[Congressional Record Volume 147, Number 173 (Thursday, December 13, 2001)]
[Extensions of Remarks]
[Page E2274]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  PATIENT CARE INNOVATION ACT OF 2001

                                 ______
                                 

                          HON. JOHN P. MURTHA

                            of pennsylvania

                    in the house of representatives

                      Wednesday, December 12, 2001

  Mr. MURTHA. Mr. Speaker, The United States is facing a serious, long-
term, shortage of health care professionals. For example, the demand 
for nurses will exceed the supply by 2010, when the first of the 78 
million Baby Boomers begin to retire and enroll in the Medicare 
program. Across the board, working in patient care has become more 
stressful and care givers are leaving their profession as more sicker 
and elderly patients are entering our hospitals and nursing facilities. 
The future therefore, will require new models of patient care and the 
efficient use of the skills of our increasingly scarce nurses and other 
health care professionals.
  Care giving has always been a demanding profession. Those men and 
women who go into it--like those who go into teaching--do so out of 
commitment. Unfortunately, conditions in the work environment are 
making it virtually impossible for them to fulfill that commitment.
  The nursing shortage has set off the alarm and the concern is 
appropriate. But before effective responses and solutions can be 
devised, policy makers need to realize that nursing and the health 
system have been at this crossroads before. Over the past several 
decades, nursing has found itself caught in a perpetual cycle of 
workforce shortages and shortsighted solutions that, over the long 
term, have failed. The result has been more demanding workloads for 
care-givers with sicker and more older patients and a weakened 
infrastructure to support patient care.
  Nurses are increasingly spending more of their time away from direct 
medical care. From lifting and moving patients and providing hygienic 
care to increasing administrative support, over 40 percent of a nurse's 
hours are spent meeting non health related support activities. This 
inefficient use of nursing care has directly reduced the level and 
quality of patient care. Unfortunately, with operating margins the 
tightest they have ever been, hospitals have scaled back the number of 
skilled care givers and reduced the mix of qualified nursing personnel 
to a level where staffing ratios are inconsistent and mandatory 
overtime has become the necessity.
  The ``Patient Care Innovation Act of 2001'' will lead to the 
establishment of new, more efficient, postures of patient care.
  The legislation establishes a federally funded program of planning 
grants for the design, and demonstration grants for the implementation 
and evaluation of new innovative models of patient care delivery that 
provides quality patient care, recognizes and utilizes the professional 
competencies of nurses, and creates workplace environments conducive to 
nurse retention and recruitment, including care giver to patient 
ratios.
  This is an important step. Health care providers need to 
fundamentally rethink the way in which they organize and deliver 
patient care to determine if there is a better way to deliver care for 
both the patient and the care giver. Nurses, health care providers and 
other direct care givers need to be involved in designing, testing and 
evaluating new and innovative models of patient care.
  The development and testing of new and innovative models of patient 
care delivery must involve changes in organizational structures and 
processes; new management practices; greater nurse autonomy and 
involvement in patient care decision-making; more effective use of 
support staff; greater interdisciplinary collaboration and the expanded 
use of technology to reduce manual documentation and repetitive 
administrative tasks.
  Obviously, one solution will not fit all environments. All the more 
reason for passage of the ``Patient Care Innovation Act of 2001''. A 
broad band of responses must be developed if we are to maintain quality 
patient care and stop the exodus of care givers from the health care 
profession.
  Planning grants will be used to bring together multi disciplinary 
clinical and administrative teams to assess current patient care 
delivery systems, collect data, define work and care environment 
problems, evaluate new approaches and develop innovative models for 
delivering efficient safe and quality patient care.
  Demonstration grants will be used to implement and evaluate 
innovative models of care to demonstrate and determine their 
effectiveness in providing quality patient care and increasing the 
professional satisfaction of nurses within various health care 
settings.
  Health care providers are already struggling to maintain day-to-day 
operations under restrained payments by Medicare, Medicaid and 
insurance companies. Grant funding will enable providers to move 
forward more expeditiously to implement new methods of care while 
addressing the shortage of health care professionals before it reaches 
the crisis stage.
  Patient care must remain the primary focus of our health care system. 
The nursing shortage will affect the health care of all Americans 
unless we act now to create and implement the means to ensure the 
highest quality of care for all patients. Ultimately, success will mean 
generating changes in attitudes and practices that have been entrenched 
in the health care system for decades.
  Can the emerging shortage of health care professionals be turned 
around? To do so, policy makers and planners must go beyond discussing 
recruitment and increasing the size of educational programs. It will 
mean generating changes in attitudes and practices that have been 
entrenched in the health care system for decades. It requires that we 
engage in a reevaluation of how health care professionals are educated, 
credentialed and employed. In particular, employers need to create 
professional work environments that promotes and ensures high-quality, 
cost effective patient care and that recognizes and rewards the 
contributions that nurses and other health care professionals make to 
the very well-being of hospitals and our health care system.
  Therefore, I strongly urge all Members of Congress to join with me 
and sponsor passage of this critical piece of patient health care 
legislation.

                          ____________________