Laura J. Wood, DNP, MS, RN
Senior Vice President, Patient Care Services
Chief Nursing Officer
Sporing Carpenter Endowed Chair for Nursing
RWJ Foundation, Executive Nurse Fellow
300 Longwood Avenue
Boston, MA 02115
Phone: 617-355-6488 fax 617-730-0632
laura.wood@childrens.harvard.edu
The Honorable John Keenan
Senate Chair, Joint Committee on Public Health
State House, Room 413B
Boston, MA 02133
The Honorable Jeffrey Sanchez
House Chair, Joint Committee on Public Health
State House, Room 130
Boston, MA 02133
October 28, 2013
Statement in Support of Senate Bill 1086
An Act to Promote Safe Patient Care
Dear Chairmen Keenan and Sanchez:
On behalf of the Department of Nursing and Patient Care Services at Boston Children’s Hospital (BCH), thank
you for the opportunity to submit written testimony in support of S.1086, An Act to Promote Safe Patient
Care. S.1086 rejects the approach of staffing based on a fixed nurse-to-patient ratio and instead promotes a
flexible patient-centered staffing model. We strongly support this flexible model as an essential process to
uphold high quality health care for patient and families, and a safe work environment for clinicians.
BCH’s Department of Nursing and Patient Care Services uses an interdisciplinary team approach to familycentered care, with staffing based on the needs of both the patient/family and the composition of the care team
within a dynamic context. We believe that every child, adolescent and adult deserves access to high quality
health care, and that hospitals have a responsibility to ensure safe practice conditions for nurses and other care
providers. We subscribe to key principles of a healthy work environment, in which both team collaboration and
data analytics inform staffing and operational planning.
We believe that the process of assigning nurses to care for patients is carried out with detailed analysis of
patient/family needs, and requires real-time assessment and judgment. When clinical leaders at BCH assign
nurses to care for patients, they take into account the experience and skill level of the nurses, the acuity and
complexity of the patient, the associated needs of the family, and the composition and specific experience level
and competencies of the care team.
At BCH, from the first moments of a shift, nursing and patient care assignments are reassessed and adjusted
through a collaborative process between bedside nurses and nurse leaders at the unit and hospital level. This
hands-on approach to staffing allows nurses to provide high quality and high value patient/family-centered
care.
We are strongly opposed to a fixed nurse-to-patient staffing ratio as specified by various bills before your
Committee. This approach removes the nursing judgment, which is essential in complex care environments,
given the dynamic rate of change in patient conditions that can arise from one moment to the next. Legally
mandating nurse-to-patient ratios impedes the ability of nurses to apply their professional judgment to interpret
and adapt staffing plans. It imposes a rigid and oversimplified approach to a complex and fluid process.
For the sake of the children and families we serve, we ask that you give a favorable report to S.1086. Again,
thank you for the opportunity to submit written testimony and for your kind consideration. Should you have
any questions, please feel free to contact me.
Respectfully submitted,
Laura J. Wood DNP, MS, RN
Senior Vice President, patient Care Services
Chief Nursing Officer
Robert Wood Johnson Foundation, Executive Nurse Fellow
Boston Children’s Hospital
Ashley Waddell MS, RN, CNOR
Staff Development Specialist
Clinical Education and Informatics
Boston Children's Hospital
Phone- 617-355-1905
Email- ashley.waddell@childrens.harvard.edu