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HOUSE OF REPRESENTATIVES             H.C.R. NO.            
TWENTIETH LEGISLATURE, 2000                 
STATE OF HAWAII                             
                                                             
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                     HOUSE 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,

 
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                                  H.C.R. NO.            
                                                        
                                                        

 
 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, Hawaii, as the "Health State," is committed to
32   providing its residents access to safe, quality health care
33   services, including services provided by licensed nurses; now,
34   therefore,
35   
36       BE IT RESOLVED by the House of Representatives of the
37   Twentieth Legislature of the State of Hawaii, Regular Session
38   of 2000, the Senate concurring, that the Hawaii Nurses'
39   Association (HNA) and the Healthcare Association of Hawaii
40   (HAH), within sixty days after the adjournment sine die of the
41   Regular Session of 2000, begin discussions to identify and
42   solve acute-care issues relating to patient safety, nursing

 
 
 
 
 
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                                  H.C.R. NO.            
                                                        
                                                        

 
 1   care, and the potential nursing shortage, including the
 2   necessity, feasibility, or advisability of requiring hospitals
 3   to adopt procedures described in S.B. No. 2735, Regular Session
 4   of 2000; and
 5   
 6       BE IT FURTHER RESOLVED that the discussions include
 7   representatives from as many of the smaller health care
 8   facilities as possible, including nursing homes, adult care
 9   homes, and community hospitals; and
10   
11       BE IT FURTHER RESOLVED that HNA and HAH submit a report to
12   the Legislature on their discussions no later than twenty days
13   prior to the convening of the Regular Session of 2000; and
14   
15       BE IT FURTHER RESOLVED that certified copies of this
16   Concurrent Resolution be transmitted to the President and Chief
17   Executive Officer of the Healthcare Association of Hawaii and
18   the Executive Director of the Hawaii Nurses' Association.
19 
20 
21 
22                         OFFERED BY:  ____________________________