CBA Article 40


40.1 The Employer and Union strongly support the proposition that adequate staffing and an appropriate trained staff are necessary to meet the needs of our patients and provide quality care. Both the Employer and Union will work to ensure that state hospitals as defined in RCW 72.23.010 are staffed according to best practices in providing a safe and healthy environment for patients and nurses. 

The Employer and Union agree to establish a process to promote evidence-based nurse staffing in each state hospital in compliance with ESHB 3123.  (Actual Bill)

40.2 The Employer and Union will continue and update the composition and mission of staffing committees to meet the requirements of ESHB 3123. 

40.3 Composition of the Joint Staffing Committees 

A. At least one-half (1/2) of the members of the nurse staffing committees shall be registered nurses currently providing direct patient care and up to one-half (1/2) of the members shall be determined by the hospital administration. The Union will select the direct patient care nurses for the committees. Each committee shall be co-chaired by the nurse executive or designee and the Union local chair or designee. 

B. Participation in the Joint Staffing Committees by employees shall be on scheduled work time and compensated at the appropriate rate of pay. Joint Staffing Committee members shall be relieved of all other work duties during the committee meetings. 

40.4 Responsibilities of the Joint Staffing Committees 

The primary responsibilities of the committees will be to: 

A. Development and oversight of an annual patient care unit and shift-based nurse staffing plan, based on the needs of patients, to be used as the primary component of the staffing budget. Factors to be considered in the development of the plan should include, but are not limited to: 

1. Census, including total numbers of patients on the unit on each shift and activity such as patient discharges, admissions, and transfers; 

2. Level of intensity of all patients and nature of the care to be delivered on each shift; 

3. Skill mix; 

4. Level of experience and specialty certification or training of nursing personnel providing care;

5. The need for specialized or intensive equipment; 

6. The architecture and geography of the patient care unit, including but not limited to placement of patient rooms, treatment areas, nursing stations, medication preparation areas, and equipment; 

7. Staffing guidelines adopted or published by national nursing professional associations, specialty nursing organizations, and other health professional organizations; and 

8. Hospital finances and resources. 

B. Semiannual review of the staffing plan against patient need and known evidence-based staffing information, including the nursing sensitive quality indicators collected by the hospital; and 

C. Review, assessment, and response to staffing concerns presented to the committee. 

40.5 Annual Report 

Produce the hospital’s annual nurse staffing plan. If this staffing plan is not adopted by the hospital, the chief executive officer shall provide a written explanation of the reasons why to the committee within 90 days of receipt of the plan. 

40.6 Posting of Staffing Plan and Staffing Levels 

Each hospital shall post, in a public area on each ward, the nurse staffing plan and the nurse staffing schedule for that shift on that ward, as well as the relevant clinical staffing for that shift. The staffing plan and current staffing levels must also be made available to patients and visitors upon request. 

40.7 Non-Retaliation 

A hospital may not retaliate against or engage in any form of intimidation for performing any duties or responsibilities in connection with the Joint Staffing Committees, or an employee who notifies the Joint Staffing Committees or the Employer of his or her concerns on nurse staffing. 

40.8 The members of the committee are encouraged to utilize the resources or assistance of the University of Washington William D. Ruckelshaus Center to help identify and apply best practices related to patient safety and nurse staffing. 

© Paul Vilja 2017