Abstract

Background & Purpose: Healthy Shared Governance contributes to a Healthy Work Environment.1 Shared governance (SG) is derived from Kanter’s theory of structural empowerment. Organizations with structurally empowered nurses are provided access to information, resources, support, and opportunities for learning and development and have the capability to affect change.2 Effective councils contribute to organizational safety, efficiency, and quality while reducing financial and patient loss.4 A large academic medical center in the Southwest United States has had SG since 2008. Council engagement and effectiveness are signals of healthy SG. This project aimed to assess the health of the organization’s shared governance councils.

Design & Methods: This Shared Governance Health project had two components. The first assessed the perceived council health using the Council Health Assessment Tool. The Council Health Assessment tool, a validated survey that uses a 1-5 Likert-type scale, measures perceptions of council health across three domains: Structure, Activities, and Membership. The survey was sent out to the hospital’s thirteen SG councils, including leaders (chair, co-chair, secretary, executive sponsor) and council members, as well as 10% of unit-based SG councils, in April 2023. The second component was a retrospective review of the hospital SG councils’ records from 2018 to 2022, assessing attendance, nurse involvement, council leadership, minutes, and completion of council goals.

Results and Outcomes: The Council Health Assessment Tool subscale Structure and Activities both scored an average of 4.66 out of 5, and the subscale Membership averaged 4.2 (n=71). These findings indicate that most SG leaders and members perceived their councils to be healthy. However, reviewing archived council records from 2018 to 2022 revealed poorly maintained records and a large variation between councils. Only 4% of councils had adequate attendance. 28% of council rosters included clinical nurses, and those clinical nurses attended meetings less than 50% of the time. While all councils had goals that aligned with the hospital’s mission, only a small percentage, 12.8%, of councils had achieved their goals, with 63% of councils keeping the same goals year after year. Meetings were shorter than planned 47% of the time, and less than 50% of meetings were spent on council goals. The chair and co-chair were the only council members contributing to meeting content 55% of the time, indicating that other council members may not have been engaged.

Conclusions & Implications: A wide disparity between how SG councils functioned and how members perceived council health was observed. Focus groups to further understand perceptions and clinical nurses’ needs from SG are planned. Additionally, nurse leaders will be increasing clinical nurse participation, educating SG leaders, and standardizing agendas, minutes, and attendance records. This project provides valuable insight into the health of the organizations' Shared Governance Councils and reveals opportunities to enhance nursing engagement and empowerment.

Notes

References:

1. Williams, M., & Christopher, R. (2023). Moving Shared Governance to the Next Level. The Journal of Nursing Administration, 53(1), 6-11. DOI: 10.1097/NNA.0000000000001235

2. Speroni, K. G., Wisner, K., Ober, M., Haines, F., Walters, C., & Budhathoki, C. (2021). Effect of Shared Governance on Nurse-Sensitive Indicator and Satisfaction Outcomes by Magnet® Recognition Status. The Journal of Nursing Administration, 51(7-8), 379–388. https://doi.org/10.1097/NNA.0000000000001033

3. Al-Ruzzieh, M.A., Ayaad, O., & Hess, R.G. (2022). The Role of Participation in and Effectiveness of Shared Governance Councils in the Nurses’ Perception of a Professional Practice Work Environment. The Journal of Nursing Administration, 52(1), 51-56. DOI: 10.1097/NNA.0000000000001102

4. Hess, R. , Bonamer, J. , Swihart, D. & Brull, S. (2020). Measuring Council Health to Transform Shared Governance Processes and Practice. JONA: The Journal of Nursing Administration, 50 (2), 104-108. doi: 10.1097/NNA.0000000000000849.   5. Speroni, K. , Wisner, K. , Ober, M. , Haines, F. , Walters, C. & Budhathoki, C. (2021). JONA: The Journal of Nursing Administration, 51 (7/8), 379-388. doi: 10.1097/NNA.0000000000001033

Description

Shared Governance (SG) offers a method to engage nurses, foster collaboration, and is associated with a Healthy Work Environment. This project aimed to assess SG health using the Council Health Assessment tool to evaluate archived council records and by council member survey. There was a wide disparity between the two.

Author Details

Tamara L. DuBose, DNP, RN, NE-BC - Magnet Program Director; 

Carliss D. Ramos, DNP, RN, EBP-C, CPHQ - Nurse Scientist;

Nicole M. Fontenot, DNP, APRN, ACNP-BC, CCNS, CCRN Manager of Nursing Science

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Shared Governance, Nursing Shared Governance -- Evaluation, Nurse Attitudes, Work Environment

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2024

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-03-03

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Perception vs. Reality: Assessing the Health of Organizational Shared Governance

Washington, DC, USA

Background & Purpose: Healthy Shared Governance contributes to a Healthy Work Environment.1 Shared governance (SG) is derived from Kanter’s theory of structural empowerment. Organizations with structurally empowered nurses are provided access to information, resources, support, and opportunities for learning and development and have the capability to affect change.2 Effective councils contribute to organizational safety, efficiency, and quality while reducing financial and patient loss.4 A large academic medical center in the Southwest United States has had SG since 2008. Council engagement and effectiveness are signals of healthy SG. This project aimed to assess the health of the organization’s shared governance councils.

Design & Methods: This Shared Governance Health project had two components. The first assessed the perceived council health using the Council Health Assessment Tool. The Council Health Assessment tool, a validated survey that uses a 1-5 Likert-type scale, measures perceptions of council health across three domains: Structure, Activities, and Membership. The survey was sent out to the hospital’s thirteen SG councils, including leaders (chair, co-chair, secretary, executive sponsor) and council members, as well as 10% of unit-based SG councils, in April 2023. The second component was a retrospective review of the hospital SG councils’ records from 2018 to 2022, assessing attendance, nurse involvement, council leadership, minutes, and completion of council goals.

Results and Outcomes: The Council Health Assessment Tool subscale Structure and Activities both scored an average of 4.66 out of 5, and the subscale Membership averaged 4.2 (n=71). These findings indicate that most SG leaders and members perceived their councils to be healthy. However, reviewing archived council records from 2018 to 2022 revealed poorly maintained records and a large variation between councils. Only 4% of councils had adequate attendance. 28% of council rosters included clinical nurses, and those clinical nurses attended meetings less than 50% of the time. While all councils had goals that aligned with the hospital’s mission, only a small percentage, 12.8%, of councils had achieved their goals, with 63% of councils keeping the same goals year after year. Meetings were shorter than planned 47% of the time, and less than 50% of meetings were spent on council goals. The chair and co-chair were the only council members contributing to meeting content 55% of the time, indicating that other council members may not have been engaged.

Conclusions & Implications: A wide disparity between how SG councils functioned and how members perceived council health was observed. Focus groups to further understand perceptions and clinical nurses’ needs from SG are planned. Additionally, nurse leaders will be increasing clinical nurse participation, educating SG leaders, and standardizing agendas, minutes, and attendance records. This project provides valuable insight into the health of the organizations' Shared Governance Councils and reveals opportunities to enhance nursing engagement and empowerment.