Design A Future Shared Governance Model For Slmc

This paper brings up my personal nursing philosophy that I am planning to deliver in my nursing career. I believe that nursing is more than merely as a profession, it also involves my medical knowledge combined it with a commitment to quality nursing care with compassion, respect, dignity, and advocacy for each patient. I believe that the interdisciplinary care and collaboration in the medical field are crucial elements that lead to a healthy relationship among healthcare professionals in promoting quality patient care that is individualized to each patient’s needs.

Caramanica, L. (2004). Shared Governance: Hartford Hospital’s Experience. The Online Journal of Issues in Nursing, Vol. 9. Retrieved from http://www.nursingworld.org/mainmenucatefories/ANAmarketplace/ANAperiodicals/OJIN/tableofcontents/volume92004/No1Jan04/HartfordHospitalsExperience.aspx

The institute of Medicine (IOM) has defined quality healthcare as safe, effective, timely, efficient and patient-centered care that is given to an individual regardless of their race, gender, financial status or health status (Wood & Haber, 2014). Quality initiatives are designed to help maximize efficiency; decrease poor work performance and resolve workforce problems through leadership, commitment and involvement (Abdallah, 2014). Abdallah (2013) also noted that trained physicians can help with the implementation of quality culture and employee morale, and it can help with the collaboration of ACNP and physician management. According to Chorostecki et al. (2015), interprofessional (IP) care includes shared decision-making, collaborative problem solving, respect in the work field, and equal contribution among all healthcare team members. Implementing effective interprofessional collaboration can help enhance quality care in hospital, acute, home or office settings (Chorostecki et al.,

Evaluating various shared governance structures, the councilor structure was determined to be most appropriate for the organization. Staff at all levels received education and training on the principles of shared governance as well as how to effectively lead shared governance councils. The BSWMC-MF shared governance structure consists of unit level councils, regional level councils, as well as Baylor Scott & White Health (BSWH) division and system level

Interdisciplinary teams in nursing basically focus on results on the basis that the involved participants share the responsibility for achieving these outcomes. These teams comprise of members from different practices in the healthcare field who gather information to achieve consensus. Based on the required skills at a specific time, the leadership of these teams may be rotated among the associates or team members. In order for the interdisciplinary teams to function effectively in the nursing field, their leaders primarily facilitate instead of directing the collective work. Interdisciplinary teams function effectively through establishing clear goals, evaluating progress, plan ahead, clarify roles, share the leadership, and capitalize on individual talents (Wenckus, 2004).

“All health care disciplines share a common and primary commitment to serving the patient and working toward the ideal of health for all.” (American Association of Colleges of Nursing, 2014, p. 1) There are many different professional members in the healthcare system. Each of them, have a specific specialty and responsibility to the patient and play an important role in the patient’s overall plan of care. “The scope of health care mandates that health professionals work collaboratively and with other related disciplines. Collaboration emanates from an understanding and appreciation of the roles and contributions that each discipline brings to the care delivery experience.” (American Association of Colleges of

Lack of collaborative care delivery and recognition of interrelatedness of various parts within organization will continue to hinder the transformation of healthcare as a complex adaptive system (Kuziemsky, 2015).

It is true that collaboration between healthcare leaders and providers is essential for effective and efficient care delivery. However, “the ability to collaborate consistently, and in a way that ensures quality care, continues to elude” (Bankston & Glazer, 2010, p.1). This is as a result of insignificant interdisciplinary challenge for nurses, providers, and leaders in today’s healthcare. The openness and autonomy of bringing healthcare leaders, and healthcare professionals is to achieve positive patient outcomes. Bankston et al. declared that “one approach to bridging this interprofessional-collaboration gap could be the development of partnerships to facilitate the creation of interdisciplinary laboratories, sometimes called “collaboratories,”

Such a structure revolves around clinical leadership dyads, or pairs of part-time physician-leaders teamed with full-time nurse administrators, based within geographic regions. The majority of the physicians involved in care delivery were independent, community-based practitioners motivated by shared professional values emphasizing high quality service and satisfying patients' needs. Their dyads regularly reviewed data on delivery costs and service outcomes, and they collaborated with one another throughout the IHC system to indentify improvement opportunities and share best practices. Equipped with sound evidence and empowered by management, the dyads formed shared baselines and drove initiatives that dramatically lowered healthcare costs by reducing the incidence of overused procedures, such as elective inductions and unplanned surgical deliveries.

