Weathering the Storm: Navigating Change with Shared Governance Amanda Ellefson, CCLS, Child life specialist II Brooke Calfas, CCLS, Child life specialist II Monroe Carell Jr. Children s Hospital at Vanderbilt May 22 nd, 2015 Agenda Introduction Open Forum & Closing Shared Governance Overview Practical Application Changes & Transition Objectives Gain knowledge about the philosophy of Shared Governance Gain insight regarding Shared Governance structure Be informed on ways to utilize Shared Governance Be equipped to implement Shared Governance within your organization 1
What does it look like? Shared Governance Example How does your current department or organization make decisions? Can you identify examples of this in your institution? What is Shared Governance? A philosophy and structure that supports: Decentralized decision-making Shared ownership and accountability Partnerships among key stakeholders Vanderbilt Definition A dynamic staff-leader partnership that promotes collaboration, shared decision-making and accountability for improving quality of care, safety and enhancing work life. Shared Governance Elements Collaboration Staff Participation Decisions close to work Changing and Evolving 2
The Concept of Shared Governance Structure Shared Governance Process Shared and collaborative decision making between leaders and staff Outcome Engagement of employees in professional practice and improvement in patient care History of Shared Governance According to Hess (2004) the nurses who actually deliver care are often absent from policymaking processes and structures. Nursing shared governance emerged as one way to give these clinical nurses equal footing with managers to allow them to participate in the decision-making processes that affect their practice (p. 2). History of Child Life Unit Board Clinical Documentation consistency Child life referrals and consults STAT responses Departmental Organization for online resources Christmas Programming and Planning Continuing Education 3
Nursing Shared Governance Model Nursing Staff Councils Discussion of issues/ Advise Leadership Medical Center Nursing Board Operational Implementation Unit/Clinic Boards Frontline Implementation/ Planning Entity Nursing Leadership Boards Operational Implementation Work, ideas, and issues can originate from the Executive/Strategic level and travel through the boards to develop into a program or policies that get implemented at the entity or unit/clinic level Nursing Administrative Board Operational planning Nursing Executive Board Strategic planning Work, ideas, and issues can originate from the Unit/Clinic level and be addressed there, or move throughout the supporting boards for input, planning, and implementation Regular meetings Expectations Document & Communicate Charter Collaborative Agendas Elected chair/cochair Evaluation Shared Governance Charter Roles and responsibilities Manager/ Leader Chair and co-chair UB members Ground Rules Creation Posted in meetings 4
Increased Time 5/9/2015 Decision- Making Process Consensus agreements All views should be heard and understood Consensus means everyone understands what he or she is agreeing to and for how long. Key decisions should include evaluation criteria and timeline for Unit Board to revisit decision. Fallback plan use Self Governance VS Shared Governance Decision- Making Decision- Making Process Leader makes decisions independently Leader makes decisions with feedback from others Staff and leader work together to reach consensus Leader has no involvement and consensus is reached by staff with restraints Increased Participation From: Board Basics 2013 5
Moving Forward Resources Customize Participation Support Key Lessons Building Infrastructure Preparation Momentum Shared Governance Change and Transition Can you think of changes your department has experienced? How did you make decisions about how to manage them? 6
Using Shared Governance Departmental Institutional Healthcare An Example Child life clinical coverage Placed on the bin list June 2013 Held meetings Created small work group Identified five options Created and implemented pilot Evaluated in 2014 Practical Application Group exercise Ground rules Identify a topic Assign roles Create Agenda Facilitate Shared Governance meeting Evaluate meeting 7
Why Shared Governance? Shared vision Empower -ment Staff-leader partnership Thank you! Leadership video clip https://www.youtube.com /watch?v=_tuh8ff3v8k Comments and Questions 8
References Hess, R. (2004). From bedside to boardroom nursing shared governance. Online Journal of Issues in Nursing, 9 (1). Retrieved from www.nursingworld.org/mainmenucategories/anamarketplace/anaperiodicals/ojin/tableof Contents/Volume92004/No1Jan04/FromBedsidetoBoardroom.aspx Kerfoot, K. (2005). On leadership: Establishing guardrails in leadership. Nursing Economics, 23, 334-335. Moore, S. C., Hutchison, S. A. (2007). Developing leaders at every level: Accountability and empowerment actualized through shared governance. The Journal of Nursing Administration, 37, 564-568. Shared Governance. (2015, January 22). Retrieved April 8, 2015, from http://www.mc.vanderbilt.edu/root/vumc.php?site=shared Governance Tickle, E. (Director) (2013, August 22). Board Basics: Agenda Planning and Facilitating Agreement. Board Basics. Lecture conducted from Vanderbilt University Medical Center, Nashville. Tickle, E. (2013). Shared Governance Overview. [Vanderbilt University Medical Center]. [PowerPoint Slides.] 1-15. Tickle, E. (2013). Shared Governance Board Basics. [Vanderbilt University Medical Center]. Contact Information Speaker Name: Amanda Ellefson Speaker Title: Child life specialist II Phone: 615-936-4575 Email: amanda.ellefson@vanderbilt.edu Speaker Name: Brooke Calfas Speaker Title: Child life specialist II Phone: 615-936-5458 Email: brooke.calfas@vanderbilt.edu 9