The internationally recognized Forum for Shared Governance has announced it has awarded one of its first shared governance accreditations to Conway Regional Medical Center. Shared governance is a management model designed to ensure that clinical staff are the ones making clinical decisions at the bedside, while encouraging them to influence the resources that support them.
“Through rigorous survey of all clinical staff, managers, and administrators, Conway Regional Medical Center has demonstrated its nurses call the shots for their patients,” said Dr. Robert Hess, PhD, RN, FAAN, CEO and Founder, Forum for Shared Governance. “Shared governance has been associated with better professional, organizational and patient outcomes, according to research studies. If patients get sick, they should make sure the ambulance takes them to a hospital accredited in shared governance.”
Hess added, “Patients often assume nurses are empowered to make decisions in their best interest. However, sometimes nurses’ decisions are superseded by managers, administrators, and others far from the point of care who don’t have the expertise or information to coordinate patients’ total care. Shared governance ensures that the status quo is bedside nurses empowered as patient advocates.”
“This is a resounding endorsement of the leadership of our clinical staff and the investment that they have in patient care at Conway Regional,” said Angie Longing, Chief Nursing Officer. “I have been overwhelmed by the response from our front line staff, particularly our floor nurses. Without their support, shared governance is just another program.”
“Some hospitals put a structure in place in name only,” Hess said. “By using extensive survey methodology, the Forum for Shared Governance has been able to determine whether a hospital has real shared governance; Conway Regional Medical Center is one of those institutions.”
C.J Newton, Director of Educational Resources, led efforts to establish shared governance at Conway Regional.
“This is truly a team effort that has involved our clinical and academic community. It could not have been accomplished without numerous employees who have invested their time and energy into the concept of shared governance. It is a team effort that starts with the ideas of the clinical staff on the floor, flows through the functional councils and Patient Care Governing Congress all the way to Angie and our CEO Matt Troup, and concluding with a very supportive Board of Directors. Without the support of all of these people, shared governance could not be as effective as it is.”
Newton added that Ché Reed, PhD, RN, CNL a nurse researcher and faculty member at UCA, served as principal investigator in documenting Shared Governance.
“CJ Newton approached me about consulting on this project prior to implementation of the shared governance model. This allowed our team to gather evidence on best practices in shared governance, gain permission from Dr. Hess to use his professional governance measurement tool, and begin systematically collecting data to examine the effectiveness of the shared governance model,” said Reed. “Following the first year of shared governance at Conway Regional, we were able to see positive changes in the way employees perceived their ability to share in the organization’s decision making processes. This is the very definition of shared governance.”
For Shared Governance to be effective, it must receive the support of the patient care staff. “It has definitely turned into something that has made a lot of improvement,” said Kristen Aday, BSN, RN, a Department Council leader who has been involved in Shared Governance for about two years. “The employees who are involved in the process feel a lot of empowerment.” Aday provided an example of how Shared Governance works.
A suggestion from a group of employees to begin use of dialysis cyclers, which will enable inpatients to receive dialysis while they are sleeping, was recently approved by Conway Regional’s Executive Leadership Team after it was discussed and endorsed by the Patient Care Governing Congress (PCGC). The Congress is made up of employees from a variety of clinical areas of the health system, including nurses, technologists, therapists and others. Aday said the dialysis cyclers will make in-hospital treatment more comfortable for patients with less risk of infection. “It started out as an idea from a group of Fourth Floor nurses, it went to patient congress and has been approved by ELT,” she said.
Courtney Lloyd, a technologist in the Cardiac Cath Lab and a co-chair of the PCGC, said Shared Governance provides employees with an opportunity to “have a voice in what goes on around the hospital.” She added, “If our staff have concerns about patient needs or ways to improve employee operations, they can take it through shared governance and actually get things improved. Before, there wasn’t an avenue where you could actually change things on your own. We have had numerous policy and procedure changes that have really made a difference for patient care and for employees.”
A recent change that affected clinical employees is the Clinical Advancement Program (ladder) that was developed through the Professional Practice Functional Council. Award letters have been sent to clinicians who met the participation requirements for bonuses because of their involvement in improving Conway Regional. Award recipients get points based on activities that they are doing on their own, and on the clock, that support improved patient care and employee satisfaction.
Lloyd added, “Another thing about Conway Regional’s Shared Governance that makes it unique is that it is inter-professional. It is not just nursing; it’s for all clinical employees.”