skip to main content
Washington State Institute for Public Policy

Use the search fields below to find specific publications that match certain criteria. If you want to find other information on our website that is not publications, you can use the search field in the navigation bar at the top, or click here to search the entire website.

Use the dropdown to select the field in which you would like to perform a keyword search.

Input the keyword you would like to search by in the textbox.

You can put multiple words inside quotes "like this" to indicate that you only want results where the entire phrase is found.

You can use the minus symbol "( - )" to indicate you only want results without the indicated word, such as: "teacher -substitute".


Select a publication author(s) to filter results by author. Once selected, you may remove an author from the search by clicking the "x".
"ANY of these authors" will return all results that include any of the authors you specified in your search criteria.

"ALL of these authors" will return only those results that include every author you specified in your search criteria.


Select a topic(s) to filter results by topic. Once selected, you may remove a topic from the search by clicking the "x".
"ANY of these topics" will return all results that include any of the topics you specified in your search criteria.

"ALL of these topics" will return only those results that include every topic you specified in your search criteria.


Select a date range if you would like to only see results published during a specified time period.

Publications

Found 1 results

Hospital Staffing Plans in Washington State
Open Publication PDF

Cory Briar, Colin Gibson - June 2024


The 2023 Washington State Legislature tasked WSIPP with analyzing hospital staffing plans submitted to the Department of Health as required by RCW 70.41.420. Specifically, WSIPP was asked to evaluate the plans in terms of timeliness, completeness, format, and the maximum number of patients assigned to nursing staff, along with trends over time. WSIPP was also directed to review professional guidance on hospital staffing and to summarize hospital staffing policies in other jurisdictions.

We find that 75% of staffing plans are submitted on time to the Department of Health annually. Only around 26% of hospitals report the same units each year, but we are not able to determine whether plans are complete due to a lack of information on hospital department mergers, openings, and closures over time. The format in which staffing information is reported is largely determined by the type of hospital unit. We find that patient-to-registered nurse (RN) ratios are lowest in critical care, post-anesthesia care, and during labor and birth, where the most involved or life-saving care is administered. Patient-to-certified nursing assistant (CNA) ratios are much higher than for RNs. Rural areas tend to have lower patient-to-CNA ratios than urban areas, suggesting that rural hospitals are more dependent on CNAs to administer care to patients. Some types of units have fairly consistent RN and CNA staffing ratios throughout the state, whereas others are more diverse.

Professional nursing and hospital associations offer similar recommendations regarding long-term guidance to solve the national nurse shortage in the US. In terms of short-term guidance, nursing organizations generally favor fixed patient-to-nurse ratios, whereas hospitals emphasize the importance of flexible staffing at the hospital level.

Washington is one of 15 states that require hospitals to produce staffing plans. Ten states also require staffing committees composed of at least 50% direct care staff, similar to Washington. Seven states have maximum patient-to-RN ratios in at least some hospital unit types.

Download:   Report    Executive Summary  
Related:
Legislation