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

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Reducing Hospital Readmissions is the case studied that was chosen.

Caleb Powell (CEO of Virginia County Regional Hospital, VCRH) wants to cut the rates for readmissions across the board so that he can avoid the penalties imposed by the Centers for Medicare & Medicaid Services (CMS), under the Affordable Care Act. Caleb Powell believes that by reducing readmissions, patients will be more satisfied. And a targeted approach is the best way to achieve this. In his initial research he has identified several key themes including the need for partnerships with doctors and the clarity of discharge plans. Caleb is concerned that an aggressive policy could be seen as too focused on the hospital’s bottom line and not patient needs. Caleb considers profiling providers of healthcare whose patients experience high rates of readmission.

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. It is a dilemma to strike a balance in providing care for patients and reducing readmissions without stopping them from getting care.

A Model for Ethical Decision Making

Caleb understands the conflict that can arise between providing quality care and reducing readmissions. He is trying to prevent a practice that would stop patients from getting care. This goes against the moral obligation of any healthcare provider.

Moral Judgement: Caleb’s initial research has revealed themes, such as the importance of establishing partnerships between physicians and clear discharging planning. He’s considering profiling the healthcare providers with high readmission rates. This action could lead to an ethical issue, as it could be seen as blaming healthcare providers for patients’ readmissions.

Caleb’s ethical behavior: Caleb has to strike a balance in order to reduce readmissions while still providing the best possible care for patients. Focus on developing partnerships with other hospitals and physicians to create a patient-centered model of care. To reduce readmissions, he can implement a discharge planning system and a nurse-driven medicine 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 which contributed to this problem: One of the main factors that has contributed to this problem is the CMS penalties imposed under the Affordable Care Act on hospitals who have readmission rates higher than normal for heart failure and heart attacks within 30 days. The penalty imposed by CMS under the Affordable Care Act puts financial pressure on hospitals and makes them focus their efforts on reducing readmissions in order to avoid the 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.

Patients, CMS, hospitals, healthcare providers and other individuals affected or involved: Health care providers could feel under pressure to lower readmissions. This may lead to conflict between hospital and patient goals. Patients might receive poor care or not feel able to seek care. The hospital management may have to pay financial penalties if readmissions are higher than predicted. CMS could impose fines on hospitals that fail to meet readmission standards.

Caleb sent an email to his leadership team, expressing his worries and goals. He stressed that readmissions must be reduced without deterring patients from seeking treatment. 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. He was successful in communicating his goals to his team. However, the idea of profiling healthcare professionals could create an unhealthy work environment that would negatively affect patient care.

Caleb’s approach was effective in reducing readmissions. It focused on partnerships with local physicians and hospitals, clear discharge plans, and nurse-driven reconciliation of medication. This patient-centered approach addresses the ethical duty of healthcare professionals to provide adequate treatment to their patients. This approach could be used to profile healthcare providers.