An Innovative Approach to Establishing Shared Governance

1. An Innovative Approach to Establishing Shared Governance Gabriele Pike, RN New Hanover Health Network October 15, 2004

2. Mission Philosophy • Assure that professional nurses have formal programs with prescribed authority to influence practice. • The Nursing Congress serves as a facilitating structure for making decisions regarding the practice of nursing across the continuum. Committee Structure • Promotes professional involvement and accountability for quality, cost and productivity and serves as the voice of nursing. Five Nursing Congress Councils make up the Nursing Congress structure.

4. Leadership Council To lead the implementation and evaluation of the strategic initiatives for NHHN’s nursing community

5. Leadership Council • Reporting Council for Nursing Congress • Membership Chair persons of 4 councils Administration (CNE) Nursing Manager Representative Magnet Manager Directors of Nursing invited on quarterly basis

6. Professional Development Council To foster the professional growth of the bedside nurse in a non-management model

7. Professional Development Council • Staff Development Pay for Certification Bonus ($1200) • Reward and Recognition Nursing Excellence Awards ($500) • Clinical Ladder Program Clinical Ladder III ($2000) Clinical Ladder IV ($4000)

8. Research and Outcomes Council Monitor, evaluate, improve processes impacting patient outcomes and nursing practices while supporting nursing research and integrating findings into evidence-based practice.

9. Research and Outcomes Council • Fosters and promotes research activity within the nursing community • Holds educational in-services on research initiatives • Hosts research day and research fairs

10. Practice Council To assure that the delivery of nursing care to our patients meets current established standards of nursing practice.

11. Practice Council • Governs policies and procedures • Ensures all policies and procedures are referenced and utilizes evidenced based practice

12. Finance Council Evaluate economic factors such as resource allocation and consumption as they relate to safety, outcomes, effectiveness, cost and social impact when developing and implementing practice innovations.

13. Finance Council • Responsible for cost containment • Productivity • Initiated floating guidelines • Developed “Nursing Resource Fund” to supplement educational opportunities for nurses

14. Strategic Plan • Nursing Congress developed Strategic Plan in 2001 to drive the outcomes of the councils. 4 Key Elements Magnet Designation Research Evidenced Based Practice Communication

16. What was the role of Nursing Congress for Magnet Designation? • CNE discussed Magnet at Congress Meetings and forums for staff • Team of Management and staff visited 3 Magnet Facilities. • Team presented report to Congress, and Congress voted to continue to pursue designation • Congress presented to the Board of Trustees to continue to seek Magnet Designation • Councils assigned specific standards, staff RNs assisted Congress members to “prove” standard in documentation • Nursing Congress members were “leaders”, took information to the staff

17. What was the role of Nursing Congress for Magnet Designation? • Co-Chairs were in “charge” of standards • Administrative Champions assisted with process • A portion of each Congress meeting was set aside to discuss evidence gathered and questions about Magnet • Evidence was gathered by self or in groups • Staff nurses were asked to assist with narratives or write narrative/ overview of how standard was “proven” with supportive evidence

18. We did it! June 2003Nursing Congress celebrated its success of becoming the 70th Magnet Designated Hospital