In a simple definition, shared governance is one of the most innovative and idealistic of organization structures, was developed in the mid-1980s as an alternative to the traditional bureaucratic organization structure (Huston & Marquis, 2004). Shared governance is based on the principals of equity, accountability, ownership, and partnership. This process of management allows each healthcare worker to have a voice in the decision-making and encourage input that will help grow the business and healthcare missions of the organization. In all, it makes each healthcare employee feel as if they are involved with a personal part in the success of the organization. The more employees who are satisfied with their jobs take their job description more serious, which then will lead to better patient outcomes. Therefore, the organization, employees, patients, and communities all benefit from shared governance.
The four principles of shared governance are equity, accountability, ownership, and partnership. Equity is a method used for incorporating staff roles and relationships into structures and processes to accomplish positive patient outcomes. Equity is a foundation that focuses on services, staff, and patients and is essential to providing safe and effective care. Accountability is a willingness to invest in a decision-making process. It is often used interchangeable with responsibility. It supports partnerships and is protected as staff produce positive outcomes. Ownership is the recognition and acceptance of the importance of everyone’s work. It requires all the staff members to commit to contribute to work. Partnership links patients and healthcare providers along to each point in the system. It is a necessity to building relationships and involving members in the decisions. This principle is critical to the healthcare system’s effectiveness. Patients are no longer satisfied with directive care, they also want, equity, accountability, ownership and partnership.
There are many benefits and challenges to shared governance. A strategy either enhances access to information, access to resources, support for the work, opportunity to develop, or a combination of these (Hutchison & Moore, 2007). A fundamental belief behind shared governance is that staff nurses at every level in the organization should govern their practice and be included in decisions that affect their practice. (Caramanica, 2004). A nurse is the primary employee who does the work and connect the organization to the recipient of its service. On the other hand, nurse managers are ideally positioned to create positive work conditions that nurture a sense of empowerment. (Hutchison & Moore, 2007). Leadership is a quality that can be a forefront to staff to increase the organization.
Nurse Managers in health care organizations that employ this type of governance demonstrate a concern for both the tasks to be accomplished and the cultivation of quality partnerships among staff; they believe both are necessary for the delivery of excellent patient care and services. (Caramanica, 2004). In shared governance, a manager is accountable for patient care delivery in their area of responsibility. In that patient care area, the nurse manager is responsible for setting the direction, looking at past results, and evaluating outcomes. While it is the manager’s role to collect the necessary resources required by nursing staff, the staff nurses must use their authority and responsibility to determine what care to provide and how to provide that care to patients.
Work settings that are structurally empowering are likely to increase employee’s feelings of organizational justice, respect, and trust in management (Hutchison & Moore, 2007). To impact healthcare in patient delivery, employees must focus on staying happy with their jobs to have more positivity about the outcomes. Examples include: longevity of employment, increased employee satisfaction, better safety and healthcare, greater patient satisfaction, shorter lengths of stay. Therefore; employees who are satisfied with their career and job setting will show more positive outcomes towards patient care.
In summary, implementing shared governance is a great partnership in the healthcare workplace. Healthcare workers should continuously strive better the work environment. It is known that shared governance requires strategic change in organizational culture and leadership. It demands a significant realignment in how leaders, employees, and systems transition into new relationships and responsibilities. In the spirit of continuous improvement and professionalism, healthcare organizations must never stop seeking ways to engender a satisfying and fulfilling workplace (Hutchison & Moore, 2007).
Caramanica, L. (2004). Shared Governance: Hartford Hospital’s Experience. The Online Journal of Issues in Nursing, Vol. 9. Retrieved from http://www.nursingworld.org/mainmenucatefories/ANAmarketplace/ANAperiodicals/OJIN/tableofcontents/volume92004/No1Jan04/HartfordHospitalsExperience.aspx Huston, C.J., & Marquis, B.L. (2006). Leadership roles and management functions in nursing: Theory and application, 288-290. Hutchinson, S.A., & Moore, S.C. (2007). Developing Leaders at Every Level: Accountability and Empowerment Actualized Through Shared Governance. The Journal of Nursing Administration, Vol. 37. Retrieved from http://www.mc.vanderbuilt.edu/root/pdfs/nursing/developing_leaders_at_every_level.pdf