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Membership Continuing Education
The Ethics of Balancing Length of Stay and Readmission Reduction in a Trauma-Informed, Patient-Centered Case Management Model

Publication Date: 5/4/2023


Length: 59 minutes 33 seconds

Content Level: 1 Intermediate Ethics CE

Abstract
Inappropriate hospital readmissions and excessive lengths of stay continue to increase the burden of unnecessary utilization on health care systems. This leads to failing to provide optimal care to patients and generating moral distress among hospital providers and staff. A patient-centered approach providing continuity and utilizing principles and methods of a trauma-informed approach to care is a critical component to identify unmet or unidentified clinical needs, as is a facility with principles of clinical bioethics and an expansive notion of palliative care. This session will review concepts in ethics, trauma-informed care and palliative care. Two illustrative cases will be examined, and practical tools will be shared. Data demonstrating a reduction in length of stay and readmissions as well as the relevance of our findings to case management and clinical care will be explored.

Learning Objectives
1. Integrate principles and methods of trauma-informed care into bedside practice of case management.
2. Formulate an approach to complex cases based on classical pillars of clinical bioethics.
3. Reframe palliative care to support a broader patient population whose need has been previously unidentified.
4. Identify ways to reduce hospital readmissions among a subpopulation of high-utilizing patients.

Speaker: Rajeev Alexander, MD | Medical Director, Continuity of Care Team | PeaceHealth / Riverbend Hospital

Rajeev Alexander earned his bachelor’s degree in English Literature at the University of Chicago, a Doctor of Medicine from University of UT School of Medicine and completed his Internal Medicine Residency from Legacy Emanuel and Good Samaritan Residency Program. He practices hospital medicine and palliative care medicine in Eugene, Oregon. He has been known to write poetry, essays and short stories that have appeared in The Chicago Literary Review, Timberline Review and elsewhere. He has spent his life trying to avoid becoming an academic.

Speaker: Kelli Augustadt, MSW, LCSW, CCM | Medical Social Worker, Continuity of Care Team Care Management| PeaceHealth / Riverbend Hospital

Kelli Augustadt is an LCSW at Peace Health at Riverbend Hospital in Springfield, OR where her focus has been primarily in oncology and palliative care. Kelli began her social work career over 20 years ago with the State of Oregon Child Welfare Program. She holds a Bachelor of Arts in Sociology from the University of Oregon and a Master of Social Work from Portland State University. She is a fierce advocate for her patients and their autonomy. Kelli is involved in team building, is a member of the Unit Based Council and serves on the hospital’s ethics committee.

Speaker: Amber Thorsen, BS, RN, ACM-RN, CHPN | Lead Care Manager, Continuity of Care | PeaceHealth / Riverbend Hospital

Amber Thorsen RN is a nurse care manager at PeaceHealth Riverbend Hospital who specializes in clinical ethics and palliative care. She studied business administration at UC Berkeley and integrates systems-based thinking into her care management work. She spends her free time gardening, hiking, and lifting the heaviest weights she can.

Please Note: Session was originally presented live at the 2022 ACMA National Conference on May 1-4 in Dallas, TX.

Keywords: Length of Stay, Readmission

The Ethics of Balancing Length of Stay and Readmission Reduction in a Trauma-Informed, Patient-Centered Case Management Model

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