Along with the Institute of Medicine's 2004 study report, “Keeping Patients Safe: Transforming the Work Environment of Nurses,” extensive research consistently shows a strong correlation between adequate nurse staffing, patient outcomes, and patient safety. 1 Institute of Medicine Keeping patients safe: transforming the work environment of nurses. The National Academies Press, Washington, DC2004 Google Scholar , 2 Hinshaw AS Keeping patients safe: A collaboration among nurse administrators and researchers. Nurs Admin Q. 2006; 30: 309-320 Crossref PubMed Scopus (10) Google Scholar , 3 Litvak V Buerhaus PI Davidof F Long MC McManus ML Berwick DM Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety. J Quality Patient Safety. 2005; 31: 330-338 PubMed Scopus (98) Google Scholar Yet no one has defined a method to establish “adequate” staffing, how to continuously provide it, and what the appropriate staffing characteristics (ratios, skill mix, etc) are. Nurse leadership appropriately challenges recent legislative efforts to mandate simple patient-to-nurse ratios as a method to ensure quality and safety, due to the high variability in unit types, nurse intensity, and care complexity. 4 Welton JM Unruh L Halloran EJ Nurse staffing, nursing intensity, staff mix, and direct nursing care costs across Massachusetts hospitals. J Nurs Admin. 2006; 36: 416-425 Crossref PubMed Scopus (42) Google Scholar There is growing consensus that traditional staffing models are inadequate to ensure safe, effective levels of care and that hospital organizations need a new, evidence-based model to effectively guide the management of and strategies for safe, effective, cost-correct staffing. Along with the Institute of Medicine's 2004 study report, “Keeping Patients Safe: Transforming the Work Environment of Nurses,” extensive research consistently shows a strong correlation between adequate nurse staffing, patient outcomes, and patient safety. 1 Institute of Medicine Keeping patients safe: transforming the work environment of nurses. The National Academies Press, Washington, DC2004 Google Scholar , 2 Hinshaw AS Keeping patients safe: A collaboration among nurse administrators and researchers. Nurs Admin Q. 2006; 30: 309-320 Crossref PubMed Scopus (10) Google Scholar , 3 Litvak V Buerhaus PI Davidof F Long MC McManus ML Berwick DM Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety. J Quality Patient Safety. 2005; 31: 330-338 PubMed Scopus (98) Google Scholar Yet no one has defined a method to establish “adequate” staffing, how to continuously provide it, and what the appropriate staffing characteristics (ratios, skill mix, etc) are. Nurse leadership appropriately challenges recent legislative efforts to mandate simple patient-to-nurse ratios as a method to ensure quality and safety, due to the high variability in unit types, nurse intensity, and care complexity. 4 Welton JM Unruh L Halloran EJ Nurse staffing, nursing intensity, staff mix, and direct nursing care costs across Massachusetts hospitals. J Nurs Admin. 2006; 36: 416-425 Crossref PubMed Scopus (42) Google Scholar There is growing consensus that traditional staffing models are inadequate to ensure safe, effective levels of care and that hospital organizations need a new, evidence-based model to effectively guide the management of and strategies for safe, effective, cost-correct staffing.