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THE SENATE                           S.C.R. NO.            S.D. 1
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                             
                                                             
________________________________________________________________
________________________________________________________________


                     SENATE CONCURRENT
                        RESOLUTION
URGING THE HAWAII NURSES' ASSOCIATION AND THE HEALTHCARE
   ASSOCIATION OF HAWAII TO BEGIN DISCUSSIONS TO IDENTIFY
   PROBLEMS AND PROVIDE SOLUTIONS FOR ACUTE-CARE ISSUES
   RELATING TO PATIENT SAFETY, NURSING CARE, AND THE POTENTIAL
   NURSING SHORTAGE.


 1       WHEREAS, on March 31, 1998, the President's Advisory
 2   Commission on Consumer Protection and Quality in the Health
 3   Care Industry (Commission) submitted a final report to the
 4   President of the United States entitled "Quality First:  Better
 5   Health Care for All Americans"; and
 6   
 7       WHEREAS, the Commission suggested that the purpose of
 8   health care "must be to continuously reduce the impact and
 9   burden of illness, injury, and disability, and to improve the
10   health and functions of the people of the United States"; and
11   
12       WHEREAS, the Commission also suggested that national goals
13   should include but not be limited to:
14   
15       (1)  Reducing the underlying causes of illness, injury, and
16            disability;
17   
18       (2)  Expanding research on new treatments and evidence
19            effectiveness;
20   
21       (3)  Assuring the appropriate use of health care services;
22   
23       (4)  Reducing health care errors;
24   
25       (5)  Addressing oversupply and undersupply of health care
26            resources; and
27   
28       (6)  Increasing patients' participation in their care;
29   
30   and
31   
32       WHEREAS, Hawaii's health care system is undergoing a
33   dramatic transformation due to an increased emphasis on managed
34   care, changes in health care financing and delivery of service,
35   and deregulation of the industry, resulting in unprecedented

 
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                                  S.C.R. NO.            S.D. 1
                                                        
                                                        

 
 1   competition and consolidation among providers; and
 2   
 3       WHEREAS, combining the realities of cost containment and
 4   cyclical nursing shortages with the priority of safe, quality
 5   care has been difficult, in part, because of the paucity of
 6   empirical data to guide decision-making; and
 7   
 8       WHEREAS, changes in the delivery of health care have
 9   dramatically increased the complexity of a registered nurse's
10   role and have caused the exodus of more experienced nurses from
11   acute care facilities and other settings; and
12   
13       WHEREAS, health care facilities on the mainland and in
14   Hawaii are now beginning to experience another nursing
15   shortage, particularly in the areas of intensive care,
16   emergency, and surgery; and
17   
18       WHEREAS, it is foreseen that cost containment initiatives
19   through a diminishment of Medicare, Medicaid, and private
20   health plan reimbursements will continue; and
21   
22       WHEREAS, ensuring a safe environment where nurses are able
23   to provide quality care for patients is essential to meeting
24   the goals of the Commission; and
25   
26       WHEREAS, S.B. No. 2735, Regular Session of 2000, addressed
27   the issue of nursing care, staffing, nursing duties, and
28   patient safety, but was not enacted; and
29   
30       WHEREAS, the public sector hospitals under the Hawaii
31   Health Systems Corporation should also engage with one another
32   in similar discussion of the issues concerning nursing care and
33   patient safety; and
34   
35       WHEREAS, Hawaii, as the "Health State," is committed to
36   providing its residents access to safe, quality health care
37   services, including services provided by licensed nurses; now,
38   therefore,
39   
40       BE IT RESOLVED by the Senate of the Twentieth Legislature
41   of the State of Hawaii, Regular Session of 2000, the House of
42   Representatives concurring, that the Hawaii Nurses' Association

 
 
 
 
 
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                                  S.C.R. NO.            S.D. 1
                                                        
                                                        

 
 1   (HNA) and the Healthcare Association of Hawaii (HAH), within
 2   sixty days after the adjournment sine die of the Regular
 3   Session of 2000, begin discussions to identify and solve
 4   acute-care issues relating to patient safety, nursing care, and
 5   the potential nursing shortage, including the necessity,
 6   feasibility, or advisability of requiring hospitals to adopt
 7   procedures described in S.B. No. 2735, Regular Session of 2000;
 8   and
 9   
10       BE IT FURTHER RESOLVED that the discussions identify the
11   rate of medical errors, consider the possibility of
12   establishing an adverse reporting system in Hawaii, and include
13   representatives of the HNA, HAH, Hawaii Government Employees
14   Association, Hawaii Medical Association, and Hawaii Health
15   Information Corporation; and
16   
17       BE IT FURTHER RESOLVED that the discussions include
18   representatives from as many of the smaller health care
19   facilities as possible; and
20   
21       BE IT FURTHER RESOLVED that the Hawaii Health Systems
22   Corporation (HHSC) and HNA enter into similar discussions with
23   the Hawaii Government Employees Association concerning public
24   hospitals; and 
25   
26       BE IT FURTHER RESOLVED that HNA and HAH submit a report to
27   the Legislature on their discussions no later than twenty days
28   prior to the convening of the Regular Session of 2000; and
29   
30       BE IT FURTHER RESOLVED that certified copies of this
31   Concurrent Resolution be transmitted to the President and Chief
32   Executive Officer of the Healthcare Association of Hawaii, the
33   Executive Director of the Hawaii Nurses' Association, Chief
34   Executive Officer of the Hawaii Health Systems Corporation,
35   Executive Director of the Hawaii Government Employees
36   Association, Hawaii Medical Association, and Hawaii Health
37   Information Corporation.