3. Definition
Shared governance in nursing is a nursing practice model
that integrates core values and beliefs embraced by professional
practice to pursue and achieve quality care. It is a working model
characterized by participatory decision-making in which nurses
and other interdisciplinary team members follow organized
decision-making processes regarding quality improvement,
practice standards, professional development, and research.
4. Definition
Tim Porter-O'Grady, a shared governance pioneer, defines shared
governance as "a structural model through which nurses can
express and manage their practice with a higher level of
professional autonomy.”
5. Origins
Shared governance in nursing was originally introduced in the
1970s and 1980s. However, its popularity waxed and waned for a
brief period.
Nursing shared governance was popularized in 1985 with the
publication of Shared Governance for Nursing: A Creative
Approach to Professional Accountability, which Porter-O'Grady
co-authored. Today, shared governance is considered the most
preferred leadership model by transformational leaders in
nursing and throughout healthcare.
6. Type
Unit-Based Congressional
● Each unit establishes its own system
● Multiple models may exist within one
institution
●No department-wide co-ordinating
activities
● All staff belong to a congress
● Similar in structure to federal
government
● Committees submit work to cabinet"
for action
Councillor Administrative
●Co-ordinating council co-ordinates activities
on department level
●Unit councils reflect department councils
●Staff nurses accountable for clinical decision
making
● Practice and management structures exist
●Forum integrates work of councils
●Councils submit work to executive council
for decisions
U.S. Shared governance models. ``Reprinted/adapted with permission from'' Yanko JR, Hardt M and Bradstock J
The clinical nurse specialist role in shared governance,Critical Care Nursing Quarterly, 18(3), p87,1995, Aspen
Publishers.
10. Benefit
1. Better Nurse Engagement: Shared governance in nursing
increases nurse engagement in all aspects of decision-making
and patient care. Engaged nurses working together to achieve a
common goal positively impact patients, nursing and
interdisciplinary teams, and the organizations they work with.
2. Increased Efficiency: One of the benefits of shared governance
in nursing is that it allows healthcare administrators to optimize
the efficiency of healthcare services.
11. Benefit
3. Improved Patient Outcomes: The goal of all nurses is to
provide high-quality patient care that improves patient
outcomes. One of the most significant results of shared
governance in nursing is improved patient outcomes. Studies
indicate improvement in the number of nursing-sensitive issues
such as hospital-acquired pressure ulcers, catheter-associated
urinary tract infections, central line-associated infections, and
falls with injuries.
12. Benefit
4. Increased Job Satisfaction: Shared governance creates
opportunities for nurses to see their ideas in action within their
work environment. This makes nurses feel like their knowledge
and skills are valued and appreciated, thereby increasing job
satisfaction and their sense of belonging.
5. Increased Nurse Retention: When nurses feel satisfaction and
a sense of belonging, they often feel a greater sense of loyalty
to their employer or organization. Their loyalty results in
increased nurse retention.
13. Benefit
6. Better Interdisciplinary Relationships: Communication and
collaboration lead to better relationships between nurses and
other interdisciplinary team members.
7. Better Patient Satisfaction Scores: Shared governance has
proven to be an effective way of handling issues related to patient
care. When committees or councils work together with facility
staff to implement measures based on shared decision-making
and solid, evidence-based practices, patient outcomes improve,
which is one of the benefits of shared governance in nursing.
14. Benefit
8. Lower Healthcare Costs: It may be attributed to the fact that
shared governance considers ideas from teams who develop and
implement measures to promote high-quality, more cost-effective
care.
9. Staff Members’Professional Growth is a Plus for Their
Organizations: Participation in shared governance involves active
learning. As nurses learn and grow, they can move from being
members of a council to chairperson. This type of growth benefits
healthcare organizations and employers because employee growth
means they can promote from within the company.
