"This ballot question threatens to disrupt our system:" A look at question 1

Learn more about the nurse staffing ratio ballot question and its effect on the Partners system if it passes on November 6.

This November at the polls voters will face a ballot question which would enforce government-mandated nurse staffing levels at all hospitals across the state. If Question 1 passes, the law would require every hospital to adopt one-size-fits-all nurse-to-patient ratios, enforced at all times, regardless of a hospital’s size, location or patient needs.

Laura S. Peabody, Chief Legal Officer & General Counsel, and Chris Philbin, Vice President of Government Affairs, talked about Question 1 and its effects on Partners and the rest of the health care system at the August Food for Thought session, and other leaders in the organization are weighing in. Question 1 proposes rigidity for our hospitals and, if passed, will take the decision-making power out of the health care professionals taking care of patients, threatening the quality of care and increasing costs for everyone.

“The nursing profession is made up of some of the smartest, most compassionate individuals in health care, and they make complicated and important decisions about patient care every day,” said Jeanette Ives Erickson, RN, Chair of the Partners HealthCare Chief Nursing Council and former Senior Vice President for Patient Care Services at Massachusetts General Hospital. “This ballot initiative would replace the expertise of nurses and the rest of the clinical care team with rigid government mandates. And, this ballot initiative will place an unprecedented amount of strain on the nursing workforce, which will severely limit access to behavioral health, psychiatry and rehabilitation services at institutions like McLean Hospital, Spaulding Rehabilitation and other distinguished organizations throughout Massachusetts. Our health care system is ranked among the tops in the nation by almost every measure and is relied upon by millions of patients and their families. This ballot question threatens to disrupt our system.”

Beyond increases in costs, if hospitals are unable to fulfill staffing ratio requirements, each location will be fined $25,000 per incident per day. Many community hospitals will be hard pressed to fulfill these ratios and will not be able to absorb added costs associated with the ratios. Hospitals across the state will be forced to make cuts to programs to adhere to new standards, and some of our largest state health care issues will suffer, namely opioid treatments and mental health services.

For patient care, this means:

• Delayed access to health care, which could result in patient harm
• Delays in emergency care due to delays in transferring patients from emergency departments to inpatient and critical care units
• Closures of hospital beds, units, programs or even entire hospitals
• Increases in patient transports to other organizations so specialty care can be received
• Delays in transportation of patients in clinical crisis from community hospitals to specialty hospitals
• Reduced availability of community services and treatments for medically complex children

 A “No” vote on November 6 would make no change in current laws relative to patient-to-nurse limits and keep decision making where it belongs – in the hands of our nurses.