Pursuing the Pathway to Excellence Engagement of Staff Utilizing Shared Governance ND Pathways to Excellence Pilot Program

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Rosamund McKinney
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1 Pursuing the Pathway to Excellence Engagement of Staff Utilizing Shared Governance ND Pathways to Excellence Pilot Program

2 Learning Objective 2 1. Identify structures and processes to support engagement of staff utilizing shared governance

3 SMART Goal 3 1. By the end of the 4th quarter of 2015, Altru Nursing will have implemented the shared governance model through the use of ACT-N and unit council interventions and education.

4 AONE Definition of Shared Governance 4 Shared governance is a professional structural model, founded on the cornerstone of principles of partnership, equity, accountability, and ownership that form a culturally sensitive and empowering framework, enabling sustainable and accountability-based decisions to support an interdisciplinary design for excellent patient care.

ownership that form a culturally sensitive and empowering framework, enabling sustainable

5 Pathway to Excellence Practice Standards 5 Practice Standard 1: Nurses Control the Practice of Nursing Introduction: Organizations receiving Pathway to Excellence designation have a defined shared governance model in place that actively supports collective decision-making among nurses at all levels. Through shared governance, direct care nurses are integrally involved in every aspect of their practice. They use new knowledge and evidencebased findings to develop and implement initiatives that improve nursing practice throughout the organization. They have substantive input into daily and long-range staffing decisions, including the hiring of new nursing staff. Nurses are openly encouraged to share staffing concerns that could potentially affect patient care and safety.

Through shared governance, direct care nurses are integrally involved in every aspect of their practice.

6 Pathway to Excellence Practice Standards 6 Practice Standard 1: Nurses Control the Practice of Nursing EOP 1.1 Describe the shared governance structure that demonstrates shared decision making. Provide a graphic depiction and any other supporting documentation necessary to explain the shared governance structure.

1 Describe the shared governance structure that demonstrates shared decision

7 Nursing Shared Decision-Making Structures should. Ensure that decisions contribute to the mission and goals of the organization and support the work of the organization 7 Tighten relationship between where decisions are made and implemented Delineate members roles and obligations Hold members accountable

organization and support the work of the organization 7 Tighten relationship

8 Nursing Shared Decision-Making Structures should. 8 Disseminate decisions and actions with follow-up for evaluation Have a framework for horizontal and vertical communication and integration all levels, units, shifts Have permeable parameters and remain flexible

Have a framework for horizontal and vertical communication and

9 Pathway to Excellence Practice Standards 9 Practice Standard 1: Nurses Control the Practice of Nursing EOP 1.2 Provide one example of a direct care nurse presenting an idea to the shared governance structure described in EOP 1.1.

2 Provide one example of a direct care nurse presenting

10 Pathway to Excellence Practice Standards Practice Standard 1: Nurses Control the Practice of Nursing 10 EOP 1.3 Provide two examples of shared governance initiatives that have resulted in a change in nursing practice, within the past 24 months, based on new information or evidencebased practice. Provide: Why the nursing practice change was recommended Description of the new practice Dates of the initiatives Bibliographical reference(s) for the new information or evidence-based practice used to make this change

months, based on new information or evidencebased practice.

11 Change Opportunity Forces Impacting RN Engagement 11 Increased engagement of RNs in shared decision-making Facilitating Forces Hindering Forces

12 Preference for Decisional Involvement 12 Defined as the pattern of distribution of authority for decisions and activities that govern nursing policy and the practice environment (Havens & Vasey, 2003, p. 332). Can be measured using the Decisional Involvement Scale (DIS) designed to measure the degree of staff nurses actual and preferred decisional involvement. DIS questions relate to six subscales: unit staffing, quality of professional practice, professional recruitment, unit governance and leadership, quality of support staff practice, and cooperation/liaison activities.

Can be measured using the Decisional Involvement Scale (DIS) designed to measure the degree of staff nurses actual and preferred decisional

13 Decisional Involvement Scale 13 Permission will be granted with the agreement that upon completion of your research, you will provide Dr. Havens with a data set. The requested data includes: demographic information a brief summary of the study you are conducting results a copy of the raw data Dr. Haven s contact information: dhavens@ .unc.edu

The requested data includes: demographic information a brief summary of the study you

Phases of Engagement Phase 1 Empower staff at at the divisional and unit level Phase 2 Build structures and processes to support decision making at the point of service Phase 3 Involve other

and monitor impact for desired outcome Educate & Train Ensure compatibility with mission, vision, & values of organization and nursing Link to reward & recognition systems Reinforce via

14 Phases of Engagement Phase 1 Empower staff at at the divisional and unit level Phase 2 Build structures and processes to support decision making at the point of service Phase 3 Involve other services and disciplines related to the patient care Assess preference for decisional involvement unit level managerial level Target areas for change Design activities for increasing engagement and monitor impact for desired outcome Educate & Train Ensure compatibility with mission, vision, & values of organization and nursing Link to reward & recognition systems Reinforce via performance management system Communication Plan Involve point-of-care physicians and other health care providers Create new horizontal relationships in response to service changes Focus on outcomes and results

15 Factors Contributing to SG Engagement Success 15 Leadership and managerial support Communication plan Education and training Role delineation Structures and processes for decision making Recognition for performance improvement Organizational slack (staffing, space, and time resources) Alignment with organizational decision making structures and priorities

decision making Recognition for performance improvement Organizational slack (staffing,

16 References: APeriodicals/OJIN/TableofContents/Volume92004/No1Jan04/SharedG overnancemodels.aspx 16 pdf Scherb-et-al-2010.pdf

aspx 16 http://www.strategiesfornursemanagers.com/supplemental/4428_book. pdf http://www.mindtools.com/pages/article/newted_06.

The Power of Shared Decision Making

The Power of Shared Decision Making What is Shared Decision Making Point of Service Decision Making - where staff who perform the work participate in decision making affecting their environment A 30 year