Assessing the Effectiveness and Efficiency of a Nursing Shared Governance Structure within a Major Pediatric Medical Center

2.50
Hdl Handle:
http://hdl.handle.net/10755/156865
Type:
Presentation
Title:
Assessing the Effectiveness and Efficiency of a Nursing Shared Governance Structure within a Major Pediatric Medical Center
Abstract:
Assessing the Effectiveness and Efficiency of a Nursing Shared Governance Structure within a Major Pediatric Medical Center
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Graf, Elaine, PhD
P.I. Institution Name:Children's Memorial Hospital
Title:Research & Funding Coordinator
Objective: Shared governance is a system of organizational structures based on lateral communication, accountability and relationships. Inherent in a shared governance structure is the belief and trust that participants, when given pertinent information and parameters, will make sound decisions related to their fundamental areas of accountability. In nursing, these fundamental areas are practice, quality assurance, clinical competence and research. The purpose of this study was to assess the effectiveness and efficiency of a nursing shared governance structure at both the hospital and unit level and make recommendations for improvements. Design: A focus group methodology was used to determine nursing staff's perceptions of the effectiveness and efficiency of the current shared governance structure. Focus group methodology is a form of qualitative research that is effective especially when the research requires the need to tap into the attitudes and perceptions of a study population related to products, services or programs. Population, Sample, Setting, Years: Population consisted of nurses working at a major pediatric Hospital. The sample included 105 nurses representing 18 different service areas. Data were collected from June 1998- July 1999. Concepts Studied: The study assessed nursing perceptions of influence in the following: nursing personnel activities, access to information, resources supporting practice, participation in shared governance activities, control over practice, ability to set goals and address conflicts. Methods: Nursing leadership recommended a representative group (6-8) of nurses who were invited to attend 2 four hour focus group sessions by unit. Focus group meetings were led by a trained group moderator and followed a scripted sequence of questions. During the first session, participants completed the Index of Professional Nursing Governance (IPNG) tool, an 86 item tool that measures six subscales of activities that provide insight into the respondents thoughts as to how decisions are made within the organization. All subscales report alpha coefficients ranging from.91-.98 and a summed tool score alpha coefficient of .90. Staff rated each item on a 5 point Likkert scale reflecting decision authority (1=nursing management/administration only to 5=staff nurse only). Participants identified unit culture and unit committee structure strengths, limitations and considered possible solutions. All sessions were audiotaped, transcribed and coded for repeating themes. During the second session, unit data from IPNG was reviewed and first session themes were validated by the participants. Based on these findings, groups proposed a new unit committee structure that reflected their specific needs and addressed communication links to hospital governance committees. Members of Nursing Leadership and Nursing Assembly Councils also completed the IPNG . Nursing Leadership was asked to score the items to reflect current shared governance responsibilities and the Nursing Assembly was asked to score the items to reflect an "ideal" shared governance decision authority structure. Management scores were compared with staff scores and Nursing Assembly "Ideal" mean scores for significant differences. Results were then shared with unit leadership and Clinical Governance Assembly. Findings: Staff and Managers' scores reflect that Nursing Shared Governance activities are primarily done by Nursing Management with some nursing staff input. Staff scores were slightly lower than management scores with the only statistically significant difference being perception of level of participation in shared governance activities. Nursing Assembly "Ideal" Shared Governance scores reflect a structure where activities are more equally shared with exception of nursing personnel activities. Staff requested better access to information regarding personnel issues and budget considerations, scheduled release time to complete hospital committee work, and secretarial support. Unit committees were either not well developed or did not routinely meet due to staffing issues. Total Scores for staff and managers reflect that the organization functioned within a shared governance format and when compared to a National Data set were found to be most similar to hospitals known for their shared governance structure and/or hospitals designated by ANCC as Magnet Organizations. Conclusions: Focus groups concluded that Unit Committee work begins with a strong Unit Coordinating Council that must meet monthly. Additional committees should develop based on specific unit needs and units should have representation on all hospital shared governance committees. Staff requested better methods of communication suggesting e-mail for all staff. Staff at satellite sites should have e-mail and conference call access to improve communication with hospital shared governance committees. Implications: The ability to benchmark with a National Data set provided a measure of how far this organization had come in implementing a new governance structure and influenced a decision to seek Magnet Recognition. Study findings provided guidance and direction for future improvements in this organization's shared governance structure. Methods were found to improve communication access, budget for staff release time, and provide more autonomy for nursing decisions related to practice.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAssessing the Effectiveness and Efficiency of a Nursing Shared Governance Structure within a Major Pediatric Medical Centeren_GB