“Running a health care organization is a team sport. It is very important that all members of the team-whether on the medical staff, in management or on the board-understand the role of governance and what constitutes effective governance” (Arnwine, 2002). Running a hospital is a difficult task. Several factors need to be seriously thought of and considered in every decision and undertaking. Unfortunately, all the three important factors in governing a hospital is not always in harmony. As likened to a team sport, if the three major components are not working with each other as a team, there will be tension and a great divide will be experienced. And often times, the patients will be in the middle and will be greatly impacted. This writer believes that there are several factors that contribute to the tension that usually exists among the medical staff, the board and administration. One factor is the disconnect, where each entity is not seeing each other eye to eye and their visions may be different from each other. Another factor may be the lack of communication in order to bridge the gap and to build a respectful and a relationship wherein there is trust for each end every member of the group. Often times, the medical staff is concerned with ensuring that patients are cared for in a manner that their practice is protected as well as the patients are getting the appropriate care. On the other hand, the board of trustees may be focused in ensuring that that

Doctors, physicians, and hospitals have been trying to improve the blank blank for a while. Their overall goal is to create superior collaboration, strategy, and resources among the medical field. The integrated-physician-model is described as an innovative model of organization and collaboration of medical doctors which grants tasks and interprets roles differently for primary medical services within the hospital. This model aims to improve participation between competing medical groups within the same hospital and between competing hospitals. By establishing this improvement, the integrated-physician-model creates merit for doctors, hospitals,and also patients.

The macro- level coordination mechanisms being used in Unit B that were not used in Unit A included mostly included organization and communication and they work as a team, forming units in various departments. Organization design is the arrangement of responsibilities, authority, and flow of information within an organization, resulting in its organization structure (Burns, Braley, Weiner & Shortell, 2012). Macro level coordination is where the focus of analysis is on the overall coordination needs and structural approaches to address those need (Burns, Braley, Weiner & Shortell, 2012). In unit A communication among the nurses, therapists, social workers, residents, and attending physicians regarding patient care is poor, and relationships among them are strained (Burns, Braley, Weiner & Shortell, 2012). In unit B nursing staff on the unit are organized into teams, with each team responsible for assigned patients from admission to discharge, the house staff in medicine in the hospital also are organized into teams, and except when beds are not available (Burns, Braley, Weiner & Shortell, 2012). Task interdependence among staff A included patient care units Nurses, physicians, and other health professionals in unit A consisted of discipline compared to unit B where conduct interdisciplinary rounds were not something team A took seriously. Differences between the effectively functioning Unit B and the chaotic Unit A are seen by many administrators and health care

Shared governance is a professional model for nurse management which leads to nurse autonomy, empowerment, job satisfaction and improved patient outcomes. Research show nurses want a professional, autonomous environment for practice that recognizes the value of its nurses, and allow greater control over the practice environment. Proximity to job and monetary gain was listed as less important.

I have found shared governance to be a very complex topic and I agree with you that each organization differs from others on how to apply this concept model. Regardless of the setting, governance model is a platform where nurses and supervisors can join forces and work together to improve the quality of care and standards within the nursing profession and the organization in general. This will be achieved under the fundamentals of partnership, accountability, ownership and equity. Shared governance allows nurses to have control in their practice and power over administrative policies. The end result of this is to guarantee patient safety, advance quality of care, provide a method for shared decision making and involve members to

The concept of governance within a health care organization must be well design and welcome cooperation (Berger, S. (2011). When those that make policies can understand how to apply cooperative regulatory structure in healthcare setting it is noted that self-interest is not the only way of motivating positive behavior. The concept of governance spells out who is responsible for ensuring and providing support and services to all members needing health resources (Berger, S. (2011).