The implementation of a shared governance model and how it influences decision making in a multicultural setting

Purpose:
The implementation of a shared governance model at KFSH&RC:-Riyadh was to provide direction and support for the professional practice of nursing. Inherent to the definition of the nursing profession is the ability to make decisions and accountability to keep patients at the center of care

Significance:
Shared governance models have been introduced to improve the nurses work environment, satisfaction, and retention. When employees participate in the decision making process, they improve understanding and perceptions among colleagues and superiors, and enhance personnel value in the organization

Strategy and Implementation:
KFSH&RC completed their first RN Survey in 2010, following the release of the results there were grave concerns regarding the work environment that nurses practice in. Decision making was one of these areas of disquiet. KFSH&RC implemented a change from a hierarchical structure to the councilor structural form of shared governance that targets decision making across practice and quality related issues. KFSH&RC has 76 units that span 10 nursing divisions. Each unit has a unit council where front line nurses have autonomy over issues associated to patient outcomes. The chairperson then represents the unit at the divisional council where issues that affect patient outcomes across the division are discussed. The Nursing Affairs wide council is where all the division chairs attend to discuss any nursing wide practice related issues. The chairperson of this committee sits on the Nursing Advisory Council where they have direct access to the Executive Director of Nursing Affairs.

Evaluation:
Analysis of our annual RN Survey show that decision making has significantly improved organizationally over the last year with the introduction of the shared governance model. The units in the organization that excelled in implementing the shared governance model showed results that were amazing

Implications for Practice:
Implementation of a shared governance model in a multicultural setting shows promise in “Decision Making” outcomes. Longitudinal follow up is required to make sure that these results improve or are maintained. Through the use of the annual NDNQI RN Survey this will be possible.