44
HOUSE OF REPRESENTATIVES             H.C.R. NO.            H.D. 1
TWENTIETH LEGISLATURE, 2000                 
STATE OF HAWAII                             
                                                             
________________________________________________________________
________________________________________________________________


                     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,
35   and deregulation of the industry, resulting in unprecedented
36   competition and consolidation among providers; and

 
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                                  H.C.R. NO.            H.D. 1
                                                        
                                                        

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

 
 
 
 
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                                  H.C.R. NO.            H.D. 1
                                                        
                                                        

 
 1       BE IT FURTHER RESOLVED that the Hawaii Nurses' Association
 2   and the Healthcare Association of Hawaii submit a report to the
 3   Legislature on their discussions no later than twenty days
 4   prior to the convening of the Regular Session of 2000; and
 5   
 6       BE IT FURTHER RESOLVED that certified copies of this
 7   Concurrent Resolution be transmitted to the President and Chief
 8   Executive Officer of the Healthcare Association of Hawaii and
 9   the Executive Director of the Hawaii Nurses' Association.