Bskv Scott And White Health Shared Governance

Baylor Scott & White Health (BSWH) has long held the belief that shared governance is the overarching infrastructure to support professional practice. Giving direct care nurses and staff a voice in the decisions that influence their practice and environment provides sustainable, accountability-based decisions. The BSWH Shared Governance Model (see Figure 1.2: Baylor Scott & White Health Shared Governance Model) provides the initial framework to be integrated into development of the shared governance model at the facility level. The shared governance structure is supported by the following:

Figure 1.2: Baylor Scott & White Health Shared

Governance Model

• Equity-no role is more important than any other

• Partnership-a collaborative

relationship among all stakeholders
• Ownership-you are committed to contribute & participate in shared decision making
• Accountability-accountable for the outcomes based on your decisions

Shared governance at BSWMC-MF continues to evolve since its introduction.

The first council formed was the Regional Nursing Professional Development (NPD) Education Council to introduce the concept to the nursing units. In January 2016, education for staff and leadership began, consisting meeting management, roles and responsibilities, facility/system resources to support success, and setting expectations for participants at all levels. The shared governance structure now includes a Unit Practice Council (UPC) for each nursing unit, Regional Nurse Practice Council (RNPC), and Regional Nurse Leader Council (RNLC). Interprofessional team members serve as ad hoc members on various shared governance councils. In orientation, the CNO sets the expectation for participation in shared governance and shares positive benefits for patients and staff. As the BSWMC-MF shared governance council structure continues to grow and mature, organizational accountability to improve quality of patient care, patient and staff safety, patient and staff satisfaction, and fostering fiscal responsibility by management of resources is created and

sustained.

Shared Governance Councils:
Unit Practice Council (UPC)
At the unit level, the UPC serves as the foundation for formal shared decision-making, fostering a culture of collaboration on unit specific concerns. Membership consists of direct care staff who may volunteer or be appointed to by their unit leader.
Each UPC determines meeting frequency, time, and duration.

Most UPCs choose to meet monthly to allow for proactive management of issues as well as to ensure timely discussion of organizational wide decisions requiring their feedback. The focus of the UPC is to address the needs of their specific patient population, evaluate existing practice as it relates to standards of care, improving the practice environment, and supporting organization goals. Idea cards submitted at the Daily Huddle may also be referred to the UPC for evaluation and input. On nursing unit, the UPC direct care nurses serve as chair and co-chair, with the unit leader serving as a facilitator, providing guidance and support to remove barriers to success. Council members disseminate information from council activities to their colleagues within the unit.

Regional Nurse Practice Council (RNPC)

The RNPC meets monthly, consists of members from UPCs as well as RNs working on a non-nursing unit such as the nurse navigator for Mammography. In addition to addressing concerns elevated from UPCs, RNPC members collaborate on organizational wide initiatives to improve patient care processes, promote clinical nurse development, satisfaction and retention, and enhance the patient experience.

Council members provide bi-directional communication between the organization and their unit. The chair of the RNPC represents the organization in the Central Texas Division Nurse Practice Council (CTX NPC), linking nurses at BSWMC-MF

in division and system related initiatives affecting the division of nursing.

Nurse Staffing Advisory Council (NSAC)
The RNPC members are also members of the NSAC, responsible for evaluating the effectiveness of the staffing plan. The NSAC meets quarterly to determine the effectiveness of the staffing plan, analyzing data related to staffing in relation to certain quality indicators. The purpose of the staffing plan is to provide the most efficient use of human and material resources within a framework of financial responsibility. Each unit evaluates and approves their staffing matrix annually and on an as needed basis when business needs change, due to either patient volume or acuity. The council requires the membership be at least 60% RNs who are in staffing at least 50% of the time. The CNO is chair of the NSAC and additional members include LVNs to represent the BSWH Ambulatory Clinics as well as BSWMC-Llano.

Regional Nurse Leader Council (RNLC)
The RNLC meets monthly and includes nursing leaders from across the region as well as the CNO. Interprofessional leaders serve as ad hoc members. The RNLC develops the Annual Nursing Strategic Plan, aligning facility nursing specific initiatives to support CTX division and BSWH system nursing specific initiatives. The RNLC provides oversight and guidance for key quality/ safety metrics, compensation and nursing satisfaction.

Facility Workgroups:
In addition to the formal shared governance council structure, BSWMC-MF has several workgroups in place providing opportunities for staff to participate in shared decision-making with a more targeted focus. Workgroups include:
• Patient Safety Committee
• Nurse Manager Workgroup
• Code Committee
The committees report their work to the appropriate shared governance council for approval and include: findings, recommendations for change, and associated implementation plans. Representatives from these committees also sit on division or system level committees where available, ensuring BSWMC-MF is involved in the decision-making structure across the entire BSWH organization.