dc.identifier.urihttp://hdl.handle.net/10755/156865-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Assessing the Effectiveness and Efficiency of a Nursing Shared Governance Structure within a Major Pediatric Medical Center</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Graf, Elaine, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Children's Memorial Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Research &amp; Funding Coordinator</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">egraf@childrensmemorial.org</td></tr><tr><td colspan="2" class="item-abstract">Objective: Shared governance is a system of organizational structures based on lateral communication, accountability and relationships. Inherent in a shared governance structure is the belief and trust that participants, when given pertinent information and parameters, will make sound decisions related to their fundamental areas of accountability. In nursing, these fundamental areas are practice, quality assurance, clinical competence and research. The purpose of this study was to assess the effectiveness and efficiency of a nursing shared governance structure at both the hospital and unit level and make recommendations for improvements. Design: A focus group methodology was used to determine nursing staff's perceptions of the effectiveness and efficiency of the current shared governance structure. Focus group methodology is a form of qualitative research that is effective especially when the research requires the need to tap into the attitudes and perceptions of a study population related to products, services or programs. Population, Sample, Setting, Years: Population consisted of nurses working at a major pediatric Hospital. The sample included 105 nurses representing 18 different service areas. Data were collected from June 1998- July 1999. Concepts Studied: The study assessed nursing perceptions of influence in the following: nursing personnel activities, access to information, resources supporting practice, participation in shared governance activities, control over practice, ability to set goals and address conflicts. Methods: Nursing leadership recommended a representative group (6-8) of nurses who were invited to attend 2 four hour focus group sessions by unit. Focus group meetings were led by a trained group moderator and followed a scripted sequence of questions. During the first session, participants completed the Index of Professional Nursing Governance (IPNG) tool, an 86 item tool that measures six subscales of activities that provide insight into the respondents thoughts as to how decisions are made within the organization. All subscales report alpha coefficients ranging from.91-.98 and a summed tool score alpha coefficient of .90. Staff rated each item on a 5 point Likkert scale reflecting decision authority (1=nursing management/administration only to 5=staff nurse only). Participants identified unit culture and unit committee structure strengths, limitations and considered possible solutions. All sessions were audiotaped, transcribed and coded for repeating themes. During the second session, unit data from IPNG was reviewed and first session themes were validated by the participants. Based on these findings, groups proposed a new unit committee structure that reflected their specific needs and addressed communication links to hospital governance committees. Members of Nursing Leadership and Nursing Assembly Councils also completed the IPNG . Nursing Leadership was asked to score the items to reflect current shared governance responsibilities and the Nursing Assembly was asked to score the items to reflect an &quot;ideal&quot; shared governance decision authority structure. Management scores were compared with staff scores and Nursing Assembly &quot;Ideal&quot; mean scores for significant differences. Results were then shared with unit leadership and Clinical Governance Assembly. Findings: Staff and Managers' scores reflect that Nursing Shared Governance activities are primarily done by Nursing Management with some nursing staff input. Staff scores were slightly lower than management scores with the only statistically significant difference being perception of level of participation in shared governance activities. Nursing Assembly &quot;Ideal&quot; Shared Governance scores reflect a structure where activities are more equally shared with exception of nursing personnel activities. Staff requested better access to information regarding personnel issues and budget considerations, scheduled release time to complete hospital committee work, and secretarial support. Unit committees were either not well developed or did not routinely meet due to staffing issues. Total Scores for staff and managers reflect that the organization functioned within a shared governance format and when compared to a National Data set were found to be most similar to hospitals known for their shared governance structure and/or hospitals designated by ANCC as Magnet Organizations. Conclusions: Focus groups concluded that Unit Committee work begins with a strong Unit Coordinating Council that must meet monthly. Additional committees should develop based on specific unit needs and units should have representation on all hospital shared governance committees. Staff requested better methods of communication suggesting e-mail for all staff. Staff at satellite sites should have e-mail and conference call access to improve communication with hospital shared governance committees. Implications: The ability to benchmark with a National Data set provided a measure of how far this organization had come in implementing a new governance structure and influenced a decision to seek Magnet Recognition. Study findings provided guidance and direction for future improvements in this organization's shared governance structure. Methods were found to improve communication access, budget for staff release time, and provide more autonomy for nursing decisions related to practice.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T15:12:58Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T15:12:58Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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