Staffing: Washington Patient Safety Act

Staffing Transparency & Accountability Act

On April 20, 2017, the House passed the Patient Safety Act, addressing WSNA’s top issue of safe staffing. The bill creates greater transparency and accountability for nurse staffing plans and the work of nurse staffing committees in hospitals.

This legislative session, WSNA worked with other union stakeholders and hospitals on the negotiated bill that builds on the 2008 staffing law to strengthen our staffing committees and increase transparency of hospital nurse staffing plans across the state.

The bill represents a real step forward in our ongoing work to hold hospitals accountable for staffing so that nurses can deliver safe, high quality care to their patients.

See Press Release 4-20-2017

Click here for bill passed by the Legislature

ESHB 1714: Nurse Staffing

April 20, 2017: Final passage by the legislature.

This bill increases transparency of staffing plan and hospital accountability by amending the current staffing law to:

  • Require hospitals to accept the staffing committee’s staffing plan or to prepare an alternative annual staffing plan that will be adopted by the hospital.
  • Requires hospitals to submit the adopted staffing plan and subsequent changes to the staffing plan to the Washington State Department of Health beginning January 1, 2019.
  • Requires the hospital to implement the staffing plan and assign nursing personnel to each patient care unit in accordance with the plan beginning January 1, 2019.
  • Allow a nurse to report to, and file a complaint with, the staffing committee any time the nurse personnel assignment is not in accordance with the adopted staffing plan.
  • Allows nurses who may disagree with the shift-to-shift adjustments in staffing levels to submit a complaint to the staffing committee.
  • Require staffing committees to develop a process to examine and respond to submitted complaints, and to determine if a complaint is resolved or dismissed based on unsubstantiated data.
  • Require the Washington State Department of Health to investigate complaints with documented evidence for failure to:
    • Form or establish a staffing committee;
    • Conduct a semi-annual review of a nurse staffing plan;
    • Submit a nurse staffing plan on an annual basis and any updates;
    • Follow the nursing staff personnel assignments as adopted by the hospital based on the complaints compiled by the staffing committee that include aggregate data that show a continuing pattern of unresolved violations for a minimum 60-day continuous period. Exceptions include unforeseeable emergent circumstances and documented reasonable efforts by hospital to obtain staffing to meet required assignments.
  • Require hospitals to submit a corrective action plan within 45 days if the Washington State Department of Health (DOH) finds a violation – and, if the hospital fails to submit a corrective action plan or doesn’t follow its corrective action plan, DOH may impose a civil penalty of $100 per day until the hospital submits a corrective action plan, begins to follow a corrective action plan, or takes other action agreed to by DOH.
  • Require the Washington State Department of Health to maintain public inspection records of any civil penalties, administrative actions, or license suspensions or revocations imposed on hospitals.
  • Requires the Washington State Department of Health to submit a report to the legislature by December 31, 2020, on the number of complaints submitted, investigated, associated costs to DOH, and any recommended changes to statute. Requires a stakeholder group including WSNA to review the report before it is submitted to the legislature.
  • This act expires on June 1, 2023.
Milestone

2008 Staffing Law

Current hospital staffing committees were created by law in 2008. This law states that:

  • Nurse staffing committee composition & responsibilities
  • Half of the staffing committee members shall be registered nurses currently providing direct patient care.
  • Nurses on the staffing committee shall be scheduled on paid work time, and cannot be retaliated against in connection with the staffing committee.
  • Development and oversight of a nurse staffing plan for each unit and shift of the hospital based on patient care needs, appropriate skill mix of registered nurses and other nursing personnel, layout of the unit, and national standards and recommendations on nurse staffing.
  • Semi-annual review of the staffing plan against patient need and known evidence-based staffing information, including nursing sensitive quality indicators collected by the hospital.
  • Review/assessment/response to staffing variations or concerns.

Primary hospital responsibilities

  • If the committee’s plan is not adopted by the hospital, then the CEO shall provide a written explanation.
  • In a public area on each patient care unit, post the nurse staffing plan and the nurse staffing schedule for that shift on that unit.
  • Make staffing plan and current staffing levels available to patients and visitors upon request.

Non-retaliation

  • Hospitals may not retaliate or intimidate an employee for performing any duties or responsibilities in connection with the nurse staffing committee; or
  • Hospitals may not retaliate or intimidate an employee, patient, or other individual who notifies the nurse staffing committee or the hospital administration of his or her concerns on nurse staffing.