Shared Governance Council Structure Overview

Shared Governance is inherent to the Department of Nursing at MetroHealth Medical Center. The purpose of the Shared Governance Councils is to provide a structure in which clinical nurses can have autonomy in practice, decision making ability related to both clinical and professional practice decisions and collaborate to ensure a high level of professional performance by all nursing team members.  

All Shared Governance Councils have identified responsibilities, outlined membership, a council charge and an identified realm of authority. A universal tenant for all councils is that the decisions made are to be consistent with the mission and vision of MetroHealth and the Department of Nursing, The ANA Scope and Standards of Nursing Practice, The ANA Code of Ethics, Nursing's Social Policy Statement, the Nursing Philosophy of MetroHealth and the requirements set forth by the Ohio Board of Registered Nurses. 

Shared Governance Councils - CNO Council 

Responsibilities  

• Oversight of shared governance councils

Membership

• Chair: CNO
• All Directors of Nursing
• APN Director
• Staff Nurse Chair of Senate
• Staff Nurse Chair of Coordinating Practice Council
• Nurse Manager Chair of Integrated Manager Council
• Director Quality
• Research Chair (only attends quarterly to provide report of activities)

Council Charge

• Develop strategic plan and assign responsibility for plan components to appropriate councils and / or ad hoc work groups
• Review reports from all councils and make recommendations for improvement
• Financial updates
• Regulatory compliance
• Magnet Accreditation oversight

Authority

• Final approval of all initiatives requiring additional resources

Shared Governance Councils - Nurse Senate

Responsibilities 

• Address workforce quality care in a safe and satisfying environment  
• Meet the changing needs of nursing throughout the organization
• Develop and implement a sustainable peer performance management feedback process and peer appeal process

Membership

• Chief Nursing Officer as Advisor  
• Staff Nurses as Chair and Co-Chair
• One Staff Nurse from each inpatient area, ambulatory cluster, and satellite cluster

Council Charge

• Disseminate information with nursing staff
• Collaborate with managers and directors on applicable initiatives
• Primary responsibility: work/life concerns (e.g. scheduling, rewards, recognition, general unit issues)
• Determine annual goals based on strategic plan

Authority

• Approve initiatives related to charge that do not require additional resources
• Make recommendatiosn to CNO Council for initiatives that require additional resources

Shared Governance Councils - Integrated Manager Council

Responsibilities 

• Transformational leadership
• Efficient patient care
• Professioanl practice

Membership

• CNO as Advisor/Mentor
• Nurse Manager Chair
• All inpatient and outpatient nurse managers

Council Charge

• Address system issues that affect professional nursing practice
• Review recommendatiosn / initiatives from other departments that affect patient care
• Determine annual goals based on strategic plan
• Design and implement self-appraisal and goal setting process for all staff and peer review process for nurse managers
• Increase nurse manager involvement in professional organizatios

Authority

• Approve initiatives related to charge that do not require additional resources
• Make recommendations to CNO Council for initiatives that require additional resources

 Shared Governance Councils - Nursing Research Council

Responsibilities 

• To promote and support nursing reserach
• To promote patient rights in the realm of informed decision making in research
• To protect the rights of nurses involved in research
• To ensure the integrity of research protocols in nursing

Membership

• Senior Research Coordinator
• Inpatient and Ambulatory Manager
• Clinical Nurse Specialists
• Staff Nurses in the role of Research Champions in the CARE Program

Council Charge

• Provide and identify opportunities, support, and resources for nursing research
• Continue to increase the number of nursing research projects and publications
• Communicate with Coordinating Practice Council as needed
• Serve as a liasion to the Institutioanl Review Board (IRB) at MetroHealth

Authority

• Final approval of nursing research project proposals prior to submission to IRB

 Shared Governance Councils - Coordinating Practice Council

Responsibilities

• Quality
• Patient Satisfaction
• Education
• Practice

Membership 

• CNO as Advisor/Mentor
• Co-Chairs: Staff Nurse & two Directors of Nursing
• Staff Chair from each Unit Practice Council
• CNS or Nurse Manager from each Patient Care Unit
• Quality Improvement Facilitator or Education Coordinator from each Patient Care Unit
• Quality Management representative

Council Charge 

• Approve practice based on accepted professional standards, regulatory requirements and published evidence of best practices
• Review MetroHealth System policies that impact nursing practice (e.g. safety goals, new and revised policies) 
• Define educational and measurement needs associated with practice changes
• Review activities of Unit Practice Council on regular basis
• Recommend adoption of best practice successes
• Recommend needed PI activities based on review of patient safety and quality data
• Answer the questin: "What areas are impacted by this idea or change?"
• Communicate with Research Council as indicated
• Improve certification of staff

