Hospital Staffing Committees - Working Together for Paient Care

Washington State’s new hospital staffing law – Senate Bill 5236 – is a commitment to supporting the well-being of both patients and hospital workforces. A direct result of collaboration between Washington State hospitals and health care unions, SB 5236 strengthens existing staffing laws to uphold the highest patient care and worker safety standards in urban and rural settings.

We all rely on a strong health care workforce to deliver quality care, and staffing hospitals and care settings is a complex, multifaceted, and dynamic process. The new hospital staffing law offers Washington hospitals and health care unions an opportunity to fortify and improve the staffing committee process.

Get the Facts

Patients and Health Care Workers Benefit from Collaborative Staffing Committees

With collaborative and inclusive input from nurses and administrators, hospital staffing committees develop staffing plans to meet patient needs in urban and rural settings.

Compliance and Accountability Measures Safeguard Quality Working Conditions for Health Care Workers

SB 5236 ensures hospitals adopt a policy regarding compliance with the staffing plan and gives the Department of Labor and Industries (L&I) a greater role in investigating complaints alongside the Department of Health (DOH).

Innovative Staffing Solutions Protect Quality Care

The Washington State Hospital Association is committed to providing guidance and working collaboratively with Washington hospitals and other stakeholders to optimize hospital staffing committees and innovative staffing and care solutions.

Download Factsheet

Testimonials

  • “Identifying, building and fostering innovative solutions that improve staffing and retention in the health care industry is essential. As a Chief Nursing Officer, I’m excited to work with our staffing committee members to develop a plan that meets patient care standards while balancing the needs of a changing workforce.”

    Michelle Curry, RN
    Chief Nursing Officer,
    Overlake Medical Center

  • “I’ve been a registered nurse in Washington for 43 years and a CNO at Pullman Regional Hospital 30 years. As a member of the staffing committee, I’m looking forward to working collaboratively with other professionals and providing my perspective as a nurse to help craft a staffing plan to meet patient needs. Safety of patients and nurses go hand in hand. It is truly essential for hospital staff and leadership to work to address concerns together.”

    Jeannie M. Eylar
    Chief Clinical Officer,
    Pullman Regional Medical Center

  • "Washington hospitals are committed to exploring and implementing innovative care delivery models and new staffing solutions, including recruitment, retention, workflow improvements, supportive technology, and any other methods that help strengthen the delivery of quality care."

    Cassie Sauer, CEO
    Washington State Hospital Association

FAQ

What is the purpose of hospital staffing committees?

Hospital staffing committees promote a safe care environment for patients and staff by establishing a mechanism to convene direct care nursing staff and hospital management to participate in a collaborative process regarding decisions about nurse staffing. Responsibilities of a hospital staffing committee include:
  • Developing an annual staffing plan for nursing staff using a standard form
  • Reviewing and evaluating the effectiveness of the staffing plan semi-annually against patient needs and known evidence-based data
  • Reviewing, assessing, and responding to staffing variations, concerns or complaints presented to the committee

How will hospital staffing committees improve patient care and worker safety?

Washington relies on a strong health care workforce to deliver quality care, and staffing care settings is a complex, multifaceted, and dynamic process. Hospital staffing committees allow direct care nursing staff and hospital leaders to engage in an informed, collaborative decision making process, keeping decisions about staffing in the hands of the individuals who best understand the unique patient care needs and staffing challenges of each hospital. Staffing committees allow hospitals to maintain flexibility to implement innovative staffing strategies to ensure patients retain access to high quality, safe, reliable, and effective care.

Who participates on the hospital staffing committee?

Hospital staffing committees are to be composed of:
  • Fifty percent direct care nursing staff to be selected by employees or their labor representatives (if applicable), and must include RNs, LPNs, CNAs and unlicensed assistive nursing staff if employed at the hospital.
  • Fifty percent hospital management to be selected by hospital administration, and must include Chief Financial Officers (CFOs), Chief Nursing Officers (CNOs), and Department Managers/Directors or their designees.
Additionally, the law requires the committee to draft a charter that serves as a resource guide for how the committee operates and resolves disputes. An effective charter promotes accountability and professional governance, particularly when used to evaluate the committee’s performance and progress towards meeting key objectives.

What are some of the new compliance and enforcement provisions?

Under the new law, hospitals must adopt a policy regarding compliance with the staffing plan. Department of Labor and Industries (L&I) will also have a more significant role in investigating complaints alongside the DOH.
Beginning July 1, 2025, hospitals must assign nursing staff according to their staffing plan, track compliance with these assignments, and report to DOH if they fall below compliance with 80 percent of the assignments in a month. Hospitals will be required to submit and follow a corrective action plan (CAP). If they fail to submit or follow the CAP, they will be subject to fines. Hospitals are also required to report staffing plan compliance rates semiannually every January and July beginning in 2026.

Are hospital staffing committees “one-size-fits-all”?

Hospital staffing committees are not “one-size-fits-all.” Each hospital is required to develop a comprehensive, fact-informed staffing plan that’s tailored to the unique needs of patients and workers in their hospital. Staffing committees allow hospitals to maintain flexibility to implement innovative staffing strategies to ensure patients retain access to high quality, safe, reliable, and effective care.

Is this the same as staffing ratios?

No. Statewide, one-size-fits-all, mandatory ratios are not the right approach to addressing staffing. Hospitals are complex organizations with unique and individualized staffing needs that change on a shift-by-shift basis and require close coordination between management and workers based on a variety of factors. Hospital staffing committees and staffing plans provide hospital leadership and caregivers with a modern strategy to address staffing needs while prioritizing patient care and worker safety.
Download FAQ

Key Dates

List of Urban/System Hospitals List of Rural/CAH Hospitals
January 1, 2024
  • Hospitals must establish Hospital Staffing Committee (HSC) with expanded membership.
July 1, 2024
  • HSC proposed staffing plan for 2025 due to hospital CEO for review and annually thereafter.
  • HSCs must file a charter with the Department of Health (DOH).
  • Uninterrupted meal & rest break requirements expand and formal compliance tracking begins.
July-December 2024
  • Hospital CEO reviews plan, provides written feedback to the HSC and works with committee on final plan.
October 30, 2024
  • First quarterly meal & rest break report due for urban/system hospitals.
January 1, 2025
  • Hospitals must submit final staffing plans to DOH and annually thereafter.
July 1, 2025
  • Hospitals must begin tracking staffing plan compliance monthly.
  • HSCs must adopt written policy and procedure regarding direct care RN and NA-C orientation and competency demonstration before assignment to work in a particular clinical area.
January 31, 2026
  • First semiannual staffing plan compliance report due for urban/system hospitals.
July 1, 2026
  • Penalties for less than 80% compliance with meal & rest breaks begin for urban/system hospitals.
October 2026
  • First quarterly meal & rest break compliance report due for rural/CAH hospitals.
January 1, 2027
  • Corrective action plan required for compliance with staffing plan less than 80% of the time. Penalties for not following corrective action plan begin.
July 1, 2028
  • Penalties for less than 80% compliance with meal & rest breaks begin for rural/CAH hospitals.
Download Full Timeline

Resources for Hospitals

Need Assistance?

We’re here to help. For additional information or assistance in implementing your staffing plan, please fill in the form below and someone from the Washington State Hospital Association (WSHA) will be in touch soon.