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Can you provide me with some tips in regard to designing a structure to support shared governance?

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Every model, structure, or process of shared governance looks different when appropriately implemented at each level of the organization. The unique character of the organization, its mission, and its staff will create a process that reflects the nursing practice and leadership in that organization. However, some features of shared governance are similar enough to provide some guidance in designing a structure to support shared governance.

All shared governance structures have certain characteristics in common:

  • There is no one way to design or structure a shared governance process model.
  • Shared governance is grounded in clinical practice
  • Nursing staff are responsible, are accountable, and have authority over all decisions related to nursing practice (practice, quality, and competence)
  • Direct care nurses are elected to the positions they hold in the shared governance structure by their peers rather than by management
  • Shared governance needs to be implemented service-wide rather than unit-by-unit
  • Direct care nurses define unit-based operational processes in the unit
  • Direct care nurses drive the structuring of the shared governance process
  • Management, in the servant (transformational) leader role, provides the support, encouragement, resources, training, and boundaries necessary for success
  • A coordinating group composed of staff and management provides guidance about issues affecting the department of nursing, communicating the organization's strategic plan, developing shared governance bylaws, approving departmental expenditures or budgets, and/or helping determine accountabilities for appropriate groups/members within the shared governance structure

—Diana Swihart, PhD, DMin, MSN, CS, APRN,BC, clinical nurse specialist at the Bay Pines (FL) VA Healthcare System

(June 2009)