Health Care

Nurses share in pandemic decisionmaking process through professional governance

Lori Wightman, senior vice president and chief nursing officer for Broomfield, Colo.-based SCL Health, credits the system’s ability to maintain patient quality outcomes and patient satisfaction throughout the pandemic to “caregivers working in a culture that embraces professional governance.”
“We listen to the caregivers in order to understand their needs: to care for patients, for themselves and for each other,” Wightman said.
A study by nurses at the University of Pennsylvania School of Nursing and Pennsylvania Hospital in Philadelphia found that hospitals with more-engaged nurses had better patient experiences, quality of care and nurse job outcomes than those where nurses were less involved in decisionmaking.
The study also makes a business case for professional governance as a way to support value-based care payment models.
“Facing a competitive, value-based purchasing environment and potential staffing shortages, hospitals have a vested interest in promoting a culture of engagement among nurses, who comprise the largest share of the hospital workforce,” the authors wrote.
Examples of how shared governance can improve operational performance vary in approach and organizational size. At Brigham and Women’s Faulkner Hospital in Boston, the nursing practice committee is working to improve communication between leadership and staff. Early on in the pandemic when there were “rapid-fire changes in practice,” those were mostly shared via email, said Colleen West, executive director of nursing professional development, practice and innovation. But nurses didn’t have time to check email as COVID-19 patients flooded in. Now, they’re working with the communications department to find ways to improve internal communications about operations.
The nurse practice council at Memorial Hospital and Health Care Center in Jasper, Ind., is creating a resiliency room (or a relaxation room; the name has yet to be decided). “It’s a space where staff can go to recharge,” said Lori Persohn, vice president of patient services and chief nursing officer at Memorial. COVID-19 has amplified the need for downtime, she said. While plans are still in the works, nurses want to create a quiet space that could have essential oils, peaceful music and a recliner.
Memorial uses its nursing councils as opportunities for career progression, Persohn said. Most of the system’s nurse managers and nursing directors were promoted after gaining leadership experience by participating in unit councils. And council participation is included as part of a nurse’s workday, so there’s not a perception that they have to work longer days to join one. 
The nursing councils have been so successful at Memorial that other departments, like the lab and pharmacy, have adopted the professional governance model, Persohn said. 
“I look at it very simply. It’s staff nurses and leaders working together to problem-solve, create a better working environment and to produce quality outcomes. All of those things increase nursing engagement, in turn retaining our nurses and providing quality of care,” Persohn said.

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