Shared governance is a model of nursing practice that empowers nurses in decision making around their profession. It originated in the late 1970s as nurses sought more control over their practice. The main goals of shared governance are to empower nurses, give them more control over practice through accountability, and improve their work environment. Shared governance uses a council structure, with units based councils and specialty councils like research, quality, practice, and operations. There are several models of shared governance including councilor, administrative, congressional, and unit-based. Principles include partnership, ownership, equity, and accountability. Implementing shared governance involves forming a steering committee, creating councils, establishing bylaws, setting a timeline, and sustaining

1. SHARED
GOVERNANCE
Reporter:ZHUANG HUIREN
2022t0854

2. Part 01 Concept and purpose

3. What is HARED
GOVERNANCE?
 A model of nursing practice, bringing
together core values to achieve quality
care.
 Helps nurses in decision making and
leadership within the profession.
 Based off of management,
organizational, and sociological
theories.

4. History and development of shared governance
The concept of shared governance, or shared decision-making, is not new. Philosophy, education,
religion, politics, business and management,and healthcare have all benefited from various shared
governance process models implemented in many diverse and creative ways across generations
and cultures.
• In the 19XXs, shared governance found its way into the business and
management literature. Organizations began to design structures and
relationships among their leaders and employees. They emphasized
making decisions from the point of service on instead of from the
organization downward.
• In the late 1970s and early 1980s, shared governance formally found its
way into the healthcare and nursing arenas, growing out of
nurses’dissatisfaction with the institutions in which they practiced. They
started to use it as a form of participative management, using self-
managed work teams.

5. Aims of shared governance
 Empowerment of individuals within the decision making
system,this empowerment is directed at increasing nurse's
authority &control over their nursing practice.
 Shared governance gives nurses more control over their
nursing practice by being an accountability-based
governance system for professional workers.
 Shared governance improves staff nurses' perception of
their job &practice environment.

6. Part 02 Council Structure

7. Shared Governance Council Structure
The purpose of the Shared Governance Councils:
 To provide a structure in which clinical nurses can have autonomy in
practice, decision making ability related to both clinical and professional
practice decisions.
 Collaborate to ensure a high level of professional performance by all
nursing team members.

8. Shared Governance Councils
1.Nursing Unit-Based Councils
It serve as a means of communication between Unit staff and
Nursing Councils regarding decisions related to the provision of care
and the care environment, competency and accountability.
2. Nursing Research Council
It advocates and supports clinical research and the use of
evidence-based nursing practices.
3. Nursing Quality Council
It makes decisions related to the advancement of quality and
safety practices. It utilizes nurse-sensitive indicators to
facilitate performance improvement measures. Directs and
implements decisions related to the nursing peer review.

9. Shared Governance Councils
4. Nursing Practice Council
It makes decisions related to the revision and implementation
of standards of clinical practice and patient care consistent with
evidence-based practice, national specialty guidelines and
regulatory requirements.
5. Nursing Professional Development Council
It makes decisions related to the educational needs of staff to
promote and coordinate professional development and
education.
6. Nursing Operations Council
It establishes the strategic nursing direction and decisions
related to final policies and procedures, supports the council
structures, reviews hospital-based committee reports and
deploys financial resources.

10. Shared Governance Councils
7. Advanced Practice Nursing Council
It promotes professional excellence and education
advancement with the goal of providing accessible,
costeffective health care to Stanford Health Care - ValleyCare
patients. Serves as mentor and resource to nurses as well as
other health professionals.
8. Nursing Coordinating Council
It responsible for coordinating, integrating, monitoring and
communicating the activities of the other councils.

11. Part 03 Shared governance Models

12. Shared governance Models
Councilor Model
Administrative Model
Congressional Model
Unit-based

13. Councilor Model
In which a coordinating council integrates decisions
made by managers and staff in subcommittees.

14. Administrative Model
A second model, the more traditional bureaucratic structure that splits
the organizational chart into two tracks with either a management or clinical
focus, although the membership in both tracks often encompass both
managers and staff as implementation progresses.

15. Congressional Model
A third structure relies on a democratic component to empower nurses to
vote on issues as a group.

