The Joint Commission is now requiring hospitals to meet nurse staffing standards as part of accreditation, marking the first time staffing has been formally designated as a national performance goal. The change embeds nurse staffing directly into how hospital quality and patient safety are evaluated across U.S. healthcare systems.

Under the new requirement, hospitals must demonstrate that staffing plans are appropriate for the patient populations they serve and that oversight is in place to ensure those plans are consistently followed. While staffing expectations have long existed across regulatory and quality frameworks, this marks the first time they are consolidated and assessed together as part of the accreditation process.

Healthcare leaders say the shift reflects long-standing evidence linking nurse staffing levels to patient outcomes. Patti Artley, Chief Clinical Officer at Medical Solutions, said the new standard brings greater accountability by explicitly naming staffing as a performance expectation rather than leaving it implied.

What Does The Joint Commission’s New Nurse Staffing Requirement Mean?

The requirement formally ties nurse staffing standards to hospital accreditation, recognizing staffing as a national performance and patient-safety measure and reinforcing its documented connection to patient outcomes, quality of care, and nurse well-being.

From Budget Line Item to Performance Measure

For years, nurse staffing has often been viewed primarily through an operational or financial lens. Artley said the new standard reframes that approach by bringing together expectations that previously existed in separate places.

“The standards are not much different than things we have had in different standards, but the first time they are represented as a staffing standard and called out together,” Artley said. “We have known for a long time that nurse staffing has a direct correlation to patient outcomes, so as The Joint Commission is making a change from National Patient Safety Goals to National Performance Goals, it makes sense to look at the reasons for the outcomes.”

While nursing labor represents one of the largest components of a hospital’s operating budget, Artley emphasized that the importance of the change extends beyond cost considerations.

“This shift reinforces just how central staffing is to patient outcomes,” she said. “It elevates staffing from a budgetary consideration to a core measure of quality and safety.”

Staffing and What Happens at the Bedside

The relationship between nurse staffing and patient outcomes is well documented, particularly through Nurse Sensitive Indicators, or NSIs. These indicators track outcomes that are directly influenced by nursing care and staffing levels.

“Safe staffing is critical,” Artley said. “There are four quality indicators known as Nurse Sensitive Indicators because we know nursing care has a direct impact on these outcomes, and they are correlated with staffing levels.”

When adverse events occur, staffing is routinely examined as part of root cause analysis.

“As nurse leaders, when one of these events occurs, staffing is part of the after-action review,” she said. “We closely examine the relationship between staffing and the event to understand contributing factors.”

By incorporating staffing into accreditation standards, The Joint Commission is reinforcing that connection at a national level.

Workforce Challenges Remain a Reality

The new requirement arrives as hospitals continue to face workforce instability, including high turnover and persistent nursing shortages. Artley said retention has become a central focus for nurse leaders.

“Nurse leaders are really focusing on retention strategies,” she said. “This is critical and important to ensure that you have seasoned nurses caring for your patients.”

She noted that many organizations have been working on retention as part of long-term strategic planning, and that those efforts will need to continue.

“Our workforce is going to continue to be in a state of transition for several years as we navigate the many changes both internal and external to our nursing workforce,” Artley said.

What Compliance Looks Like in Practice

Under the new standard, hospitals must maintain a written staffing plan and policy that reflects the needs of the patient populations they serve. Oversight is also required to ensure those plans are followed consistently.

“There also needs to be clear oversight to ensure the plan is being followed and that staffing matches what the organization believes is needed,” Artley said.

For many hospitals, the day-to-day mechanics of staffing oversight will not drastically change. Most organizations already rely on chief nursing officers, nursing supervisors, and hospital leaders to manage staffing around the clock.

What will need to evolve is how staffing data is used.

“Organizations will need to assess and use staffing data by correlating it with negative patient outcomes, trending those events, and ensuring the staffing model remains appropriate over time,” Artley said.

A Broader Role for Nurse Leaders

For nurse managers and leaders responsible for staffing decisions, the new standard may expand how performance is monitored and reviewed.

“The biggest change will be in monitoring and trending staffing data more intentionally,” Artley said. “Using staffing data alongside quality outcomes will be critical.”

While core leadership responsibilities may not change, staffing data will increasingly be incorporated into quality investigations and organizational analyses already underway.

What Frontline Nurses May Experience

From the bedside perspective, the change signals that safe staffing is being taken seriously at the highest levels of healthcare oversight.

“I think it sends a message that others are also valuing the importance of safe staffing,” Artley said. “This standard is an accountability metric that is now measured in a slightly different way.”

She also highlighted the connection between staffing, burnout, and moral distress.

“Safe staffing has such a correlation to burnout because many nurses experience burnout when they do not have the time to get the things they believe need to be accomplished done day after day,” she said. “If you feel you are not giving good care, you have a moral distress that takes a toll on your mental well-being. That has a direct impact on morale.”

How Hospitals Are Preparing

Hospitals are actively assessing how their current practices align with the new standard.

“They are doing their gap analysis between what the standards say and what they do,” Artley said. “They will put infrastructure in place to close those gaps and meet the standards, which does not happen overnight.”

Policies and governance structures are also being updated to support compliance. According to Artley, many of the strategies being implemented align with existing practices and are generally effective when applied thoughtfully.

A Catalyst for Broader Workforce Conversations

Artley believes the standard will influence broader discussions around workforce planning, staffing councils, and investment in nursing.

“Most organizations have councils that address this today, but for those that don’t, it will be an adjustment,” she said. “We need to look at the area of care and determine what is needed to provide appropriate care for the type of patient we are looking after.”

The Bigger Picture

For nurses, the takeaway is not just about accreditation.

“It really is not about the standard,” Artley said. “It is about doing the right thing for our patients.”

By formally recognizing nurse staffing as a performance measure tied to outcomes, the new requirement reinforces accountability across healthcare organizations.

“By incorporating staffing into the evaluation of outcomes, it helps keep us accountable to ensure we are looking at staffing and how it impacts our patient outcomes,” she said.

For the nursing profession, the message is clear. Safe staffing is no longer implied. It is measured, expected, and central to quality care.