BC Expert: Patient Safety Act
office of news & public affairs
Connell School of Nursing Associate Professor
Judith Shindul-Rothschild is a certified psychiatric nurse clinical specialist. Her research and writings have focused on the relationships between health care policy and finance, nurses' working conditions, staffing and quality of care, use of unlicensed assistive personnel in hospitals; consumers' health care rights and health care reform. She is currently researching the impact of Chapter 58, which is the model for the Affordable Care Act, on nurses’ working conditions in Massachusetts hospitals. Dr. Shindul-Rothschild is co-author of the book Aging and Public Policy: Social Control or Social Justice? She has published numerous articles on the impact of health policies on patient care and nursing practice in professional journals such as: Journal of Nursing Care Quality, Journal of Emergency Nursing, Critical Care Nursing, Journal of Nursing Education, Revolution, The American Nurse, The American Journal of Nursing, and Advanced Practice Nurse, among others. She and journalist Suzanne Gordon have published articles on the adverse effects of competition or market based health financing in: The Los Angeles Times, The Utney Reader, The Nation, Mother Jones, The Miami Herald, and The Boston Globe. She has been widely quoted by the national print, television and radio media in the United States and Canada including: Good Morning America, NBC Nightly News, PBS, Canadian Broadcasting Company, The New York Times, US News & World Report, Newsweek, USA Today, and National Public Radio.
It’s a bill that’s been languishing on Beacon Hill for a decade – the Patient Safety Act – a proposed law that would cap the number of patients Massachusetts’ registered nurses can care for. On Monday, advocates are expected to pack the Gardner Auditorium on Beacon Hill as experts tell lawmakers the time is now for the bill to become a reality.It’s a bill that’s been languishing on Beacon Hill for a decade – the Patient Safety Act – a proposed law that would cap the number of patients Massachusetts’ registered nurses can care for. On Monday, advocates are expected to pack the Gardner Auditorium on Beacon Hill as experts tell lawmakers the time is now for the bill to become a reality.
“I think it’s absolutely critical that the Patient Safety Act is approved,” says Judith Shindul-Rothschild, Ph.D., RNPC, associate professor at the Connell School of Nursing at Boston College, and research expert who will be testifying on Monday. “It’s critical because we have a critical mass of hospitals that are not staffing to the standard that is necessary to provide quality, safe nursing care.”
The bill, now scheduled to go on the ballot in November if lawmakers don’t pass it, would replicate the success California has seen since it enacted a nurse-patient ratio cap in 2008. The legislation not only implements limits on the numbers of patients assigned to nurses, but also aims to help reduce errors caused by fatigue and overwork by prohibiting mandatory overtime. Among other things, the bill would also stop hospitals from assigning unlicensed workers to perform duties licensed nurses should be handling. Currently there is no law or standards in place for the number of patients that can be assigned to a nurse at one time in Massachusetts hospitals.
“From the public’s perspective, it is absolutely in their interests to support this ballot initiative so that when they’re in the hospital or a loved one is in the hospital, there is no doubt there will an adequate number of registered nurses to care for them to assure they get safe, quality nursing care,” says Shindul-Rothschild, whose article in the Journal of Nursing Care Quality (http://journals.lww.com/jncqjournal/Fulltext/2014/04000/Predictors_of_Excess_Heart_Failure_Readmissions_.4.aspx) showed an association between nurse staffing and readmissions for heart failure.
“Multiple studies have demonstrated there’s an impact on what we call ‘failure to rescue’ – patients who shouldn’t have died in the hospital but did because there weren’t enough nurses,” says Shindul-Rothschild. “The research evidence is clear there is a causal relationship.”
To the argument this legislation will cause hospitals an undue financial burden, Shindul-Rothschild says look to the West.
“The number one cause of readmission is heart failure, which cost hospitals in one year $34 billion,” says Shindul-Rothschild. “How do you avoid that? Don’t be short-sighted. Put registered nurses by the bedside. California has much lower readmission rates. One reason, they have better nurse staffing. That’s why. So if you want to save money in the long run and you want to keep your institution financially sound you need to invest in registered nurses.
“We have a significantly smaller proportion of nursing staff to total hospital personnel in Massachusetts hospitals than in California. This law, if enacted, is simply going to force hospitals to shift resources from administrators and other non-direct providers back to the bedside. That’s what’s this is going to do.”