New Bill Would Boost Patient Safety in California Hospitals

Legislation introduced late last week by State Sen. Leland Yee and sponsored by the California Nurses Association/National Nurses United would strengthen Californias landmark safe hospital staffing law by stepping up enforcement to enhance patient protections.

SB 554 would provide for fines for hospitals that demonstrate "a pattern of violation" by repeat violation of the safe staffing law. It would also direct the state Department of Public Health (DPH) to inspect hospitals for compliance with safe staffing during normal periodic hospital inspections.

Under a 1999 CNA-sponsored law, all California hospitals are required to maintain minimum, specific nurse-to-patient ratios at all times. The law, enacted to combat a sharp decline in care conditions in California hospitals during the corporate hospital restructuring craze of the 1990s has been a "spectacular success story," says CNA/NNU co-president DeAnn McEwen, and "provided California patients and families the comfort of knowing they have the safest hospital staffing standards in the U.S."

Documentation of that safety record came in a study last year by University of Pennsylvania researchers published by the policy journal, Health Services Research. Comparing California to comparable hospitals in Pennsylvania and New Jersey, the study found that New Jersey hospitals would have 14 percent fewer deaths, and Pennsylvania 11 percent fewer if they matched Californias ratios in surgical units.

The study, led by researcher Linda Aiken, RN, PhD, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, also demonstrated that California RNs have far more time to spend with patients and miss fewer changes in patient conditions because of their workload.

While the majority of California hospitals do adhere to the law, McEwen noted, some rogue facilities in the state ignore the important protections it requires putting patients at risk. Current law permits citation, but not fines. "This important bill will close that loophole for the benefit of patients and nurses, and assure a level playing field for all California hospitals."

Yees office quoted DPH data showing that 40 percent of hospitals have been issued deficiencies for failing to meet the nurse-to-patient ratio requirement that went into effect in 2004. The rate of noncompliance is likely even higher as hospitals are not currently inspected for staffing ratios on a routine basis.

"SB 554 will help ensure hospitals are not cutting corners and patients are provided the best possible care," Yee says.