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THE SENATE                           S.C.R. NO.            S.D. 2
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,
16             and 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,

 
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                                  S.C.R. NO.            S.D. 2
                                                        
                                                        

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

 
 
 
 
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                                  S.C.R. NO.            S.D. 2
                                                        
                                                        

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