What’s in your charter?

To comply with the hospital staffing committee law, charters are detailed and thorough, addressing over a dozen committee functions related to roles, responsibilities, and processes.

This story was published in the Winter 2024 issue of The Washington Nurse.

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In 2023, changes were made to strengthen Washington State’s nurse staffing law. One important change was an expansion from nurse staffing committees to hospital-wide committees. Effective in 2024, hospitals must establish hospital staffing committees (HSC) to adopt patient care unit– and shift-based staffing plans. With this change, HSCs are required to develop a charter that includes standard elements to guide the committee.

To comply with the hospital staffing committee law (RCW 70.41.420), charters are detailed and thorough, addressing over a dozen committee functions related to roles, responsibilities, and processes. The HSC charter is collaboratively developed by voting committee members comprising at least 50% nonsupervisory / nonmanagerial direct patient care nursing staff and 50% from hospital administration. The HSC charter is due to the WA Department of Health on July 1, 2024.

The Hospital Staffing Committee charter must include —

  • A process for electing HSC co-chairs and their terms of service.
  • Roles, responsibilities, and processes by which the hospital staffing committee functions, including:
    • Patient care staff job classes represented on the committee as nonvoting members.
    • Number of members serving on the HSC.
    • Process to ensure a quorum and the ability of HSC members to attend.
    • Process replacing HSC members who do not regularly attend.
  • Schedule for monthly meetings (more frequent, as needed).
  • HSC members provided 30 days’ notice of meetings.
  • Process for reviewing staffing complaints, including investigation and resolution, noting the date received, as well as initial, contingent, and final disposition of complaints and corrective action plan(s) where applicable.
  • Process to resolve complaints within 90 days of receipt or longer with the majority approval of the HSC.
  • Process to provide the complainant with a letter stating the outcome of the complaint.
  • Process for HSC attendance by any employee involved in a complaint.
  • Process for labor representative to attend HSC if requested by the employee involved in the complaint.
  • Process for HSC to conduct quarterly review of the following:
    • Staff turnover rates, including new hire turnover rates during the first year of employment.
    • Anonymized aggregate exit interview data on an annual basis.
    • Hospital plans regarding workforce development.
  • Standards for HSC approval of meeting documentation, including meeting minutes, attendance, and actions taken.
  • Policies for the retention of meeting documentation for a minimum of three years, consistent with the hospital’s document retention policies.
  • Process for the hospital to provide the HSC with information regarding patient complaints involving staffing made through the patient grievance process according to 42 C.F.R. 482.13(a)(2).
  • Process for the use of reports, described under RCW 70.41.420 (7), to inform the development and semiannual review of the staffing plan.

The Washington Department of Health and the Department of Labor and Industries must provide technical assistance to hospital staffing committees for compliance with charter requirements. Technical assistance may not be provided during an inspection or between when an investigation of a hospital is initiated and when the investigation is resolved.