The American Nurses Association found a sponsor for a federal bill that would require hospitals and other healthcare institutions to make public their numbers of nurses, nurse staffing ratios, mortality rates and patient outcomes.
Rep. Maurice Hinchey (D-N.Y.) introduced the bill, known as the "Patient Safety Act," last week.
"I'm not here to criticize hospitals," Hinchey said. "They are constantly under pressure from insurers and from the current congressional majority to cut costs in any way they can. I want people to know that those costs have real effects on the kind of care they and their families receive."
The bill also would subject hospital mergers and acquisitions to review by HHS. The department could block any transaction that threatened the health and safety of patients, the community and employees.
Further, the bill would add language to the Medicare law to protect staff nurses who report poor staffing levels from retribution by their employers.
The ANA is working on comparable bills to be introduced at the state level.
According to an outline the ANA provided to MODERN HEALTHCARE, hospitals would have to make public:
How many registered nurses provide direct care.
How many unlicensed personnel provide direct care.
How many patients are assigned to each nurse.
How high patient mortality rates are.
How many adverse patient-care incidents occur.
How the hospital determines staffing levels.
These are all hot-button issues among nurses, who believe that in many instances patient care has been compromised by slap-dash internal restructurings and substitution of less-trained workers for registered nurses.
Hospitals also would have to make public any complaints filed with the state, with HCFA or with a Medicare accrediting agency.
The ANA has been reworking and refining its proposal since the debate over national healthcare reform began in 1993. The basic elements of the bill were agreed on last December. The ANA has been shopping it around Congress this spring.
The ANA is aware its proposal is not exactly in tune with present congressional thinking. Christine deVries, an ANA political officer, called it "a proposal that's real regulatory-oriented in a Congress that's not real regulatory-oriented."
One longtime observer of nurses and nursing unions called the bill "a blatant attempt at featherbedding."
Jack McGervey of Pleasant Hill, Calif., who retired after working 18 years with Kaiser Permanente as a labor contract negotiator, said: "It hardly differs from the third airline pilot in the cockpit, the caboose engineer on trains and hod carrier unions' demands for limits to the number of bricks that could be laid in a day. The `safety' claims in that collective bargaining and legislation made the same sounds as the `quality' claims of today."