15. Benefit
10. It is the Cornerstone for Magnet Accreditation: Magnet status
is the highest credential nursing facilities in the United States and
worldwide can obtain. Medical facilities must meet the criteria to
measure nursing excellence as established by the American Nurses
Credentialing Center. Work environment, nursing excellence,
quality patient outcomes, and innovations in nursing practice are
considered. Another fundamental requirement of medical facilities
applying for Magnet status is demonstrating an effective model of
shared governance.
16. Succeed Case
When nursing leaders at Houston Methodist Hospital in Texas used
the shared-governance structure to improve nurse turnover rates.
“Nurses value a positive work environment, autonomy, leadership
support, and opportunities that promote professional growth and
job satisfaction,” study authors said. “Shared governance offers a
vehicle to engage nurses and fosters team collaboration as peers
challenge each other to achieve a common goal. Reinforcement
comes when leaders recognize and reward employees who add value
to the organization.”
18. nurses and management
interdisciplinary team
19. nurse managers
Acting as a developmental facilitator
Helping committees function smoothly without taking charge
Helping committee members see all sides of an issue
Coaching committee members on the process and role
Addressing questions without attending meetings
Serving as a guide and catalyst for action
Fostering creativity, productivity and ownership
20. nurse managers
Clearly explain shared governance and its importance
Create a structure of shared governance
Make shared governance accessible
Prioritize coaching
Serving as a guide and catalyst for action
Fostering creativity, productivity and ownership
23. 1. Establish a Steering Committee:
All nursing shared governance models should have a steering
committee. The steering committee should represent nurses from all
clinical areas and nursing roles. Diversity among committee
members helps to ensure the perspectives of nurses from all levels
are represented.
24. 2. Determine Criteria for Accepting Volunteer Memberships:
Each council should have membership criteria to ensure invitations
are extended to those most appropriate to fill the membership role.
3.Elect or Appoint Chair and Co-Chairs:
Although the goal of shared governance in nursing is to have a
team approach to decision-making, there remains a need to have a
spokesperson(s) to bring ideas or concerns to the appropriate
department head. Therefore, once a committee is established,
facility administrators may opt to appoint a chair and co-chairs or
allow the committee members to vote.
25. 4.Develop Councils:
Some organizations ask for staff nurse volunteers, while others
choose to hold an election to determine council members. A few
examples of types of shared governance councils include unit-based
councils, specialty nursing councils, coordination councils, and
leadership councils.
26. 5.Create a Mission Statement:
Each committee exercising shared governance should have a mission
statement relevant to the needs and goals of their unit or
organization.
In most cases, each committee member makes suggestions for what
should be included in the mission statement; then, the committee-
appointed or elected chair and co-chairs create a final draft for
approval by members.
27. 6.Establish Bylaws:
Bylaws are the governing rules by which an organization operates. It
is essential to establish bylaws before implementing any shared
governance nursing model. Bylaws for shared governance should
include determining the maximum number of members, meeting
schedule and cadence, term limits for members, plans for member
turnover, and a written policy of confidentiality and open
communication. Additionally, the bylaws should include guidelines
for bringing issues to the council for consideration.
28. 7.Educate Nurses in All Clinical Areas About the Shared
Governance Model and Their Role:
Once the type of nursing shared governance model is determined,
nurses in the relevant clinical area should be educated about the
purpose of the model and their role in implementing shared
governance.
29. 8.Establish Guidelines for Bringing Issues of Concern Before the
Council for Consideration:
As with any successful organization or committee, there should be
clear guidelines for how issues are presented to the council, the
anticipated timeframe for having the issue addressed, and how
decisions will be made announced.
30. 9.Establish a Preferred Method of Communication for Staff of All
Levels of the Organizations:
Depending on the type of organization where shared governance is
implemented, committee or council members may work alternating
shifts or opposite shifts from one another. Establishing a preferred
method of communication allows team members to know the
expectations for communication and what to anticipate regarding
responses to communication.
31. 10.Determine a Timeline for Implementation:
Establishing protocol and implementing measures to promote
shared governance in nursing requires work. Timelines may differ
depending on your organization's nursing culture and its willingness
to accept change. It is essential to set reasonable timelines which
allow for appropriate planning and implementation to ensure
success.
