Restoring a Unit-Based Shared Governance Committee

Shared governance is a pillar of the American Nurses Credentialing Center’s Magnet culture. However, during the COVID-19 pandemic, committee participation waned as hospitals shifted their focus to the crisis. That was the case on the cardiothoracic surgery stepdown unit in the Heart, Vascular and Thoracic Institute (HVTI) at Cleveland Clinic’s main campus.

“As we started coming out of COVID in 2023, we thought it was the perfect time to reinitiate our Shared Governance Committee,” says Colin Soeder, BSN, RN, a clinical nurse on the unit who took over as co-chair of the committee along with Megan Early, BSN, RN. “We made a concerted effort to spread the word that we planned on having monthly meetings and we wanted to hear everyone’s voices.”

Monthly meetings are foundational

In 2023, Monica Cummins, MSN, APRN, ACCNS-AG, PCCN, a clinical nurse specialist, asked Soeder and Early to step up as committee co-chairs. They agreed and began meeting with Cummins to develop a strategy to restore the unit-based committee.

The strategy prioritized nursing leadership buy-in, structured monthly meetings and dedicated time to complete shared governance projects. Meetings are held on the second Monday of each month from 4 p.m. to 5 p.m. They align with the Cleveland Clinic main campus Shared Governance Council meetings, which occur from 7 a.m. to 3 p.m. This allows Soeder and Early to receive hospital-wide updates, then share them with caregivers on the cardiothoracic surgery stepdown unit the same day.

In addition, nurses discuss quality improvement projects, teamwork and recognition, certification and other concerns during the unit-based meetings. Afterward, Soeder and Early create meeting minutes and share ideas with nursing leadership.

“Shared governance gives us a voice with management,” says Early, a clinical nurse in the unit. “We can go to our leaders one-on-one, but it’s nice when we collectively voice our opinions, ideas and concerns.”

One issue raised by nurses in a shared governance meeting was the need for door signs indicating when a sterile procedure is underway. Soeder and Early shared the request with leaders, and Cummins subsequently joined the enterprise-wide signage committee to share the unit’s ideas and obtain approval for sterile procedure signs.

Goal setting keeps shared governance on track

Goal setting was key to the success of revitalizing the unit-based Shared Governance Committee. In addition to holding one meeting a month, which the committee achieved, the group’s 2023 goals included:

• Participate in one volunteer activity – Nurses decided to collect aluminum pull tabs from soda cans as part of the Ronald McDonald House of Northeast Ohio’s Pull Tab Initiative. The charity works with a local recycler to trade in the tabs for money for its family fund. The Shared Governance Committee has been collecting tabs in a bucket in the break room for months and plans to select a donation day soon.
• Display nomination posters for nursing awards – Nurse recognition is a priority for the committee. The unit placed posters with nomination cards in a high traffic area near the nurses station so patients, families and colleagues could nominate outstanding caregivers for the DAISY Award and Cleveland Clinic’s EMERALD Award.
• Increase PCCN certifications – The committee set a goal of three clinical nurses passing the Progressive Care Certified Nurse exam from the American Association of Critical-Care Nurses (AACN). Several nurses are currently studying for the exam and have discussed forming a study group with Cummins.
• Submit for the Beacon Award of Excellence redesignation – In August 2023, the unit submitted an application for renewal of the Beacon Award from AACN, which recognizes units that provide exceptional patient care.
• Create an unofficial holiday scheduling list – With management approval, the committee developed a sign-up sheet for nurses to request off on two non-official holidays per year, such as Halloween, Juneteenth, St. Patrick’s Day and Mother’s Day. This has been a staff satisfier especially for weekend holidays.

The committee has added other goals this year, such as increasing use of the Epic Rover mobile application interface to improve real-time documentation and reduce workstations on wheels in hallways.

Three tips for rejuvenating a unit-based committee

Soeder, Early and Cummins offer a few tips for nursing units that want to start or restore a unit-based committee. First, select two to three nurses who will champion the cause.

“One person might be able to do it on their own, but when our unit sees the three of us and our supportive management team working together that inspires confidence and other nurses join in,” says Soeder. “That collaboration is important.”

Second, set at least one goal that is easily achievable and visible.

“Those quick wins – like the DAISY and EMERALD award posters on our unit – are a visual reminder of what shared governance can do. It helps bring people on board,” says Cummins. “You may pick a bigger project next time, but the quick ones really support change.”

Finally, in addition to posting announcements about committee meetings and emailing nurses, committee chairs should reach out in person, too.

“A part of our role is to pull people aside and say, ‘I appreciate working with you, and I see the value you bring to this unit and organization. What can we do for you to make your day better?’” says Soeder. “When people see that shared governance can bring about change, they buy in.”