Shared governance is a leadership structure that enables nurses to influence decisions that affect their practice. Our shared governance model provides a framework that aligns nursing with the organization's overall goals and empowers all nurses to play an important role within our corporate strategic plan.
Memorial University Medical Center has adopted a "councilor model" of shared governance. In this model, issues that impact functional areas of nursing across the organization are identified, addressed, and resolved at various levels by the appropriate committee in the following committee structure:
Issues identified at the point of patient care are initially addressed within the unit by the unit practice committees. These committees are authorized to make decisions that affect their unit. Decisions are made by consensus and supported by evidence-based practice. Issues that extend beyond the specific unit are brought to the nursing specialty councils.
These councils address operational, practice, educational, and performance improvement issues that extend across all or most of the units within the specialty council and/or have been identified by the shared governance councils. Memorial University Medical Center has the following nursing specialty councils: maternal-infant, pediatrics, critical care/stepdown, medical-surgical/behavioral/rehab, and peri-operative/procedural.
These councils address issues on operations, practice/research, education, and performance improvement as they relate to professional nursing and care delivery spanning the entire organization. Each governing council includes leadership representation consisting of one director, one manager, and one or more content advisors. Governing councils are chaired by elected staff nurses.
The coordinating council oversees and makes decisions related to the overall nursing practice, such as patient care and policy changes, quality issues, patient throughput, etc. The coordinating council also facilitates the movement of information between councils, ensuring the issue isn't an organizational one. If it is organizational (covering more than one specialty area), it is assigned to a governing council. The coordinating council is open to all registered nurses and includes the chief nursing officer, clinical directors, nursing supervisors, and advanced practice nurses. The leaders are elected and the number is limited so that there is never an overwhelming number of nurse leaders at any one meeting.
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