Before the Joint Committee on Public Health
The Massachusetts Medical Society wishes to be recorded in
opposition to H.1469, "An Act Relative to Patient Safety."
The Massachusetts Medical Society supports the concept of
adequate nurse staffing levels without across-the-board statutory
or regulatory ratios. The Society has grave concerns about
enacting laws and regulations to establish standards of medical
care. While we have done so in the past, for example in the
areas of mammography and obstetrical length of stay, we did so
reluctantly and only when it is evident that legitimate patient
issues were being unmet. Best medical practices and
standards of care are generally not appropriate for codification in
statute or regulation. In this case, we are not
convinced that an across-the-board "one size fits all" staffing
ratio is a useful approach. On an individual basis, each
patient deserves the best care as determined by that patient's
caregiver. Just as each caregiver brings different
experiences to patients, each hospital provides varied clinical,
physical plant and technological resources to its patients.
There are unpredictable variations in the presentation of patients
to a hospital, as well as variations in the need for specialized
care within different clinical areas in a hospital. Thus, we
believe that no single formula or solution should be applied to all
facilities by statute or regulation.
We are deeply concerned that such a mandate will result in
clinical delays or inefficiencies in rendering care to
patients. These inefficiencies can result in overcrowding or
boarding of patients in emergency departments and in delays in
getting patients to appropriate medical/surgical units within a
hospital. Likewise, the possibility of diverting patients
from one institution to another may jeopardize the provision of
timely, local care to patients in need of emergency care.
Each patient's care must revolve around the needs of the individual
patient, not around the staffing of one component of their total
care.
We urge the Committee to reject House Bill 1469.
