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For years, nurses have sounded the alarm that staffing isn’t just a workforce issue—it’s a patient safety issue. They have pointed to missed assessments, delayed care, rising burnout, increasing turnover, and the moral distress that comes from knowing what patients need but not always having the time or resources to provide it.
Now, one of healthcare’s most influential accrediting organizations is making that connection more explicit.
In an exclusive interview with Ken Grubbs, DNP, RN, Chief Nursing Executive for the Joint Commission, held at the 2026 AACN NTI Conference in San Diego, we discussed why workforce planning and staffing have been elevated through National Performance Goal 12, part of the organization’s Accreditation 360 redesign.
The goal, he says, is to highlight a reality many nurses already know: how care is delivered—and who is available to deliver it—directly affects patient safety and quality.
For frontline nurses, however, the announcement raises an important question: Will hospitals act?
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A New Focus on Staffing Without Mandating Ratios
The Joint Commission is not entering the nurse staffing ratio debate.
In fact, Grubbs was clear that the organization does not support a one-size-fits-all approach to staffing. Instead, he believes healthcare organizations should determine staffing models based on patient acuity, workforce competency, available resources, physical layout, and the services they provide.
That distinction matters.
While staffing discussions often focus on nurse-to-patient ratios, Grubbs argues that safe care depends on much more than numbers alone. A patient experiencing rapid clinical deterioration may require significantly more nursing resources than a stable patient, even if both occupy the same type of bed.
In this context, “staffing” means ensuring that the right clinician, with the right skills, experience, and licensure, is available to meet patient needs at the right time.
When Staffing Breaks Down, Patient Safety Suffers
According to Grubbs, inadequate care delivery models create risks that extend far beyond employee dissatisfaction.
When organizations lack the appropriate skill mix or clinical expertise, patients become more vulnerable to preventable harm, including pressure injuries, missed assessments, delayed recognition of deterioration, and failure-to-rescue events.
Clinicians experience the consequences as well.
Burnout, turnover, and workforce instability are often symptoms of care delivery models that fail to adequately support both patients and staff. Grubbs emphasized that patient safety and workforce well-being should no longer be viewed as separate conversations.
When asked whether workforce well-being and patient safety are inseparable issues today, his answer was unequivocal.
“Absolutely.”
How Hospitals Can Tell When Staffing is Creating Risk
For healthcare leaders, one of the challenges is identifying whether a staffing model is truly working.
Grubbs points to several warning signs that organizations should monitor closely:
- Patient safety events
- Culture-of-safety survey results
- Employee engagement scores
- Patient experience measures
- Staff turnover
- Workforce retention
- Burnout trends
Together, these indicators can reveal whether a care delivery model is supporting safe, effective care—or creating hidden risks for patients and clinicians alike.
Technology May Help, But it Won’t Replace Nurses
As hospitals increasingly explore virtual nursing, artificial intelligence, and hybrid staffing models, Grubbs sees opportunities to reduce administrative burden and improve efficiency.
Virtual nursing programs can assist with admissions, medication reconciliation, and discharge education, helping relieve some of the cognitive workload carried by bedside nurses.
He also pointed to AI-powered documentation tools that can capture assessments and clinical conversations, reducing time spent charting.
But he cautioned against viewing technology as a substitute for professional judgment.
Technology should augment clinicians, he said—not replace the nurses, physicians, and healthcare professionals responsible for making critical decisions and ensuring safe patient care.
The Business Case for Safe Staffing
Hospital leaders often face competing pressures to improve quality while controlling costs. Grubbs argues that the two goals are not in conflict.
“The most expensive care is unsafe, low-quality care,” he said, noting that preventable harm, workforce turnover, and poor outcomes carry significant financial consequences for healthcare organizations.
In his view, strong patient safety programs and effective care delivery models ultimately strengthen organizational performance while improving outcomes for both patients and staff.
What Nurses Need to Know
National Performance Goal 12 does not create mandatory staffing ratios. What it does do is place staffing, workforce planning, competency, and clinician well-being squarely within the patient safety conversation.
For nurses, that recognition may feel long overdue.
Whether it ultimately translates into safer assignments, stronger staffing models, and meaningful change at the bedside remains an open question. But the Joint Commission’s message is becoming increasingly clear: staffing is no longer simply a workforce issue. It is a patient safety issue.
