10.24.2007

Patient Safety Advocates of all Ages Urge Passage of "The Patient Safety Act" at State House Hearing

Hundreds Come Together to Expose Dangers of Hospital Understaffing

Cite New Survey Showing Almost One-Quarter of A Million Massachusetts Patients Per Year Feel Their Safety Has Been Compromised in Bay State Hospitals

Boston, MA—Armed with new statistics on patients' increased concern over quality care in Massachusetts hospitals as well as evidence linking disease and deaths to poor patient oversight, hundreds of elderly Massachusetts residents, mothers and children, nurses, and other consumer and health-care advocates from across the state converged on the State House this morning to urge passage of The Patient Safety Act, House Bill 2059, at a hearing before the Joint Committee on Health Care. The Bill would set limits on the number of patients a nurse can be forced to care for at one time.

For more than a decade, bedside nurses in Massachusetts have been sounding an alarm that patients are being harmed because nurses are being forced to care for too many patients at one time. A version of the safe staffing legislation was first introduced in 1994. Since the bill's initial introduction, hospital-acquired infections and medical errors have soared, with the Centers for Disease Control (CDC) now reporting that 2,000 people, or 6 people per day, are dying because of them every year in Massachusetts. Nationally, 2 million people are harmed by hospital-acquired infection and medical error, and nearly 100,000 of them die each year. As of today, more patients are killed each year by hospital-acquired infections than by AIDS and breast cancer combined.

A statewide survey conducted by Opinion Dynamics Corporation (ODC) and released in conjunction with the hearing indicates that more than one-quarter (28 percent) of Massachusetts hospital patients and their families say that their safety, or a family member's safety, was directly compromised by nurse understaffing, Based on the total number of hospital stays in the Commonwealth as tabulated by the state's Department of Health Care, Finance and Policy, this translates into more than 235,000 Massachusetts patients annually whose safety is compromised by a lack of available nurses.

In addition, nearly three-quarters (73 percent) of past patients agree that the overall quality of patient care in Massachusetts hospitals is suffering because nurses are forced to care for too many patients at once. And more than one-third (35 percent) of these past patients and their families say that their nurse had too many patients to care for during a recent hospital stay.

"Massachusetts patients are saying loudly and clearly that they are concerned about the impact that the persistent understaffing of nurses in Massachusetts hospitals is having on the safety of their care during their hospital stay," said John McCormack, the co-chair of The Coalition to Protect Massachusetts Patients, which comprises more than 120 leading health-care and consumer organizations. "My baby daughter, Taylor, died in 2000 at the age of two in a Boston hospital because she didn’t get the care she needed. When I carried her to the hospital morgue, I promised her that I would fight my hardest so that this wouldn’t happen to another child."

The elderly and the parents of young children have coalesced around the issue of setting safe limits on nurses' patient loads because those populations (seniors and children) are most at risk of contracting hospital-acquired infections.

John Bennett, president of the Massachusetts Senior Action Council, is disturbed by the fact that so many of the state’s elderly are at risk for injury or harm in the hospital as a result of understaffing.

"As an older citizen and leader of a grassroots organization of seniors, I have been continually hearing complaints from our members about problems they and their family members have experienced as a result of nurse understaffing,” Bennett said. “Members of my own family have been hospitalized and over the years I have watched the care they received deteriorate – not because nurses don’t care or aren’t working hard, but precisely because they are working too hard, running from patient to patient to doing what they need to do. The suffering the lack of nursing care causes is unacceptable."

A number of studies link the rise in hospital-acquired infections and other medical complications to understaffing of nurses, including one published in the July issue of the journal Medical Care that found that safer RN staffing levels could reduce hospital acquired infections by 68 percent.

"The hospital industry’s mantra every year for more than a dozen years has been, 'Leave it to us to fix this problem. We know best,'" said Karen Higgins, co-chair of The Coalition to Protect Massachusetts Patients. "While we have waited for the hospitals to ’fix it,’ thousands of patients have died and continue to die throughout the Commonwealth. The time for waiting is over. The Commonwealth’s hospital patients and their families can’t afford to wait any longer.”

The Patient Safety Act (HB 2059) would improve hospital conditions by setting a rational, safe limit on the number of patients a nurse can be forced to care for at one time, while also creating initiatives to increase nursing faculty and nurse recruitment. Similar legislation to set safe patient limits was passed in California and was implemented in 2004. Testimony about the bill’s success in California was presented by a panel of frontline nurses from California and by Karin Berntsen, RN, BSN, a California nurse administrator and one of the nation’s leading patient safety experts.

Leading National Patient Safety Expert and California Nurse Administrator Endorses Mass Staffing Bill
Contradicting assertions by the hospital industry that the bill is inflexible and the wrong approach to improving patient safety, Karin Berntsen testified about the success of the California law and said that the Patient Safety Act introduced in Massachusetts is even better than the California legislation.

Ms. Berntsen, the author of the books The Patients Guide to Preventing Medical Errors and Fatal Care, testified that she observes a "Massachusetts understaffing crisis," and that Massachusetts hospitals "approach is counterproductive and dangerous to patients."

“One of the nation’s leading organizations on patient safety, the Agency for Healthcare Research and Quality, examined over 90 studies on nurse staffing and reported that reducing the number of patients a nurse cares for at one time is associated with reduced hospital mortality and reduced adverse patient events,“ she said. “Furthermore, The Patient Safety Act has been well thought out and builds in the principles of improved safety and efficiency, including a balanced approach to nurse staffing, ramping up of the staffing requirements, and supporting nurse recruiting to assist with the bedside nursing shortage,” Ms. Berntsen added. "The legislation is flexible, and promotes staffing plans that are balanced for all hospitals," she concluded.

Evidence Presented at Hearing Calls the Hospital Industry's Solutions Into Question
At a time when patient safety is being increasingly endangered by RN understaffing, the state's hospitals continue to post record profits of nearly a half-billion dollars for the first six months of 2007 – a 35 percent increase over the previous year's second quarter profits. If the trend continues, the hospital industry is poised to record its third straight year of profits in excess of $1 billion.

Instead of investing in safer nursing care, the Massachusetts hospital industry’s response to the mounting death toll has been to create a “Patients First” web site that posts proposed nurse staffing “plans” with no guarantee that the staffing plans are accurate, and with no uniform standard of care that patients can expect in all hospitals.

The patients who responded to the ODC survey said the web site is of little or no value to them. Nearly 90 percent of recent hospital patients report that they did not have the time to research staffing levels prior to their hospital visits. In fact, only 14% were aware of the web site, and only 4 percent used it.

Audrey Heath, a senior from Worcester, said she was insulted by the assumption that she would be able to check a web site to safeguard her hospital stay. "You think I have time to look at a web site when I’m on my way to the hospital? Most people my age are in serious condition when they arrive at the hospital. They’re not thinking about the internet."

The Patient Safety Act is co-sponsored by State Senator Marc Pacheco (D-Taunton) and State Representative Christine Canavan (D-Brockton).