Health care system is a sphere that demands constant development at each level of its structure. The effective management system is agreed to be a powerful lever ensuring this development, that is why the unit-based councils (UBCs) have been established. These councils are based on the idea of shared governance and usually consist of the hospital employees of almost every level. The idea is to organize regular meetings that will create the environment for teamwork and will allow nurses to directly contribute to the development of patient care and administration.
To observe the interaction between the council members and the process used to arrive at decisions, I was instructed to attend the council meeting in my health care organization. To determine whether the existing decision-making process is a form of shared governance, I am going to compare our organization’s UBC with those having all the intended features of an ideal UBC.
In my organization, the UBC function is to engage the hospital personnel into the discussion of safety issues, directions for development and ways to help or celebrate the staff. The council has monthly meetings where its participants debate on the mentioned issues. There is an assigned chairperson who leads the meetings, and members include nursing managers, nurses and certified nursing assistants (CNAs) working in the unit. This fact fully corresponds with the idea of the UBC as shared governance “creates a model for supporting nursing decisions that play a part in quality and productivity of the health care system” (Overcash, Petty, & Brown, 2012, p. 1). However, it is usually advised to engage as many employees as possible: technicians, nurses, pharmacists, support team, therapists, night-shift staff, and so on (Shiskowsky & Krugman, 2016). In this case, my organization, seemingly, keeps to the terms of the meetings regularity and participants.
One of the UBC goals is to create an excellent teamwork, as well as to satisfy the needs of the employees. According to KentuckyOne Health (2017), “the council encourages team participation and focuses on improving partnerships at all levels of team member involvement” (para. 2). The UBC in my organization is likely to succeed in this direction. They nominate employees of the quarter, raise the fund for gift baskets for nurses’ week, CNA week, and Christmas. They have also created shadow boxes in the hallway to post pictures from events nurses have attended or were a part of. Thus, the employees’ satisfaction level is likely to be high.
The basic concept of the UBC is that its members take an active part in the meeting discussion. It is expected that “clinical nurses are involved in decisions that directly affect clinical care and procedures” (Overcash, Petty, & Brown, 2012, p. 2). My observations showed that nurses do not actively participate in a decision-making process. It seems they attend the meeting to keep themselves up to date on what is going on in the unit, and to help in making things happen when the board agrees things need to be set in motion. This fact allows assuming that shared governance, as such, is not implemented in my organization in its full form.
Initially, unit-based councils were established to give team members a possibility to share their ideas on the current issues of their units. Collaborative decision-making is usually expected to lead to positive outcomes. The example of UBC in my organization demonstrates that lack of shared governance results in an inability of the team to propose their ideas and perform the intended collaborative decision making.
References
KentuckyOne Health. (2017). Unit based councils. Web.
Overcash, J., Petty, L., & Brown, S. (2012). Perceptions of shared governance among nurses at a Midwestern hospital. Nursing Administration Quarterly, 36(4), E1-E11. Web.
Shiskowsky, K., & Krugman, M. (2016). Jump-starting unit-based councils. Web.