Nurses share in pandemic decisionmaking process through professional governance
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • 'Little old West Virginia' sets pace on vaccine rollout
      merrill goozner
      Healthcare groups should end all political donations—permanently
      Sticking to Mediterranean diet is good for the brain
      Joe Biden
      Revamp of the nation's vaccination effort may not be enough
    • 'Little old West Virginia' sets pace on vaccine rollout
      COVID-19 hastens hospitals' revenue cycle outsourcing moves
      Operation Warp Speed Dr. Moncef Slaoui, Pfizer Group President Angela Hwang, Moderna CEO Stephane Bancel, CVS Health Executive Vice President Karen Lynch and McKesson CEO Brian Tyler participate in a panel discussion on the COVID-19 vaccine.
      Hospitals, drug companies strive to stand out virtually at JPM
      Dr. Bruce Siegel
      By protecting the healthcare safety net, Biden can put us on the path to a stronger country
    • The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
      Trenda Ray
      Q&A: Arkansas nursing leader looking for creative staffing solutions as COVID cases surge
      Cook Lydia 4x6_i.jpg
      Northeast Ohio health systems increase community benefit values in 2019
      Vaccine rollout hits snag as health workers balk at shots
    • CMS approves rule forcing insurers to ease prior authorization
      COVID-19 still a big uncertainty for insurers in 2021
      Health insurers' outlook boosted after Dems' Georgia win
      humana_i.jpg
      Humana supports Ohio not-for-profits with $500,000
    • 'Little old West Virginia' sets pace on vaccine rollout
      Joe Biden
      Revamp of the nation's vaccination effort may not be enough
      CMS will raise Medicare Advantage plan payments by 4.08% in 2022
    • Operation Warp Speed Dr. Moncef Slaoui, Pfizer Group President Angela Hwang, Moderna CEO Stephane Bancel, CVS Health Executive Vice President Karen Lynch and McKesson CEO Brian Tyler participate in a panel discussion on the COVID-19 vaccine.
      Hospitals, drug companies strive to stand out virtually at JPM
      Intermountain, Trinity, Memorial Hermann behind $300M private equity fund
      Operation Warp Speed to bump up McKesson's stock price
      Reporter's notebook: J.P. Morgan's 2021 health conference
    • A man in a room with servers.
      Momentum grows to outsource hospital tech functions in 2021
      5 things to know about Google's $2.1B Fitbit acquisition
      Providence bets on machine-learning, consolidating data centers
      Mental health treatment was most common telehealth service during COVID
    • Sticking to Mediterranean diet is good for the brain
      Chance of COVID-19 triage care looms over Arizona hospitals
      U.S. ramps up vaccinations to get doses to more Americans
      367146427.jpg
      Should businesses mandate that staff get the COVID vaccine?
    • Cone Health CEO, CFO to depart amid pending Sentara merger
      Tower Health's finance chief resigning after years of steep losses
      AHRQ director Gopal Khanna resigns in response to Capitol riot
      Brigham president stepping down after Moderna controversy
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • InDepth Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • New care model helps primary-care practices treat obesity
      doctor with patient
      COVID-19 treatment protocol developed in the field helps patients recover
      Rachel Wyatt
      Project to curb pressure injuries in hospitals shows promise
      Yale New Haven's COVID-19 nurse-staffing model has long-term benefits
    • Michellene Davis
      Healthcare leadership lacks the racial diversity needed to reduce health disparities
      Dr. James Hildreth
      How medical education can help fight racism
      Modern Healthcare InDepth: Breaking the bias that impedes better healthcare
      Videos: Healthcare industry executives describe their encounters with racism
      Quotes from rebadged employees
      Outsourcing IT, revenue cycle takes toll on internal culture
    • A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      self service station
      COVID-19 pushes patient expectations toward self-service
      Targeting high-risk cancer patients with genetics
      A nurse holds up a phone with a message to a family member saying surgery has started.
      Texting, tablets help hospitals keep family updated on patient care
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Highmark Health inks six-year cloud, tech deal with Google
      Study: 1 in 5 patients report discrimination when getting healthcare
      HHS proposes changing HIPAA privacy rules
      Android health records app launches at 230 health systems
    • California hospitals prepare ethical protocol to prioritize lifesaving care
      Amazon, JPMorgan Chase, Berkshire Hathaway disband Haven
      Digital pathways poised to reshape healthcare continuum in 2021
      Healthcare was the hardest hit by supply shortages across all U.S. industries
    • A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      New care model helps primary-care practices treat obesity
      How hospitals are building on COVID-19 telehealth momentum
      Researchers: Hospital price variation exacerbates health inequities
    • MedPAC votes to boost hospital payments, freeze or cut other providers
      Most Next Gen ACOs achieved bonuses in 2019
      Congress recalibrates Medicare Physician Fee Schedule after lobbying
      CMS approves rule to encourage value-based drug pricing
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
      Dr. Bruce Siegel
      Why taking a hospital not-for-profit was Dr. Bruce Siegel’s boldest move
    • Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
      John Daniels Jr.
      Health equity: Making the journey from buzzword to reality
      Mark C. Clement and David Cook
      We all need to 'do something' to fight inequities and get healthcare right, for every patient, every time
    • Dr. Bruce Siegel
      By protecting the healthcare safety net, Biden can put us on the path to a stronger country
      Healing healthcare: some ideas for triage by the new Congress, administration
      Dr. Sachin H. Jain
      Medicare for All? The better route to universal coverage would be Medicare Advantage for All
      Connectivity: a social determinant of health that can exacerbate all the others
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Best Places to Work in Healthcare Logo for Navigation
      Nominations Open - Best Places to Work in Healthcare
      Nominations Open - Health Care Hall of Fame
      Nominations Open - 50 Most Influential Clinical Executives
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Top 25 Minority Leaders
    • Top 25 Women Leaders
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • Leadership Symposium
    • Healthcare Transformation Summit
    • Women Leaders in Healthcare Conference
    • Workplace of the Future Conference
    • Strategic Marketing Conference
    • Social Determinants of Health Symposium
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala (2022)
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Carter Dredge
      Next Up Podcast: Ready, set, innovate! Innovation and disruption in healthcare
      Next Up Podcast: COVID-19, social determinants highlight health inequities — what next?
      Ceci Connolly
      Next Up Podcast: How to navigate the murky post-election waters
      Next Up Podcast: Saving Rural Health
    • An older man wearing a mask receiving a vaccine.
      Beyond the Byline: Verifying information on the chaotic COVID-19 vaccine rollout
      doctor burnout
      Beyond the Byline: How healthcare supply chain struggles contribute to employee burnout
      Beyond the Byline: Covering race and diversity in the healthcare industry
      Beyond the Byline: How telehealth utilization has impacted investor-owned company earnings
    • Leading intention promote diversity and inclusion
      Introducing Healthcare Insider Podcast
    • The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
      The Check Up: Dr. Kenneth Davis
      The Check Up: Dr. Kenneth Davis of Mount Sinai Health System
      The Check Up: Dr. Thomas McGinn
      The Check Up: Dr. Thomas McGinn of CommonSpirit Health
      The Check Up: Mark Ganz
      The Check Up: Mark Ganz of Cambia Health Solutions
    • Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Governance
October 17, 2020 01:00 AM

