18 Aug Case Study: Reducing Hospital Readmissions
Case Study:
Reducing Hospital Readmissions
Caleb Powell was preparing the agenda for the upcoming executive leadership meeting and he shook his head ruefully. As chief executive officer for Virginia County Regional Hospital (VCRH), Caleb believes that a key piece of VCRH’s future success lies in reducing readmission rates, not only in the areas identified by federal guidelines, but across the board. A few weeks ago, he read a piece from the National Institutes of Health discussing strategies associated with reduction in readmission rates. He decided that he wanted to discuss the issue in detail with his leadership team.
Caleb’s goal is to align the hospital’s strategic planning with the goal of reducing readmissions. The stakes are high; under provisions of the Affordable Care Act, hospitals with higher than expected 30 day readmission rates for heart failure, heart attack and pneumonia are penalized with reduced payments. Historically, hospitals (including VCRH) have struggled to avoid the penalties, but Caleb believes that a focused approach will allow them to be successful. He also believes that reducing readmission rates will improve patient satisfaction, which has become a key metric in measuring hospital quality.
Caleb’s initial research into this issue revealed that while many facilities were incurring the Centers for Medicare and Medicaid Services (CMS) penalties, there was still significant variability in terms of hospitals implementing successful strategies for reducing their readmission rates. However, several themes have emerged. Hospitals that established partnerships with physicians, physician groups and other local hospitals have had greater success. In addition, a clear discharge planning process and nurse driven medication reconciliation have also been associated with reducing the risk of readmissions.
At the same time, Caleb is concerned that an aggressive policy to avoid readmissions could be construed as too focused on the hospital’s bottom line and indifferent to patient needs. The last thing he wants is to create a policy that prevents patients from seeking or receiving care. Caleb hopes that this meeting will begin a productive discussion around developing strategies to improve VCRH’s performance in this area.
Caleb’s email to the executive leadership team with the agenda for the meeting included the following note:
“As we research the readmission rate issue for improvement, we need to be aware that we cannot add additional days to the patient’s initial stay. It’s a balancing act. We also cannot hinder a patient from coming back into the hospital for a readmission. I’ll be asking for your input about whether we should create a system to profile health care providers whose patients have high readmission rates.”
NOTE: Case study options are given, but I chose that one for my paper, DO NOT USE ANY OTHER CASE STUDY PLEASE
Introduction
Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
- Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
- Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
- Competency 3: Apply ethical principles and academic standards to the study of health care.
- Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
- Discuss the effectiveness of the communication approaches present in a case study.
- Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
- Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
- Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others, and that is consistent with expectations for health care professionals.
- Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
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