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.