FOR IMMEDIATE RELEASE/September 6, 1996

CONTACT: Sara Foer [202-651-7023]

American Nurses Association Commends President Clinton's Focus on Quality Health Care

ANA is Seen as Key Force in the Establishment of New Federal Commission

According to White House officials, the Commission was developed in part as a result of ANA's strong stand and public efforts on the issue of preserving the safety and quality of care for all patients and consumers.

In a September 6 letter to President Clinton, ANA President Beverly Malone, PhD, RN, FAAN, confirmed ANA's commitment to this endeavor. "We are fully in support of your efforts to spearhead a broad-based, national effort to make health quality a national priority," she wrote. Malone further stated that the "announcement of a national commission on health care quality represents a critically important step toward identifying the impact of current changes in health care financing and delivery on patient safety and quality of care."

Creation of the Commission was spurred in large part by recent public unrest surrounding certain health care practices, such as discharging new mothers anywhere from 8 to 24 hours after delivery and forbidding health care providers from revealing to patients financial incentives their health plan might have for denying care.

Speaking to an audience of senior citizens and members of the Florida Nurses Association in Sunrise, Fla., yesterday, Clinton said, "What we are trying to do is to understand how these changes in the health care system are going to affect America's families all generations of families: yours, mine, everyone else's." "What are the financial implications, what are the health care implications, what else should we do? But I am confident that being for a consumer's right to know is the right thing to do here," he continued.

Focusing on some of the same issues that are integral components of ANA's quality endeavors, the Commission will study and, where appropriate, develop recommendations for the President on: 1) consumer protection; 2) quality measures; and, 3) access and availability of treatment and services, especially to the underserved, in a rapidly changing health care system. According to the White House, the Commission expects to submit a preliminary report by September 30, 1997 and a final report 18 months after its first meeting.

Under the auspices of Vice President Gore's Reinventing Government Program, the Commission will be co-chaired by the Secretary of Health and Human Services, Donna E. Shalala, and the Secretary of Labor, Robert B. Reich, and will consist of 20 appointments -- 10 health care providers and 10 consumers. ANA has been requested to submit names of potential appointees to the White House by mid-September.

ANA shares President Clinton's enthusiasm not only about the Commission, but also about two bills geared to protecting the consumer and ensuring quality health care. In her letter to President Clinton, Malone in particular praised Clinton's "clear and outspoken support for current legislative efforts to eliminate arbitrarily shortened maternity hospitalizations and to end the use of gag' rules that prevent nurses, physicians, and other professionals from speaking freely with their patients regarding treatment options. As you know, ANA has worked with other provider and consumer groups to achieve passage of these patient protection measures, and we deeply appreciate your support." Highlighting the "Newborns and Mothers Health Protection Act," which calls for appropriate lengths of stay for mothers and newborns, Clinton said, "We strongly supported a bill that says that you cannot kick a mother and her newborn child out of a hospital sooner than 48 hours. ...It ought to be a decision that [is made] based on what is best for the mother and the baby..."

Similarly, in a position statement released in February, ANA called for a standard of care that includes length of hospitalization based on the mother's and infant's needs and a provision for postpartum home nursing care. ANA supports legislation that would ensure ample opportunities for health care providers, in particular nurses, to observe and assess a mother and her newborn, to provide adequate teaching and to ensure that the mother has learned needed skills for caring for her new baby.

The other legislation, the Patient Right to Know Act, sponsored by Rep. Ed Markey (D-MA) and Rep. Greg Ganske (R-IA), would prohibit managed care organizations from limiting practitioners' abilities to discuss with patients the full range of treatment options..."

ANA has long been opposed to "gag" rules and has recognized that patients need full knowledge of their treatment options in order to make informed decisions about their care. The ANA House of Delegates (HOD), at its meeting this summer, declared its opposition to the use of "gag" rules, and ANA has been working on Capitol Hill with a broad range of other consumer advocates and practitioner groups to oppose the use of such "gag" rules.

Health care professionals "must not face discrimination when they uphold their oath to give patients the best care," Clinton said. "Patients should feel safe in the knowledge that they have been given the full story of what all their treatment options are and what are best for them."

Earlier this year, ANA drew attention to the issue of safe, quality care and consumers' rights to know through the results of a consumer survey, "Nursing and the Quality of Patient Care," in which respondents indicated that they are worried about many of the changes in our health care delivery system and how they affect the quality of patient care in health care institutions. As many as three-quarters of the adults polled indicated serious concern that the quality of patient care is being diminished by some cost-cutting practices -- a concern that has increased significantly since 1994.

For example, whereas 67% of respondents in 1994 rated the reduction in RN staffing as a key factor leading to deterioration of the quality of patient care in hospitals, that percentage rose to 75% in 1996. In addition, in 1996 75% of the survey respondents believed that reducing the number of registered nurses who provide bedside patient care in hospitals lowers the quality of care, and 67% said that increasing the use of unlicensed health care workers for care traditionally performed by RNs has the same quality-diminishing effect.

The creation of the Commission and its goal to preserve and protect quality health care builds on one of ANA's key issues of which the consumer survey played a key role. Over the past two years, ANA has mounted a highly effective public education campaign, "Every Patient Deserves a Nurse" to increase awareness of the growing trend of reduced registered nurse staffing in hospitals and its impact on the safety and quality of care. The campaign has resulted in sustained, high-profile coverage by print, wire and broadcast media, and stimulated support and grass-roots initiatives by state nurses associations and consumer coalitions. Federal and state legislation have been introduced to call for consumer access to information about nurse staffing and patient outcomes as well as to provide "whistle blower" protections for nurses who speak out publicly about patient care issues. In addition, ANA has spearheaded the development of nursing "report card" efforts, which would identify and promote the use of nursing quality indicators to measure and monitor the quality of health care.

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