Advocates For Patient Safety Urge Legislature to Act
Coalition for Safe Staffing Bill holds press conferences outside or near five hospitals across the State
Understaffing of RNs Leads to Preventable Medical Errors That Cause Needless Suffering for Patients and their Families
Public Hearing on The Patient Safety Act To Be Held November 3 at the State House
WORCESTER, Mass.—Advocates for patient safety from across Central Massachusetts gathered today at St. Vincent Hospital in Worcester to urge lawmakers to swiftly pass legislation to set limits on the number of patients a hospital nurse must care for at once. House Bill 3912 – The Patient Safety Act – comes before the Legislature’s Joint Committee on Health Care tomorrow, November 3 at 10:00 a.m. at the Massachusetts State House. Similar events were held in the vicinity of four other hospitals across the state.
Holding signs that read “patients deserve safe care” and “safe staffing saves lives,” advocates from the Coalition to Protect Massachusetts Patients (CPMP) spoke out about the dangers of understaffing at area hospitals, and called on elected leaders to pass The Patient Safety Act, which directs the state’s Department of Public Health (DPH) to set a safe limit on the number of patients a nurse is assigned to care for at one time. Additionally, The Patient Safety Act calls for staffing to be adjusted based on patient needs, bans the dangerous practice of mandatory overtime, and includes initiatives to increase nursing faculty and nurse recruitment.
William Hawley, a Massachusetts Senior Action Council leader and activist, underscored the importance of the Patient Safety Act for the state’s elderly residents by providing a personal perspective, stating "Senior citizens spend more time in the hospital than any other group of citizens and deserve to see patient safety legislation finally passed. I know that mistakes are made because it happened to my wife when she had knee surgery, but not because her nurse wasn’t conscientious. My wife's nurse was overloaded because she had too many patients who all needed her attention at the same time. The mistake that occurred could have been much worse.”
Referring to a 2009 report showing St, Vincent Hospital had more accidents and medical errors during the previous year than any other acute care hospital in Massachusetts, Marie Ritacco, a registered nurse at the hospital for more than 20 years, addressed her concerns about the dangerous staffing issues at the facility.
“In my years of practice at St. Vincent Hospital, I have seen what understaffing does to the care of my own and my colleagues’ patients first-hand,” said Ritacco “For years, we have been fighting for improvements in the staffing levels at our hospital, using every means at our disposal. The Patient Safety Act needs to become the law in Massachusetts now. Every patient, no matter where they receive care, deserves a safe, predictable standard of care that is enforceable by law, not the whim of hospital administrators.”
Lynne Starbard, a maternity nurse at UMass Memorial Medical Center’s Memorial Hospital campus, pointed to numerous studies showing that understaffing of registered nurses leads to many cases of hospital-acquired infections, preventable errors, and avoidable complications. One of those sources, the Massachusetts Coalition for the Prevention of Medical Errors, reports that 2,000 patients—or six people per day—are dying in Massachusetts every year because of preventable infections. “More patients will continue to suffer unless Massachusetts provides nurses with safe patient limits,” Starbard said.
Preventing these and other preventable medical errors would reduce loss of life and could reduce health care costs in Massachusetts by as much as 30 percent, according to a report by William E. Encinosa and Fred J. Hellinger in the July 2008 issue of the journal Health Services Research,
"Many hospitals are struggling to survive financially," study co-author Encinosa, senior economist at the Agency for Healthcare Research and Quality, said in a statement. "The point of our paper is that the cost savings from reducing medical errors are much larger than previously thought."
Referring to previous research that looked at the business case for setting a limit on the number of patients a registered nurse is assigned at any given time, the researchers concluded: "It is quite possible that the post-discharge costs savings achieved by reducing adverse events might just be enough for the hospital to break-even on the investment in nursing."
Joseph P. Carlson, president of the Central Massachusetts AFL-CIO, also spoke in favor of establishing safe staffing limits as a means of protecting the health of working families throughout Greater Worcester.
“When our sons, daughters, husband, wives, grandmothers and grandfathers enter a hospital, we want to know that when they push the call button, their nurse is ready to respond to do whatever is necessary to keep them safe and sound,” said Carlson. “However, everywhere I go to talk about this issue, my members have told me horrific stories about what has happened to them and their loved ones because their nurse had too many patients to care for. In this state, which bills itself as a Medical Mecca, this level of care is a disgrace, and it is unacceptable.”
To date, more than 125 of the state’s leading health care and consumer advocacy groups have endorsed the bill and have joined the CPMP to push for passage in both the House and Senate. Similar events were held outside Carney Hospital in Dorchester, Mercy Medical Center in Springfield, as well as at public parks near Brockton Hospital and Anna Jaques Hospital in Newbury Port.
Key components of the bill include the following:
- The bill directs the Massachusetts Department of Public Health to develop and implement staffing standards and enforceable limits on the number of hospital patients assigned to a registered nurse at any one time.
- The staffing standards would be developed within 12 months of the bill’s passage and be based on scientific research on nurse staffing levels, patient outcomes, expert testimony, and standards of practice for each specialty area.
- The bill calls for the safe staffing limits to be implemented in all teaching hospitals by 2011, with implementation in all community hospitals by 2014.
- The bill allows DPH to grant waivers to hospitals in financial distress.
- The bill provides flexibility in staffing and accounts for patients who require more care. Once established, the staffing levels will be adjusted up or down based on patients needs using a standardized, DPH-approved system for measuring patient needs.
- The Act will reduce errors caused by fatigue and overwork by prohibiting hospitals from forcing nurses into mandatory overtime. It will also prevent hospital administrators from moving nurses into unfamiliar assignments without proper orientation.
- The Act prevents the reduction of support services, including services provided by licensed practical nurses, aides, and technicians.
- The bill establishes a number of nurse recruitment initiatives—sought by the hospital industry and supported by the Coalition—to increase the supply of nurses by providing nursing scholarships and mentorship programs, as well as support for increases in nursing faculty to educate new nurses. It also creates refresher programs to assist nurses who want to return to practice at the hospital bedside. A survey of Massachusetts nurses found that more than 65 percent of those not practicing in hospitals would be likely to return if a law providing safe limits was passed. In California, where similar limits have been in place for three years, 80,000 nurses have returned to the bedside, according to the California Board of Nursing.
- The bill establishes strong consumer protections for safe RN staffing, including a prominent posting of the daily RN staffing standards in each unit.
Visit the Coalition the Protect Massachusetts Patients Web site for a complete list of the organizational members of the Coalition to Protect Massachusetts Patients, including Worcester-area advocacy groups.