Thursday, August 15, 2019
Mhp Nursing Shared Governance Essay
What is Shared Decision Making â⬠¢ Point of Service Decision Making ââ¬â where staff who perform the work participate in decision making affecting their environment â⬠¢ A 30 year old decision making model meant to give equal voice to nurses â⬠¢ A decentralized style of management that creates an environment of empowerment Shared Decision Making A Journey Not a Destination We TO They Why Shared Decision Making â⬠¢ Essential to achieving the best patient outcomes by giving nurses control of their practice ââ¬â they know best! â⬠¢ Recognizes the power already present in a role and allows that power to be expressed legitimately â⬠¢ Builds autonomy into the profession Shared Decision Making ââ¬â The Process A dynamic process that is centered on 4 critical principles of fully empowered organizations: Partnership Accountability Equity Ownership Operational Definitions â⬠¢ Partnership ââ¬â nursing staff and leadership work together at the unit and system level to move practice forward and achieve the best outcomes â⬠¢ Accountability ââ¬â staff and managers share ownership for the outcomes of our work and are answerable to our colleagues, the institution and the community we serve Operational Definitions â⬠¢ Equity ââ¬â Integrating roles to achieve outcomes; everyone contributes within the scope of their role as part of the team â⬠¢ Ownership ââ¬â Everyone must realize that success is linked to how well they do their jobs Shared Decision Making Our Model Professional Advancement Council Administrative Council Safety First C rd oo ina tin g Quality & Safety Council Cou ncil Unit Patient Research & Evidence Based Nursing Practice Council Great Place to Work Professional Nurse Council Family Community Clinical Excellence Councils Coo Education Council rdin atin g Cou ncil Think of yourself as a Patient APN Council Research Council Financial Strength CCHS Shared Decision Making Councils â⬠¢ Quality & Safety Council â⬠¢ Research & Evidence Based Nursing Practice Council â⬠¢ Education Council â⬠¢ Professional Nurse Council â⬠¢ Coordinating Council Education Council ï⠧ Collaborates with unit and system councils to identify educational needs, develop educational priorities with appropriate time lines and determine resources for all education impacting the Department of Patient Care Services ï⠧ Disseminates approved educational strategies to unit leaders and support staff ï⠧ Develops and maintains a communication network between unit and systems councils Research & Evidence Based Nursing Practice Council ï⠧ Promotes the spirit of inquiry in clinical nursing practice ï⠧ Evaluates the literature in order to use best practices to transform clinical practice at the point-of-care Quality & Safety Council ï⠧ Provides planned, systematic and collaborative approaches to oversee and direct quality and safety relating to the nursing process, functions and services provided. ï⠧ The councilââ¬â¢s scope includes performance improvement and safety measures throughout the Department of Patient Care Services Professional Nurse Council ï⠧ Works to enhance the professional image of nursing within CCHS and the community ï⠧ Supports the spirit of the professional advancement program ï⠧ Identifies and supports implementation of recruitment and retention strategies Coordinating Council ï⠧ Provides overall coordination of the systems councils. ï⠧ Reviews the system strategic plan and adopts the plan for the Department of Patient Care Services and the nursing Shared Decision Making structure. ï⠧ Serves as the portal for other departments or disciplines requiring assistance with the Shared Decision Making structure of nursing. Problem Solving The Old Way â⬠¢ Problem identified by staff and communicated to manager â⬠¢ Manager may or may not have asked for feedback about solutions â⬠¢ Manager made final decision or had final authority for approving a solution Problem Solving The New Way â⬠¢ Staff identify issues and communicate them to the unit council â⬠¢ Unit council formulates a response and communicates this to staff â⬠¢ Staff provide feedback via the comment form. How Does The New Way Work â⬠¢ Unit Council: ï⠧ Collects Data ï⠧ Develops a proposed plan using evidenced based practice ï⠧ Develops a time line ï⠧ Presents Plan for Feedback (Open Comment) ï⠧ Revises Plan Based Upon Feedback ï⠧ Forewards plan to system council, as needed How Does The New Way Work â⬠¢ Unit Council: ï⠧ ï⠧ ï⠧ ï⠧ Implements Plan Evaluates Outcome Report Results to Unit Staff Seeks staff feedback, formally and informally on councilââ¬â¢s performance How Does It Work ââ¬â Problem Solving Methodology â⬠¢ Identify an Issue or a Problem â⬠¢ Gather Data â⬠¢ Design a Solution â⬠¢ Obtain Feedback â⬠¢ Finalize a Proposal â⬠¢ Implement â⬠¢ Evaluate â⬠¢ Report Increased Incidence of Pressure Sores Problem Unit Problem: Unit Council Problem Solving Model Results: Positive Outcomes System Level Practice Research Problem Coordinating Operations Education Problem Solving Model Results: Positive Outcomes Nurse Managerââ¬â¢s Role â⬠¢ Create a climate that is actively supportive and not just tolerant of shared decision making â⬠¢ Facilitate a leaning environment for staff growth and comfort with shared decision making â⬠¢ Support ââ¬Å"release timeâ⬠for staff to participate in shared decision making activities Nurse Managerââ¬â¢s Role â⬠¢ Share with staff your knowledge of leadership and help staff to minimize implementation barriers â⬠¢ Commit to the ââ¬Å"New Wayâ⬠Role of Unit Based Council Chair â⬠¢ â⬠¢ â⬠¢ â⬠¢ â⬠¢ â⬠¢ â⬠¢ â⬠¢ Set meetings Develop the agenda Move council to consensus Ensure members participate (per charter) Facilitate group assignments Ensure consensus for decision making Call emergency meetings, as needed Mentor Chair-elect Benefits of Shared Decision Making â⬠¢ Increased Staff Nurse Satisfaction (increased autonomy, increased control over practice, improved communication between nurses, physicians and administration) â⬠¢ Improved Nursing Retention ($90,000 to replace an RN ââ¬â 2006 Advisory Board) â⬠¢ Improved Patient Safety Outcomes Benefits of Shared Decision Making â⬠¢ Improved collaboration and team Building â⬠¢ Improved quality of care and clinical effectiveness â⬠¢ Increased staff confidence, personal and professional growth â⬠¢ Development of new knowledge and skills â⬠¢ Increased professionalism and accountability Requirements for successâ⬠¦. â⬠¢ Place the Patient First and focus on providing the best care possible â⬠¢ Trust and respect is essential â⬠¢ Communicate openly and honestly â⬠¢ Embrace change and strive for improvement â⬠¢ Staff and managers hold each other accountable. â⬠¢ Organizational support of accountability in the performance appraisal process Final Thought Shared decision making is a journey, not an event. It is not achieved overnight, and there is no conclusion ââ¬â no point when it is fully in place. It only provides a foundation for further growth. Tim Porter-Oââ¬â¢Grady
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