Nurse Staffing — A Step Forward

As one component of WSNA’s ongoing efforts to address our #1 priority of safe staffing, we have been actively engaged with the Health Care Authority (HCA) to create a link between nurse staffing, quality care and improved patient outcomes.

WSNA is pleased to announce that the Health Care Authority, through its State Innovation Plan, has broadened their “Starter Set” of Performance Measures to now include three Nursing Sensitive Measures in their Medicaid Quality Incentive program. Achievement of measure benchmark goals is tied to the incentive payments to hospitals through the safety net assessment program. By creating a financial incentive to provide quality care through safe staffing conditions, a new and essential link has been created in maintaining hospital accountability and competitiveness.

Beginning July 2016 through December 2016, non-critical access hospitals will be required to collect and submit to the HCA threshold data on the following quality nursing sensitive performance measures:

• Catheter Associated-Urinary Tract Infections Per Device Days
• Central Line Associated-Blood Stream Infection per Device Days
• Pressure Ulcers

In addition, the HCA will also require hospitals to answer the following questions related to nurse staffing committees:

1. Did the nurse staffing committee meet in 2016 and make recommendations to the executive team? (Yes/No)
2. Did the executive team provide their response back to the nurse staffing committee? (Yes/No)
3. Did the nurse staffing committee and executive team have access to the unit level data on the nursing measures? (Yes/No)

Benchmarks will be established by HCA, and hospitals will earn points based on their performance on the three nursing sensitive quality measures. In addition, hospitals can earn bonus points on the three nurse staffing committee questions. As a result of points earned, hospitals can then “earn back” 1% of the hospital safety net assessment withheld and designated for this program.

Expected timeline:

• July 1, 2016 to December 31, 2016 -- Hospitals collect performance data.
• April 2017 -- HCA determines which hospitals qualify for payment.
• July 2017 -- Qualifying hospitals receive incentive payment and next year begins.

As more details come forward about this program and implementation gets underway, look for updates on the WSNA website. We will be rolling out a series of education workshops throughout the state this fall and winter to empower our nurses to effectively engage in their nurse staffing committees and strengthen our voice for safe staffing.