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Implementing shared governance: a false start.

J M Hibberd1, C E Storoz, H A Andrews

  • 1University of Alberta, Edmonton, Canada.

The Nursing Clinics of North America
|March 1, 1992
PubMed
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Implementing shared governance in nursing faced challenges like leadership changes and budget cuts. A revised model, developed by staff nurses, now aims to build a stronger foundation for success.

Area of Science:

  • Healthcare Management
  • Organizational Change
  • Nursing Leadership

Background:

  • Shared governance models are increasingly adopted in healthcare to empower nursing staff.
  • Implementation of such models can be complex and face significant organizational hurdles.

Purpose of the Study:

  • To present a case study on the implementation of shared governance in a large teaching hospital.
  • To identify critical factors that jeopardized and threatened the survival of the shared governance initiative.
  • To highlight strategies employed to overcome challenges and re-establish momentum.

Main Methods:

  • A qualitative case study approach was used.
  • Analysis of implementation processes, including challenges and facilitators.
  • Examination of organizational factors, leadership, and staff responses.

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Main Results:

  • The shared governance implementation was threatened by executive turnover, budget reductions, lack of planning, and resistance to change from some managers.
  • Layoffs, union issues, and role ambiguity created conflict and reduced morale.
  • A staff nurse-led task force developed a customized governance model to address initial flaws.

Conclusions:

  • Successful implementation of shared governance requires robust planning, sustained leadership support, and effective change management strategies.
  • Addressing staff morale, union engagement, and role clarity is crucial for overcoming resistance and conflict.
  • A flexible, customized approach developed by frontline staff can enhance the sustainability and effectiveness of shared governance.