Nurses share in pandemic decisionmaking process through professional governance

Ginger Christ
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print
    The Nursing Practice Council at Memorial Hospital and Health Care Center
    MEMORIAL HOSPITAL AND HEALTH CARE CENTER

    The Nursing Practice Council at Memorial Hospital and Health Care Center in Jasper, Ind., is one of its many staff-driven decisionmaking councils.

    Like health systems across the country and around the world, Emory Healthcare in Atlanta faced a personal protective equipment shortage when the coronavirus pandemic hit.

    The system was running out of gowns and had to decide whether to recycle or wash them. Instead of making that decision themselves, Emory’s leaders turned to their nurses.

    “As we were moving through the pandemic, I had really thought about how much are we engaging our front-line clinicians in making decisions about what they do to keep themselves safe,” said Sharon Pappas, chief nurse executive for Emory.

    Because Emory has what is called a shared governance or professional governance system in place, nurses already served on unit-, hospital- and system-level governance councils in which they share in decisionmaking. When Pappas directed the gown dilemma to the councils, nurses came together to decide to transition from paper gowns to cloth ones that could be washed.

    “To me, that was a wonderful application of professional governance engaging them,” Pappas said. “When people feel in control of decisions, it contributes positively to their well-being. They don’t feel like decisions are being pushed to them.”

    Involving nurses in conversations and decisions about patient care, safety, training and operations has helped systems better respond to the coronavirus pandemic in a way that empowers them, even as they tackle unprecedented levels of stress, leaders say.

    “These individuals are in the best position to really decide what clinical care should look like,” Pappas said. “It’s our job as clinical leaders to create a work environment where that’s possible.”

    Since its introduction a few decades ago, professional governance is now in place at about a quarter of the country’s roughly 4,200 acute-care hospitals, estimated Tim Porter-O’Grady, a nurse and a healthcare consultant who is often referred to as the pioneer of the professional governance model. “It’s still a journey that we’re on,” Porter-O’Grady said. “As much as I’d like to think we’re at a place where we value what each professional brings to the collective, it’s still not fully there.”

    The tenets of professional governance are embedded in the American Nurses Credentialing Center’s voluntary Magnet and Pathway to Excellence programs, which recognize healthcare organizations that value and prioritize nursing. At last count, there were 540 Magnet and 192 Pathways to Excellence-recognized hospitals, a number that grows about 10% to 15% each year, according to Rebecca Graystone, vice president of the Magnet Recognition and Pathway to Excellence programs.

    “While it is a recognition of nursing excellence, it is a recognition of the entire healthcare organization because of the interprofessional nature of how healthcare is delivered. It’s a recognition of all of those voices,” Graystone said.

    Gaining from engagement
    Quality and job satisfaction improve with higher engagement, something shared governance is designed to improve.

    Nurse engagement level
    Measure Overall Least Somewhat Moderate Most
    Very dissatisfied with job 24% 43% 37% 30% 13%
    Nurse-reported quality of care on unit
    described as fair or poor
    15% 33% 23% 15% 8%
    Overall grade on patient safety is poor or failing 6% 15% 10% 5% 2%

    Source: Journal of Nursing Administration, “Nurse Engagement in Shared Governance and Patient and Nurse Outcomes,” November 2016

    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.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Health systems revamp vetting process during COVID-19
    Health systems revamp vetting process during COVID-19
    Top Beaumont Health cardiologist makes case to oust CEO, other leaders
    Top Beaumont Health cardiologist makes case to oust CEO, other leaders
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • InDepth Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Top 25 Minority Leaders
        • Top 25 Women Leaders
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Leadership Symposium
        • Healthcare Transformation Summit
        • Women Leaders in Healthcare Conference
        • Workplace of the Future Conference
        • Strategic Marketing Conference
        • Social Determinants of Health Symposium
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala (2022)
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing