FOR IMMEDIATE RELEASE/January 31, 1997

CONTACT: Sara Foer [202/651-7023]

Consumers' concerns about health care echo nurses' warnings says ANA

WASHINGTON, DC -- Findings from three different consumer surveys released this month echo the concerns nurses have expressed over the past two years about the current direction of health care, where quality of care is often sacrificed in the name of cost containment, according to the American Nurses Association (ANA).

"From their vantage point as frontline care givers, nurses were the first to realize how care decisions motivated by short-sighted cost savings jeopardize the quality of patient care," said ANA President Beverly L. Malone, PhD, RN, FAAN. "We are hardly surprised that consumers lack confidence in a system that often puts profits above patients."

Collectively, the surveys' findings voice a general concern that consumers believe health care is becoming more impersonal and that patients desire more information, communication, and respect from their care givers.

Specifically,

• In a survey commissioned by the National Coalition on Health Care (January 23), seven out of ten people agree that there are serious problems with the quality of health care and that quality of care is often compromised to save money.
• Satisfaction surveys from a sample of more than one million patients identified factors that affect their likelihood of recommending a hospital. Of the top ten factors, six were related to the quality of nursing care (Press, Ganey Associates, January 10).
• Qualitative and quantitative research findings identified consumers' concerns about the impact of staff decreases and increased use of lesser skilled workers on the quality of care (American Hospital Association, Picker Institute, January 27).

"In today's environment, individuals are not admitted to a hospital unless they require round-the-clock care by professional nurses," said Malone. "These surveys show that patients understand the relationship between adequate nurse staffing and good care, yet, those with an eye on the bottom line fail to understand the relationship between good nursing care and cost-effective care. Therefore, nursing budgets are often the first to be cut in the name of cost savings."

According to the findings of a survey of more than 7,000 nurses published in the November issue of the American Journal of Nursing, nurses are experiencing a labor trend known as "speed-up." This means that nurses are expected to work harder and faster with fewer resources, providing care for greater numbers of sicker patients in the same amount of time. Such a pattern invariably leads to higher turnover and an increase in work-related injuries, and ultimately jeopardizes quality of care.

Almost three quarters of the survey respondents reported having less time to teach patients and families, comfort and talk to patients, document nursing care, and consult with the health care team. Furthermore, on average, almost 2 out of 5 nurses reported an increase in patient complications, medication errors, hospital-acquired infections, skin breakdown, and injuries to patients. One of the most telling statistics is that 37% of RNs would not recommend that a family member receive care in their hospitals, and while almost 15% would rate the quality of care at their facilities as poor or very poor, only 10% would rate the care as excellent.

A priority since 1994, the American Nurses Association has mounted Nursing's Safety and Quality Initiative, which focuses on educating the public and policy makers about changes in health care that impact the safety and quality of that care. Part of the initiative includes the collection and measurement of data to further demonstrate the link between RN care and positive patient outcomes, such as reduced mortality, morbidity, complication, and readmission rates -- which ultimately means lower costs.

ANA lobbied vigorously for the introduction of The Patient Safety Act of 1996, a bill introduced by Rep. Maurice Hinchey (D-NY), intended to make hospitals accountable for their staffing decisions. The bill, expected to be reintroduced in the 105th Congress next month, mandates public disclosure by hospitals of staffing levels and patient outcome data, calls for "whistle blower" protection for nurses who speak out on behalf of patient care issues, and requires Department of Health and Human Services review of proposed mergers and acquisitions to determine the impact on the health of the community. In addition, similar legislation has been introduced in some state legislatures.

"We strongly encourage our colleagues, both hospital administrators and physicians, to work with the American Nurses Association to advance our quality initiatives in order to steer the future of health care in a direction that will restore Americans' confidence in the system," said Malone.

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