Shared governance 101: What you need to succeed!

Background: Shared governance has evolved over time and focuses on shared decision making between leadership and direct patient care staff. Shared governance is based on the principles of partnership, accountability, ownership, and equity. Local problem: The shared governance structure and councils have been in place for 30 years at this quaternary medical center, but never formally assessed. Method: A quality improvement project aimed at assessing effectiveness of the shared governance was conducted. Permission was obtained to utilize the Council Health Survey (CHS), which is intended to evaluate council effectiveness through three subscales: membership, structures, and activities (Hess et al., 2020). All shared governance representatives were voluntarily and anonymously asked to complete a baseline CHS in January 2022 and a follow up in January 2023. Results/Conclusions: Baseline results showed that the majority of shared governance respondents (n= 83) were nurses (86%) and agreed or strongly agreed (80%) with effectiveness of shared governance structures and activities. The membership subscale item of “formal education or training for new members/leaders” showed 40% of responses were neutral, disagree, or strongly disagree with a mean score of 3.51 on a 5-point Likert scale. As a result, “Shared Governance 101” was created and rolled out in July 2022 as a quarterly standardized orientation to new shared governance members. The follow-up CHS “formal education or training for new members/leaders” increased to a mean score of 3.63. Post evaluation subscales of structures and activities remained consistent with baseline. A paired sample t-test for Shared Governance 101 attendees showed a significant increase in confidence with skills for role from pre (M=3.46, SD= 1.2) to post training (M=4.69, SD=.47), t (25) = (-5.67, p\u3c.001). Implications: Baseline survey results highlighted strong and consistent performance in shared governance structure and activities, but an opportunity to improve membership with a standardized orientation