2017 Staffing Transparency and Accountability Act

In 2017, the Washington State Legislature passed the Patient Safety Act, which creates greater transparency and accountability for nurse staffing plans and the work of nurse staffing committees in hospitals. The bill builds on the 2008 staffing law and 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.

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.
• Require hospitals to submit the adopted staffing plan and subsequent changes to the staffing plan to the Washington State Department of Health (DOH) beginning Jan. 1, 2019.
• Require hospitals to implement the staffing plan and assign nursing personnel to each patient care unit in accordance with the plan beginning Jan. 1, 2019.
• Allow nurses to report and file a complaint with the staffing committee any time the nurse personnel assignment is not in accordance with the adopted staffing plan.
• Allow 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 DOH 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 DOH to maintain public inspection records of any civil penalties, administrative actions, or license suspensions or revocations imposed on hospitals.
• Require DOH to submit a report to the legislature by Dec. 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 law expires June 1, 2023.

Read the full text of the bill passed by the Legislature.