Nursing

Please update the slides on the power point and have the agenda match (it currently does not match the slides). 

The goal is to have a shared governance retreat within a behavioral health hospital staff (70 people) 

As we are on the pathway to excellence journey through ANCC.

-Add two breakout sessions (one to discuss core councils, will need instructions on how to get them speaking on this.  and one to create the shared governance model (I have the instructions for this). 

-Please add more examples to the core councils and put them all on a slide. 

-I would like pictures added to the slides (the theme is green which is the mental health color, and it will be held on St. Patrick’s Day). 

-for the slides that are wordy, please use bullet points instead and place speaker notes

-Add speaker notes for each slide

Shared Governance Core Council examples:

Evidence based practice and Education Council

Informatics

Quality and Safety Council

Finance and operations Council

Engagement and Resilience Council

Nursing Leadership and Action Council

Transformational Leadership and Nursing Advisory Council

Nursing Excellence Council

Shared Governance
Pathway to Excellence Journey

Learning Objectives

At the end of this presentation, the readers will be able to:

Define what is shared governance
Concepts of shared governance in nursing
History of shared governance
Contributing factors towards shared governance
Action towards shared governance
Growing needs in shared governance for collaboration, engagement in HealthCare Practices
Governance Models
Appreciate shared governance
Implementation of shared governance

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Shared Governance

It is a model of nursing practice that is designed to integrate core values and beliefs that professional practice embraces, which becomes a means of accomplishing quality care (Anthony, 2004)

It means giving all members of the healthcare workforce a say in
decision-making, which promotes diverse and innovative feedback
that will aid the organization’s business and healthcare missions.

It is a shared decision-making based on the principles of
partnership, equity, accountability and ownership at the point of
service.

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Shared Governance Definition

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Concepts of Shared Governance

Shared governance focuses on four main principles that serve as the foundation and the cornerstones of the concept. Collectively, when one incorporates the four principles of
shared governance

Partnership – Developing collaboration and healthy partnerships among the
healthcare team

Accountability – Achieving clear understanding of each members role and
expectations, and taking responsibility for their actions and
decisions

Equity – focusing on having an equal stake in the outcomes of the care and
quality that the team member provides

Ownership – the success of an organization depends on how well each
member of the healthcare team performs their jobs.

into a team’s behavior, one creates a professional work environment of empowerment.

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Shared Governance

Shared by Who?

It is shared decision making between the staff nurses or bedside nurses and nurse leaders, including resources, nursing research or evidence based practice initiatives, new equipment purchases, and staffing.

Who will benefit?

The people in the surrounding communities, our patients, the staff, and the organization will benefit in shared governance

Who governs?

The healthcare team led by the nurse leader will be responsible for safe system delivery of patient care, providing adequate resources. The nurse leader will be helped by staff nurses who will be accountable for patient care outcomes.

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Brief Background of Shared Governance

A proof that philosophy, education, religion, politics, business and management, and healthcare have all benefited from a variety of shared governance process models implemented in many diverse and creative ways across generations and cultures (Swihart, 2011).

Socrates (470–399 BC), an ancient Greek philosopher, integrated shared governance concepts into his philosophies of education. The Socratic Method encourages students to use reason rather than appeal to authority.

The government model for the United States was established on the concepts of shared governance— “of the people, by the people, for the people” (from Lincoln’s Gettysburg Address, 1863)—wherein the very citizenry is directly responsible for the government on both state and federal levels.

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Brief Background of Shared Governance

Eventually, organizations began to design formal structures and relationships around their leaders and employees. Positive outcomes emphasized movement from point of service outward shared governance found its way into the business and management literature (Laschinger, 1996; O’May & Buchan, 1999).

In the late 1970s and early ‘80s, shared governance found its way into the healthcare and nursing arenas as a form of participative management. It engaged self-managed work teams and grew out of the dissatisfaction nurses were experiencing with the institutions in which they practiced (McDonough, Rhodes, Sharkey, & Good roe, 1989; O’May & Buchan, 1999; Porter-O’Grady, 1995).

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Contributing Factors towards Shared Governance

Shared governance has a decentered structure of power and decision making.
Shared governance is a major departure from traditional management-drive systems. It requires commitment and investment from all of nursing.
Moving to shared governance affects the way in which nurses work and relate to the organization.
Governance structures of educational institutions directly influence the faculty members and the staff and their occupational satisfaction.
One challenge is how to engage and then supporting more junior nurses in joining teams

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Brief Background of Shared Governance

Providing various groups of people a share in key decision-making processes, often through elected representation
Allowing certain groups to use key responsibility for specific areas of decision making.
The principle of shared governance goes down in the use of councils and committees. These groups should be represented by motivated and capable staff nurses whose main interest lies in the greater good.
Applying and supporting shared governance calls for a real correspondence between management behavior and the structural imperatives of a shared decision-making model is much needed.
Synthesis between the staff’s competence in making their own decisions about practice, and their profession and the leader’s ability to facilitate them should be present.
Leadership must be able to promote a safe and developmental context for both staff and themselves so that the challenges associated with a substantial change in the old-fashioned locus-of-control can be carefully tackled, and professional practice can justly progress.

