatment. Higher than normal readmission rates could result in financial penalties being imposed on hospital administrators. CMS could impose sanctions on hospitals who do not comply with the readmission rates standards.

Communication method: Caleb shared his worries and goals via email with his executive team. He stressed that readmission rates should be reduced without preventing patients seeking medical 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. While the communication was efficient in conveying his objectives and concerns to his colleagues, his question about profiling health care providers could cause a hostile work environment which can adversely affect patient care.

Caleb’s effective approach to reducing readmissions focused on building partnerships with doctors and local hospitals, creating clear discharge plans, and nurse-driven medication reconciliation. The patient-centered approach addresses healthcare providers’ ethical responsibility to give adequate care. It is possible to identify healthcare providers using this approach.

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