Video: Health Policy Commission Patient Protection Committee Presentation of Final Regulations Underpinning ICU Law
Below is a video of the meeting on Wednesday of the Health Policy Commission Quality Improvement and Patient Protection Committee’s presentation of their final draft of regulations underpinning the ICU Safe Patient Limits Law, which the committee approved to be brought for a final vote for approval at the HPC meeting on June 10. We had previously posted and shared a link to the redlined copy of the final regulations, but this video provides valuable insight into the committee’s thinking in coming up with the final regs. As shared earlier, the MNA has serious concerns about these regulations, including:
The regulation’s failure to support the law’s key intent, which was that there is a default one nurse to one patient standard of care for all patients in ALL ICUs.
The regulations call for the committees formed at each hospital to create an acuity tool to support nurses in determining if and when they can take a second patient to be only advisory in nature, leaving management with final say on what tool is submitted to DPH for certification.
The regulations appear to allow management to step in and guide staffing decisions when a nurses assessment is in conflict with the acuity tool (the intent of the law was for nurses on the unit to have sole discretion on determining patient stability, and the tool was there to augment that process, with management having a say only when the staff nurses on the unit couldn’t agree). As written, the nurse’s judgement and the tool appear to be given equal weight and again, management is given the authority to step into the decision making process when a nurse and the tool disagree.
The regulations fail to ensure that notice of the law is posted in all ICUs so that patients and their families are informed of the standard of care called for under the law. The regulations also call for very limited and lax reporting.
Most important of all, the Committee has failed to clarify the law’s intent that it applies to ALL ICUs, including adult ICUs, NICUs, PICUs, etc. In fact, the committee is leaving it to the full HPC to decide that issue at its meeting on June 10. Again, this is in direct violation of the letter and intent of the law that was passed unanimously by the legislature.
We want to thank MNA member Harley Keisch, an ICU nurse at Berkshire Medical Center, for his incredible effort to put this videotape together. As this video is very long, Harley has also created a document providing a time index (PDF link) to help with easily accessing specific portions of the meeting. The index also includes Harley’s transcriptions and summaries of key remarks by commissioners and staff.