Authority  

• Approve initiatives related to charge that do not require additional resources
• Make recommendations to CNO Council for initiatives that require additional resources

 Shared Governance Councils - Advanced Practice Nurse (APN) Council  

Responsibilities

• Professional practice
• Review standards for Advanced Practice Nurses (APNs) and address practice related issues
• Collaborate with other disciplines to design and promote educational programs
• Collaborate with organizational leaders in designing and providing quality patient care services

Membership 

• Director of Advanced Practice Nursing serves as Chair of the Council
• Membership is open to any APN but consists of at least one representative from each APN group if possible. These include at least one CNP, CRNA, CNS, CNM, and Psych APN

Other Responsibilities  

• Maintain minutes
• Communicate with APN staff
• Chair sits on CNO Council and reports on activities on regular basis

Council Charge 

• Members will communicate practice concerns, innovations and recommendations in the area represented as it relates to Advanced Practice Nurses 
• Communicate actions and decisions to other APNs
• Regularly attend and participate in Council meetings
• Recommend, revise or create policies, procedures, processes, and forms to support improved practice and compliance among APNs.
• Provide basic resources, education and support to improve individual practice

Authority

• Approve initiatives related to charge that do not require additional resources
• Make recommendations to CNO Council for initiatives that require additional resources

 Shared Governance Councils - Professional Development Council

Responsibilities 

• Recruitment, retention and development of MetroHealth's talented nursing staff

Membership 

• CNO as Advisor/Mentor
• Chair: Director of Nursing
• Human Resources Representative
• Education Specialist
• CNS Representative
• CARE Program Representatives
• Nurse Manager Representative
• Mentor Program Representative
• Other nursing staff (mix: tenured and newer of less than two years)

Council Charge 

• Oversee existing functions of nurses week, Mentoring Program, Preceptor Group, CARE Program, CA Program, Nurse Ambassador Program, work force diversity and monitor applicable metrics
• Review staff engagement data and make recommendations for improvements to PCUs and for global issues
• Develop and make recommendations for staff development
• Review activities of the various project and role development groups for care program roles
• Determine annual goals based on strategic plan and develop ad hoc work groups to achieve these goals
• Review annual educational assessment and related educational plan
• Develop plan to increase numbers of those pursuing formal education (BSN, MSN, etc).

Authority  

• Approve initiatives related to charge that do not require additional resources
• Make recommendatiosn to CNO Council for initiatives that require additional resources

Unit Practice Councils  

Responsibilities 

• Quality, Patient Satisfaction, Education and Clinical Practice 

 Membership

• Co-Chairs: Staff Nurse & either Clinical Nurse Specialist or Nurse Manager
• Staff Nurse Representative from every unit involved in the council
• CNS and Nurse Manager representatives
• CARE Program Representatives
• Director as Advisor/Mentor (on ad hoc basis)

Council Charge 

• Review practice standards/policies as assigned by Nursing Standards Committee
• Determine educational and measurement needs for practice changes
• Review unit level outcomes including patient safety and quality data
• Make recommendations for unit / service PI projects
• Answer the question: "What areas are impacted by this idea or change?"
• Ensure that communication to individual units occurs

Authority 

• Determine PCU-specific standards (final approval rests with DON)
• Communicate recommendations for changes, education and PI for assigned standards that cross two more PCU's to the Coordinating Practice Council (CPC) (final approval rests with CPC)
• Make recommendatiosn for unit-based PI and educatin activities (DON to facilitate assignments)
• Disseminate information to unit

Nursing Standards Committee  

Responsibilities

• Ongoing standards review
• Literature review for select standards 

Membership 

• Co-Chair: Clinical Nurse Specialist and Nurse Manager
• Additional Nurse Manager and Clinical Nurse Specialist Representatives
• Three staff nurses

Committee Charge 

• Identify stakeholders for all nursing policies, standards and protocols
• Distribute documents to respective unit practice councils (1st month of each quarter)
• Assign reviews to two unit practice councils when more than two or more PCU's are covered by a protocol
• Resolves discrepancies for reviews completed by two unit practice councils
• Complete literature review and make recommendatiosn for revision, staff educatin and PI measurement for all standards that are applicable to PCU's

Authority 

• Communicate recommendations for changes, educatio and PI for assigned standards that apply to all PCU's to the Coordinating Practice Council (CPC) (final approval rests with CPC)
• Make grammatical revisions and update references / dates for any standard that crosses more than one PCU and does not require a change to practice (final approval rests with Nursing Standards Committee)