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Growing Needs in Shared Governance

 
Establishing clear lines for accountability for the roles in nursing, and fully deploying shared governance to the point of service became the next pivotal step in designing a system that endorsed the staff nurse’s authority, responsibility, and accountability for her/his practice.

It was an important fundamental step to create a nursing structure whereby the nurse manager’s role changed to one of facilitator, integrator, and coordinator of the processes that support the work of the staff nurse – empowering that nurse to control her/his own practice.

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Growing Needs in Shared Governance

 
Today’s as transformational relationship-based healthcare, which is driven by technology, generates a new paradigm with distinctive goals and objectives in an organizational learning environment. Leaders, administrators, and employees are learning and applying new ways of delivering care, new technologies, and new ways of thinking and working. In the process, they acknowledge more and more that the nurse at the point of service is key to organizational success.

Nurses and managers must be ready for different roles, new relationships, and latest ways of managing. Shared governance is about stirring from a conventional hierarchical model to a relational partnership model of nursing practice hence there is a dire need for its adaptation in many healthcare organizations/institutions around the world.

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Growing Needs in Shared Governance

What are the formal and informal lines of power and authority?
To what degree is the organization decentralized?
What is the level of staff participation in decision making?
What are the formal and informal lines of communication?
Is information freely shared?
What are past experiences with change?

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Shared Governance Models

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Councilor

Congressional

Administrative

Shared Governance Models Councilor

Councilor Model

Children’s Hospital of Philadelphia

Councilor model: Structural empowerment and engaged nurses in their practice.

Councilor shared governance in nursing
 involves nurse leaders partnering with councils or teams to share guardrails for determining solutions to issues that impact direct care employees and the services they provide.

The Councilor Model features various councils focusing on specific aspects of nursing practice, composed of staff nurses and management representatives who collaborate to address practice issues.

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Shared Governance Models Congressional

Congressional Model
Mercy One

Congressional model: Central collaboration of members across the healthcare organization, where all nursing staff belong and work is assigned to cabinets.

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Shared Governance Models Administrative

Administrative Model
Brigham and Women’s Hospital

Administrative model: Integrating core values and beliefs to achieve quality care.
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Shared Governance Golden Rules

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Unit Based Councils

Core Elements of practice

Reporting structure

Shared Governance Golden Rules

There is only one rule:

MANAGEMENT CAN’T IMPLEMENT IN A SILO

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Conclusion

Alice:
“Would you please tell me, which way I ought to go from here?”

Ceshire Cat:
“What depends a good deal on where you want to go?”

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References

 
  
Brooks, B., (January 31, 2004). Measuring the impact of shared governance. Online Journal of Issues in Nursing. Vol. 9 No.1, Manuscript 1a. Accessed from
www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume92004/No1Jan04/MeasuringtheImpact.aspx

Hess, R. (2019). Five tips for a thriving shared governance model in 2018. Accessed from

page_id=2525

Flynn, M. K. (1997). Correlates of staff nurse work satisfaction in hospitals with shared governance (Order No. 9728363). Available from Nursing & Allied Health Database. (304418490). Retrieved from
https://
search.proquest.com/docview/304418490?accountid=38643

HCPro, Inc (2006). Shared Governance: A practical approach to reshaping professional nursing practice. Retrieved June 19, 2020 at http://www.strategiesfornursemanagers.com/supplemental/4428_book 4. Marky Medeiros (2018).

McKnight H, Moore SM (2019). Nursing Shared Governance. Retrieved June 18, 2020 at
https://www.ncbi.nlm.nih.gov/books/NBK549862
/

Porter-O’Grady, Tim (2001). Is Shared Governance Still Relevant? Retrieved June 07, 2020 at Journal of Nursing Administration, 31(10), 468-473.
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=ovfte&NEWS=N&AN=00005110- 200110000-00010.
Swihart, D. (2011), Shared Governance: A Practical Approach to Transform Professional Nursing Practice, Second Edition 2nd Edition

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Jackson behavioral health hospital shared governance retreat agenda

Date: Monday, March 17, 2025

Time: 8:00 am – 4:00 pm

#

AGENDA ITEMS

LEAD

TIME

1.

Welcome / Icebreaker

8:00 am – 8:30 am

2.

Agenda Review

8:30 am – 9:00 am

3.

CNO State of the Union

9:00 am – 9:45 am

4.

BREAK

9:45 am – 10:00 am

5.

Nursing Department Review

· Mission, Vision, Values

· Strategic Plan

10:00 am – 11:00 am

6.

Shared Governance at JBHH

· Where We’ve Been

· Where we are now

11:00 am – 12:00 pm

7.

LUNCH

12:00 pm – 1:00 pm

8.

Review of Council Charters/By-Laws

· Are they still reflective of the council’s specific work?

· What should remain?

· What should we remove?

1:00 pm – 2:00 pm

9.

Goal Setting Presentation

2:00 pm – 2:30 pm

10.

Council Goal Development

· Individual Council Activity

· Council Report Out

2:30 pm – 3:30 pm

11.

Wrap-up/ Where to go from Here

3:30 pm – 4:00 pm

Location: DTC 259 (JMH)

NOTES:

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