CNO/CNS Partnership to Implement Shared Governance
and Support Professional Nursing Practice
Midwest Orthopedic Specialty Hospital/ Wheaton
Franciscan Healthcare Franklin
Sheila Gansemer DNP, RN Chief Nurse Executive
Amy Ketchum MS, RN, OCNS-C Clinical Nurse Specialist
Laurie Ellsworth BSN, RN Chair- Shared Governance Practice and Development Team Amanda Gast RN, OCN Co-Chair- Shared Governance Practice and Development Team
Wisconsin Association of Clinical Nurse Specialists CNO/CNS/Shared Governance Breakfast
Background and Significance
~
To Nursing and Shared Governance~
Wheaton Franciscan Healthcare Promise Statement
“To carry out our Mission of providing exceptional and
compassionate health care service…Nothing is more important to
us than your health and well being”
Midwest Orthopedic Specialty Hospital Commitment Statement
“Midwest Orthopedic Specialty Hospital’s vision is to be the
premiere destination for orthopedic care in the Midwest…Patients
are at the center of everything we do and that their positive
experience, clinically and personally, is the result of the collective
activities and interactions they have with every person in our
hospital.”
Project Overview
Purpose:
• design and implement a Nursing Shared Governance model that supports:
• commitment to patients
• development of professional nursing practice. Setting/ Population:
• WFH-FRK
• 52 bed hospital
• 121 registered nurses
• 2 inpatient units, 6 bed ICU, 15 bed ED, 5 ORs, 4 endoscopy suites, 2 cath labs, an interventional radiology suite and OP care.
• MOSH
• orthopedic specialty hospital
• 61 registered nurses practicing
• 16 bed inpatient unit, 6 ORs, 2 procedure rooms and pre/post-operative care. Procedure:
• 3 step process
• identify key stakeholders,
• design a nursing shared governance model and
• implement shared governance activities that support the tenets of professional practice.
Project Description
Goal 1: Design a shared governance model that supports
professional nursing practice.
Design Team
•
Goals:
•
Represent all areas and roles where nursing is practiced at
WFH-FRK/MOSH
•
Follow an evidence based process for the design and roll
out of Nursing Shared Governance at WFH-FRK/ MOSH
•
Steps
•
Literature Review
•
Model Design
•
Structure Recommendations
•
Education Plan
•
Roll out
WFH FRK/MOSH Model for Shared
Governance
•
Theme: Creativity,
Innovation and
Environment
•
Patient Centered
•
Overlapping Relationships
of Operations, Practice and
Quality
•
Inclusive of the
Design Team: General
Recommendations for structure
•
Goal Alignment, creation of the Coordinating Council
•
Shared Governance Principle:
Ownership
•
Standardized Charter, revisions where needed to existing
teams
•
Shared Governance Principle:
Equity
•
Shared Governance Principle:
Accountability
•
Communication Plan, dashboards
Shared Governance described
by the Design Team:
•
Shared Governance is: a medium through which
nursing care is designed and transformed via
positive, forward thinking and collaborative practice
and development of the professional nurse.
•
Our Goal is: to empower nurses with the tools they
need to drive Evidence Based Practice changes in all
venues resulting in increased engagement and
positive patient outcomes through collaboration,
development and unity within the discipline of
nursing.
•
I am looking forward to: the formation of a
cohesive nursing voice that is recognized as a leader
in driving nursing practice.
We are all a part of Shared
Governance!
This is our way of practicing as a Nursing
Profession going forward
•
Support Shared Governance and provide
feedback
•
Use your Shared Governance resources to
Project Description
Goal 2: Incorporate tenets of professional nursing practice into
activities of Shared Governance.
AORN ANCC Magnet, Accountable Care and
Perioperative Services: the Current Reality
AORN Pre-Conference developed in collaboration with the ANCC Credentialing Knowledge Center (2014)
10
Goal 1: Design a shared governance model that supports professional nursing practice.
Goal 2: Incorporate tenets of professional nursing practice into activities of Shared Governance.
Interventions/Outcomes
Triggers Priority Goals
Tenets of a Profession
Trigger 1: No defined structure for professional nursing shared governance.
Trigger 2: Changing healthcare environment requiring adaptation of professional nursing roles and the interdisciplinary team process.
Interventions/Outcomes
Self regulation:
• PDM updates including a portfolio design. • 1st RN chair/co-chair
practice and development team.
Peer Review: Nurse Grand
Rounds
Unique Body of Knowledge:
Use of data to drive improvements in Nurse Sensitive outcomes.
Code of Conduct:
ANA Code of Ethics update chosen as topic for nurses week celebration.
Contract with Society: WFH
FRK/MOSH Nursing Shared Governance model designed with the patient at the center of our work.
Project Results
•
Development of Shared Governance Goals
in alignment with WFH/MOSH strategic
goals
•
Professional nursing activities:
•
Poster presentations,
•
Conference participation/presentation,
Project Results
Project Results
Project Results
Implications for
Nursing Practice
Autonomy
Authority
Accountability
AORN ANCC Magnet, Accountable Care and
Perioperative Services: the Current Reality
AORN Pre-Conference developed in collaboration with the ANCC Credentialing Knowledge Center (2014)
References
Design/Implementation Bibliography
• ANCC Magnet Recognition Program http://nursecredentialing.org/Magnet.aspx
• AORN ANCC Magnet, Accountable Care and Perioperative Services: the Current Reality AORN Pre-Conference developed in collaboration with the ANCC Credentialing Knowledge Center (2014)
• Bretschneider, J., Glenn-West, R., Green-Smolenski, J. , Richardson, C. Strengthening the
Voice of the Clinical Nurse-The Design and Implementation of a Shared Governance Model
Nursing Administration Quarterly 34(1) (2011) 41–48
• Haag-Heitman, B., George, V. ANCC Guide for Establishing Shared Governance: A Starter’s Toolkit (2010)
• Hess, R. Slicing and Dicing Shared Governance In and Around the Numbers Nursing Administration Quarterly 35 (3) (2011) 235–241
• Houston, S. et al Decisional Involvement in Magnet, Magnet-Aspiring, and Non-Magnet
Hospitals Journal of Nursing Administration 42 (12) (2012) 586-591
• Porter-O'Grady, T. Reframing Knowledge Work: Shared Governance in the Post digital Age Creative Nursing 18. 4 (2012): 152-159.
• Ruch, S. Primary Nursing: A Call for Clarity, Empowerment, and Accountability Creative Nursing 18. 4 (2012): 175-176.
• Wessel, S. Impact of Unit Practice Councils on Culture and Outcomes Creative Nursing 18. 4 (2012): 187-192.
