Across Penn Medicine, a "Shared Governance's" structure is used to empower frontline nurses to share leadership, identify concerns and drive decisions to improve professional practice, patient care, quality and safety. The Hospital of University of Pennsylvania (HUP), Penn Presbyterian Medical Center (PPMC) and Pennsylvania Hospital (PAH) all share the philosophy that accountability and empowerment are essential to the Magnet® journey. Penn’s Shared Governance model gives nurses a strong voice, creating a culture of excellence.
Some nurses describe Shared Governance as the true voice of the clinical nurse, face-to-face with administration. It enables nurses to drive the practice of nursing to greater excellence.
Creating a Culture of Excellence in Nursing
Many of the nursing best practices at Penn hospitals are designed and implemented by the professional clinical nurses. The Shared Governance model has provided a structure that led clinical nurses to:
- Design a campaign to increase nurses’ flu vaccinations
- Implement a new patient call bell system with staff positioning/ locators to decrease noise and measure call response time
- Institute hourly patient care rounds that resulted in fewer calls and an overall initial 20% reduction in nursing steps
- Install noise level monitors at high-volume areas on all units
- Re-structure visiting hours to support family presence and patient and family centered care principles
- Establish standards for professional image including adoption of a standard professional nurse uniform
With slight variations at each entity, the Shared Governance model comprises:
- Core Council
- Practice Council
- Quality/ Patient Safety Core Council
- Professional Development Council
- Unit Based Councils, led by clinical nurses
- In 2012 the nurse Shared Governance structure at HUP was re-designed to include a Board of Nursing
The Shared Governance structure promotes nurses to become advanced in their approach to problem solving and enhancing their nursing practice through their Shared Governance councils. The Shared Governance model continues to evolve as the Chief Nursing Officers from each Penn hospital seek to create opportunities to engage nurses in hospital-wide decision making. This effort gives nurses a voice that creates total transparency between the boardroom and the frontline through bi-directional communication.