Hearing Highlights Concerns About Patient Harm in Hospitals

Contact: Dawn Kettinger or (517) 721-9688

Nurses, bipartisan sponsors urge action to add accountability and transparency to the industry

MNA member Katie Scott, RN, tells the House Health Policy Committee a powerful story about how a patient died due to understaffing. The Safe Patient Care Act (House Bills 4629-4631) took a huge step forward with this legislative hearing.

(Lansing, MI) Registered nurses today welcomed a hearing on the Safe Patient Care Act in the House Health Policy Committee as major progress in the effort to add much-needed accountability and transparency to the hospital industry.

“Registered nurses appreciate this opportunity to raise awareness about this legislation, which is needed to make sure that hospitals create conditions in which nurses can keep our patients safe from harm and provide the best care possible,” said John Armelagos, RN and president of the Michigan Nurses Association. “The Safe Patient Care Act has broad support from legislators from both sides of the aisle. This hearing represents a sea change in terms of more legislators recognizing this as an urgent, nonpartisan public safety issue. Michigan nurses applaud Chairman Vaupel for bringing the Safe Patient Care Act up in committee and we look forward to continuing to work with all legislators to move this forward.”

More than 70 registered nurses from around the state attended the hearing to show support, including RNs from as far away as Marquette. Nurses also presented more than 4,000 postcards from registered nurses urging legislators to take action on the bills.

The Safe Patient Care Act is made up of three bills that aim to increase the safety of patients in Michigan’s hospitals and maintain a strong nursing workforce:

  • HB 4629, sponsored by Rep. Jon Hoadley, establishes safe limits on the number of hospital patients a nurse can be assigned. There is currently no law, which too often results in nurses being stretched too thin to provide safe care.
  • HB 4630, sponsored by Rep. Stephanie Chang, limits the number of hours a nurse can be ordered to work to 12 consecutive hours, with exceptions for special circumstances. Currently, there is no law regarding hours, so nurses too frequently are forced to work 16 or 18 hours at a time.
  • HB 4631, sponsored by Rep. Aaron Miller, adds transparency to hospitals by requiring them to disclose their RN-to-staff ratios so consumers can make informed decisions.

Although the Safe Patient Care Act has been introduced in previous sessions, this session is different because the legislation is broken up into three parts and has more bipartisan support than ever. Fifty-one legislators have signed on to at least one of the bills in the package.

“As policymakers, we want to fix the problem of Michigan having no law that limits the number of patients that a nurse can be assigned at one time,” said Rep. Jon Hoadley (D-Kalamazoo), sponsor of HB 4629. “While many hospitals do fine with staffing, we know from listening to RNs around the state that there are too many times when nurses are stretched too thin and can’t keep their patients safe and well-cared for. It doesn’t make sense that we have laws that require day cares to have a certain number of caregivers per child but when it comes to sick or injured kids, we have no law to make sure their nurse doesn’t have an unsafe number of patients.”

Rep. Stephanie Chang (D-Detroit), sponsor of HB 4630, said she has heard too many horror stories about nurses being ordered to work 16 or 18 hours in a row, which is unsafe.

“While nurses are hard-working and dedicated professionals, it’s unreasonable to expect them to provide good care when they are exhausted or sleep deprived,” Chang said. “We have laws that limit working hours for truck drivers and airline pilots to keep the public safe, and we should have a law for nurses, too. There is wide, bipartisan support for this bill to protect registered nurses from being forced to work excessive overtime because it just makes sense.”

Rep. Aaron Miller (R-Sturgis) sponsored the bill to require hospitals to disclose their actual RN-to-patient ratios, which can vary widely from their plans. Miller said this Legislature has taken strong leadership when it comes to transparency, and he hopes it would stay true to that principle as it applies to the public’s concerns about health care.

“It’s wrong that consumers and employers don’t have access to basic information about hospital care, including how many patients a nurse has to take care of at one time,” Miller said. “Transparency in healthcare is essential so that people can make informed decisions about spending their hard-earned money, and it’s a principle that all legislators can get behind. Since the number of patients per nurse is a key indicator of good outcomes for hospital stays, it’s one of the factors that we all should have the right to know.”


Preventable patient harm is the third-leading cause of death in America. Estimates are that more than 1,000 people die every day. (1) Although Michigan hospitals are not required to report harmful incidents, the Michigan Health and Hospital Association reported that in 2014, participating Michigan hospitals voluntarily self-reported 52,000 adverse events or “near misses,” which is 1,000 per week. (2)

(1) Source: “A new, evidence-based estimate of patient harms associated with hospital care,” Journal of Patient Safety, September 2013

(2) Source: 2015 MHA Keystone Center Annual Report

The Michigan Nurses Association is the largest labor and professional association for registered nurses in Michigan.

Documents are available at www.misaferhospitals.org, including a one-page cheat sheet on the bills and a chart showing sponsors and cosponsors of each bill.

The Safe Patient Care Act is also pending in the Senate, as follows:

Safe limits on patient assignments: SB 387 (Sen. Rebekah Warren, D-Ann Arbor), identical to HB 4629 (Hoadley)
Limits on forced overtime for RNs: SB 388 (Sen. Tom Casperson, R-Escanaba), identical to HB 4630 (Chang)
Transparency on RN-to-patient ratios: SB 389 (Sen. Joe Hune, R-Fowlerville), identical to HB 4631 (Miller)


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