Leveraging the Power of Shared Governance

Cynthia S. Cohen, Walden University


Shared governance (SG) creates an evidence-based framework to support decision making in healthcare organizations by encouraging nursing staff ownership of nursing practice issues. This project assessed the current state of shared governance at a community hospital through: (a) deployment of Hess's Index of Professional Nursing Governance (IPNG) and the National Database of Nursing Quality Indicators (NDNQI) nursing satisfaction surveys which were open to nurses working in areas included in the SG framework at the project site, and (b) retrospective review of Unit Practice Council (UPC) and Nursing Senate (NS) minutes and agendas. Kotter's theory of change and the logic model informed interventions aimed at creating an effective SG. IPNG data were analyzed using Hess' scoring guidelines to establish total governance and subscale scores. Mean IPNG scores of nurse leaders, clinical nurse managers, and staff nurses were compared using a 1-way ANOVA based on job title, education, employment status, and shift. NDNQI results were analyzed based on benchmarked Magnet objectives and comparison to previous year's surveys. Meeting agendas and minutes were analyzed for attendance and initiation of interventions. Outcomes of this project included successful creation of a UPC on a medical telemetry unit; alignment of meeting times to promote attendance; paid access to remote meeting attendance; standardization of meeting minutes and agendas; and unit-specific, outcomes-data dashboards. Implementation of this model to improve the effectiveness of SG can lead to positive social change through improvement in the decision-making process in the nation's healthcare institutions. Inclusion of all members of the healthcare team in the decisions that impact practice helps ensure comprehensive, evidence-based, and patient-centric care.