Shared Governance Conference

1. Shared Governance Conference St. Luke’s Health System

2. Definition of Shared Governance • Shared governance is a professional practice model, founded on the cornerstone principles of partnership, equity, accountability, and ownership that form a culturally sensitive and empoweringframework, enabling sustainable and accountability-based decisions to support an interdisciplinary design for excellent patient care.

3. Key Points • Practice Policy Principles • Professional Mandate • Expectations • Clarification of roles

4. Practice Policy Mandates • Standardize principles, customize practice • Standardize at system level • Decrease number of policies; change to guidelines, pathways • Translate/customize and implement at unit level • What are we NOT going to do any more? • Creative destruction • Caring as principle

5. Professional mandate • View Nursing as a profession, not a job • Apply for privileges to practice to become a member of the community • unit council approves (peer interviewing) • Change job description to position charters • Performance demonstration vs. appraisal • Expectation to participate in shared governance vs. volunteer or be hand selected. • Professional ladder expectations, • cross purposes with shared governance

6. Expectations • Reinforce participation in shared governance is an expectation not an option. • Increase knowledge (detail – rotation + goals) • Website resources • Level setting council SG Education • Change our vocabulary • Productive time = direct care • non-productive time = value added time

7. Clarification of roles • Clarification of roles, manager, staff; shared decisions being made • Accountability vs. responsibility • Interface with PI, clarity on decisions; UNITS are accountable, role of councils • Recognize Shared Governance is a journey – Have PATIENCE!

8. Added slides from Tim Porter-O’Grady’s presentation

9. Professional Foundations • Mature profession • Not employee work group • Professions are a social contract • Greater than the workplace • Personal obligation (person and profession are one)

10. Shared Governance • Power of a profession is in its practice • SG by expectation, not invitation • Structure for sustainable behavior • No “warm and alive syndrome.” It’s not enough to show up for work “warm and alive” but not willing to come to the table.

11. Knowledge work is capital investment Structure creates context for behavior Who owns this (and setting tables) Abandon process for value Leaders do not decide You can’t incentivize moral leadership Managing professionals, not employee work group Knowledge workers are faithful to the work not the workplace New Leader Realities

12. Quantum Leadership • In a technological world, staff must be designers not merely implementers. • If you manage professionals the same way you manage employee work groups; you will always get employee work group outcomes. • Professionals are accountable, not responsible: • What difference did I make? • What value did I advance? • What impact did I have?

13. Leading Life at the Intersection • Leaders create the conditions/context for a “goodness-of-fit” • Social networks • Process networks • Evidentiary networks • Interdisciplinary networks • Interfacing service networks

14. Leader elements: Objective Outcomes oriented Computer “savvy” Accountability-based Expectation-driven Inquiry-grounded Issues: Past practice Policy and procedure Faulty evidence Role awe Ritual & routine Lots of experience Evidence-driven leader

15. Quantum leader skills Willingness “Setting the table” (gathering) “Tough love” language Confronting dependencies Leading “movement” “Storytelling” the journey Making sense of the “noise” Making the journey safe Surrender attachment to: Motivating others Owning other’s issues Charismatic imaging (ego ID) Creating dependencies Employee work group “ism” Directing and controlling Parentalism Non-accountability structures Quantum Leadership

16. Focus on creating context “Agent” of the decision (both staff and management) Responsible for success of SG Develops staff leaders (mentors them, too) Helps staff evaluate/change/adapt Must “live” shared governance Modeling willingness and skills to make shared governance work Assure competence and good process of unit staff decision-making Presence and monitoring of unit council and staff role in decisions and actions Evaluating and guiding performance and impact of staff skills, decisions and actions Managers are critical to success

17. Nursing is a Profession, not a job. Shared Governance gives us our voice If you want to build a ship, don’t drum up people to gather wood, saw it and nail the planks together. Instead, build in them a passionate desire for the sea.