While I never profess to be an expert about acuity-based staffing models, I have dabbled a bit and have been aware of the debates in California regarding mandated staffing ratios. Several other states have attempted to pass legislation to create models for staffing that enhance patient safety and are based in the foundation of addressing the appropriate needs of the sickest patients. One such model has recently been passed in Illinois. In short, this new legislation (which was passed on 29 May 2007) will mandate that each hospital create a team to develop acuity-based staffing models. Each team must be comprised of at least 50% direct-patient care nurses. The hope is that each hospital, with the involvement of their nurses, can create a model which best suits that organization’s unique needs and challenges. Instead of me rambling on about it, interested folks can view some of the detail at the following link on the Illinois Hospital Association’s website:http://www.ihatoday.org/advocacy/state/sb867.html. A very cursory review of other models suggests that California, Kentucky, Nevada, and Oregon are among the states that have passed legislation around acuity-based models. One report indicated that more than 25 states have considered such legislation. So, what are your thoughts regarding this?