Shared governance is a leadership model that uses structure and process for partnership, equity, accountability, and ownership. It puts the responsibility, authority, and accountability for practice related decisions into the hands of the individuals who will operationalize the decision. Shared governance allows managers and staff to come together in the decision-making process. We define shared governance as “a leadership model in which positional leaders partner with staff in decision making processes while creating ownership for improvement in practice” (Guanci & Medeiros).
In shared governance, leadership continues to have responsibility for regulatory requirements, immediate safety concerns, performance management and operations decision such as hiring and staffing. However, decisions relating to practice are the ones that are decided in partnership in a shared decision-making model.
Facing a competitive environment and potential staffing shortages, hospitals have a vested interest in promoting a culture of engagement among nurses and interprofessional partners, who comprise the largest share of the hospital workforce.
There is a significant amount of research on the patient outcomes that result from implementing shared governance in nursing practice. In addition, organizations that foster employee engagement through shared decision-making outperform their counterparts in terms of job satisfaction and retention, profitability, and performance.
Facing a competitive environment and potential staffing shortages, hospitals have a vested interest in promoting a culture of engagement among nurses and interprofessional partners, who comprise the largest share of the hospital workforce.
Nursing leadership and nursing practice within the shared governance model is foundational to professional practice and a pillar of the ANCC Magnet® culture. Utilizing this approach in the hospital and ambulatory settings allows for better nurse satisfaction, patient care, and improved outcomes. The process of building nursing excellence through this type of structure and the related processes can be challenging among nurse administrators, leaders at all levels, and bedside nurses.
For many organizations their biggest challenges currently are nurse retention and recruitment. Today’s workforce demands empowerment, and ownership of their practice and using council-based governance enhances nurse autonomy and strengthens employee engagement. With the help of companies like Creative Health Care Management (CHCM), you can implement shared governance within any healthcare setting, and you will see positive outcomes.
We provide education, structures, processes and ongoing support that enhances staff members’ ability to make the best decisions for your organization, while developing a greater sense and new level of ownership for their work. We not only support staff members as they embark on increased ownership; we also support the leaders who often have to change the way they make decisions and lead.
Shared Governance is a model of partnership of leaders and staff in which decisions regarding practice are made by the people who will be carrying out the work. Leadership enhances these decisions by sharing the guardrails for successful decisions. Our experts offer structures, processes, education and evidence-based practices to support your vision.
This type of shared process allows for active engagement throughout the healthcare team to promote positive patient outcomes and also creates a culture of positivity and inclusion, which benefits job satisfaction. Shared governance leads to engaged and empowered staff, and leads to professional growth along with better working conditions and quality work environment.
Creative Health Care Management has a long-standing history of implementing shared governance and transforming cultures to help ensure employees feel heard and respected, knowing that their contributions matter and they are making a positive difference to help the organization thrive.
In a shared governance culture, staff members are empowered to design their own work, which leads to a high degree of ownership for achieving results! It’s also a cornerstone of the ANCC Magnet Recognition Program®, the highest international distinction a healthcare organization can receive for nursing excellence and quality of care.
Shared Governance is a tenant professional practice that promotes nursing empowerment and decision making by giving nurses the responsibility, authority and accountability for decisions that impact practice, policies, procedures, and outcomes at the point of care. There is no question that this is an effective technique for creating a positive culture and improving patient safety.
Through the incorporation of shared governance in healthcare organizations, increases in nurse engagement helps improve both staff and patient outcomes, such as increased RN satisfaction, job and patient satisfaction.
CHCM offers a continuum of solutions to cultivate a culture of empathy, compassion, and trust in individuals, teams, and patients and families. Our expertise includes sustainable cultural change methods, open communication, leadership development, engagement of staff and providers to deliver exceptional patient and collegial relationships, and the advancement of an overall culture of quality, excellence, and Wellbeing.
Creative Health Care Management has partnered with healthcare organizations of all sized on five continents on everything from one-day presentations to organizational and system-wide assessments, workshops, shared governance, and multi-year Relationship-Based Care® implementations and Magnet® or Pathway® journeys.
CHCM provides thought leadership not only through consultation, but through the publication of numerous award winning and bestselling books and journal articles in a variety of publications.
The benefits of a shared governance structure has been cited for years in stronger staff partnerships, ownership of data and outcomes, healthier work environments, increased employee satisfaction and retention, better patient experience, and of course the financial benefits tied to all of these improvements.
Staff members participating also exhibit increased autonomy and a stronger sense of meaning and purpose in their work. It is gratifying for staff and leaders to see the accomplishments and outcomes of council work, and the ownership of the data by councils and committees ensures that data drives practice.
By implementing shared governance, decision making assists nursing management by creating measurable patient care and improved positive patient outcomes. Having shared governance councils and a shared governance structure also improves nursing care which leads to job satisfaction.
Implementing shared governance is a leadership model and a key expression of an organization’s culture. Shared governance is not the replacement or elimination of positional leadership, a strategy to support downsizing leadership, or self-governance. Instead by implementing shared governance clinical nurses, and interprfessional staff, as well as their leaders become more involved with the process and structure of the practice or organization in which they work.
Many organizations start off with strong structures in place and lose steam over the years. Councils and committees are still meeting, yet it seems as though nothing is happening. Meeting time is costly in financial, human, and time resources.
A best practice is to make sure councils and committees have a strong purpose and set goals that align with the organization’s strategic priorities. As a way to remind members of their purpose, state that goal at the top of your meeting agenda. When building your agenda keep in mind the goals of the group and attach times to each agenda item. This will help the group stay on task and know what topics will be covered during each council meeting.
Strategic planning is an important part of shared governance. High-functioning cultures engage in routine planning, typically on an annual basis, during a facilitated retreat that includes people from all levels of the organization.
By Gen Guanci MEd, RN-BC, CCRN, CEO and Consultant The use of a skilled facilitator to support council success is an often overlooked or underutilized
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