16. 1 2 单击此处添加标题
No department-wide
co-coordinating
activities
3
单击此处添加标题
Multiple models may
exist within one
institution
单击此处添加标题
Each unit established
its own system
工作Unit-based model
完成情况

17. Comparison between four shared governance models

18. Part 04 Principles of Shared Governance:

19. PPARTNERSHIP
Emphasis on
teamwork among
nurses, healthcare
providers and their
patients.
Principles of SHARED Governance
OWNERSHIP
Each team
member owns his
or her
contributions to
healthcare
decision-making.
EQUITY
Equal focus on
services, patients and
staff because each is
essential in providing
safe and effective care.
ACCOUNTABILITY
Considered the core
of shared governance,
it is the willingness to
take responsibility for
decision-making.

20. Part 05 Steps

21. Steps of implementing shared governance
1
2
3
4
5
Form a Steering
Committee
Establish Council Bylaws
Reinforce & Sustain
Shared Governance
Set a Reasonable
Timeline for
Implementation
Create Councils

22. Steps of implementing shared governance
1. Form a Steering Committee
Your steering committee should be made up of nurses representing all clinical areas and
nursing roles. By having a diverse group, you will ensure you are approaching shared
governance from the perspective of nurses at all levels. After you’ve completed the deep
dive into your current protocols, the steering committee will:
 Create a mission statement for the organization regarding shared
 governance
 Write bylaws detailing the structure of your shared governance
 Propose a redefined nursing leadership structure
 Establish a method of communicating general information and outcomes of
shared governance to staff at all levels of your organization
 Educate nurses in all clinical areas on your model of shared governance and
their role in it

23. Steps of implementing shared governance
2. Create Councils
To create your councils, you can either ask for staff nurse volunteers or hold an election,
and each council should elect a chairperson. If you are adopting a combined unit-based and
councillor model, you will want to form three types of councils.
 Unit Based Council – A unit-based council should be formed for each
patient care unit and is responsible for making nursing practice decisions for
that unit.
 Specialty Nursing Council – The specialty nursing councils represent the
nurses and practice decisions for a specific area of nursing.
 Coordinating or Leadership Council – This council will coordinate activities
among all councils and serve as a direct link to the organisation’s
administration.

24. Steps of implementing shared governance
3. Establish Council Bylaws
Each council will need a set of bylaws to lay the ground rules for how the
councils will operate. Bylaws should include the following:
 Standard for accepting volunteers for membership
 A maximum number of members
 The schedule and cadence for meetings - these meetings should be
mandatory and should be facilitated by the chairperson
 Term limits for members and plans for member turnover
 A policy of open communication and confidentiality

25. Steps of implementing shared governance
4. Set a Reasonable Timeline for Implementation
As you can tell from tips one through three, there is quite a
bit of work that goes into implementing shared governance.
It is important to understand that implementing shared
governance is a marathon not a sprint and because of that it
is critical to set a sufficient and reasonable timeline for its
implementation.

26. Steps of implementing shared governance
5. Reinforce & Sustain Shared Governance
 It’s important to remember that with shared
governance the job is never truly done. It’s a
constantly evolving practice model, and ongoing
training will be needed for nurses who are
transitioning into a decision-making role or who are
new to the organization.
 You will also need to create instruments to help
you and other nursing leaders evaluate the
outcomes of shared governance. This will allow you
to pivot and adjust your framework as needed to
ensure your shared governance is producing the
highest quality patient outcomes.

27. Part 06 Advantages

28.  It empowers nurses to use their clinical knowledge and expertise to
develop, direct and sustain our own professional practice.
 It allows nurses to network with colleagues and collaborates among units
and departments.
 Establish and monitor standards of clinical practice.
 Promote excellence in professional performance among the nursing staff.
 Facilitate the quality of professional life of its members.
 Provides nurses with a way to communicate concerns and work toward
solutions that benefit everyone.
 Helps create an environment that promotes the retention and recruitment
of highly qualified professional nurses.
Advantages of shared governance

29. Part 07 Essential actions

30. Ten essential actions for nurse leaders
• Be clear about what shared governance is
• Help staff members understand why shared
governance is important
• Orient council chairpersons on the basics of
planning and running meetings, once
councils are formed, staff chairpersons need
education on how to run a meeting, plan an
agenda, keep meaningful minutes,set goals,
and more
• Cultivate a sense of ownership
• Encourage a continuous focus on mission
and vision
• Provide council members with protected time
to meet
• Include staff in council development or
redesign
• Coach and mentor chairpersons
• Recognize excellence
• Study the successes (and struggles) of
others

31. THANK YOU