Inside scoop from our experts: Give nurses autonomy with a shared decision-making model

HCPro's Weekly Update on the ANCC Magnet Recognition Program®*, February 17, 2009

This week, a reader asks how to institute a shared governance model. Read the response from our advisor Barbara Hannon, RN, MSN, CPHQ, coordinator for the ANCC Magnet Recognition Program® at the University of Iowa Hospitals and Clinics in Iowa City, IA.

Q: As we begin our journey toward Magnet Recognition Program® designation, we would like to implement shared governance. Can you provide best practices for instituting a model?

A: The fundamental belief behind shared governance is that nurses at every level should govern their practice and be included in all decisions that affect their practice. This belief requires a redistribution of influence among managers and staff from one in which all decisions are made by administrators from the “top down” to one in which decisions are agreed upon collaboratively from the “bottom up.” 

A main goal for instituting a shared governance model is the creation of a method for effective shared decision-making. A shared decision-making model allows for the inclusion of diverse perspectives from multiple viewpoints to solve issues and make decisions. This produces quality decision-making that is easier to implement. Staff nurse perspectives from the bedside can be included alongside perspectives from management, allowing for all sides of an issue to be explored in a common setting.

In addition, staff nurse involvement in decision-making increases the likelihood of “buy in” at the unit/bedside level. Utilizing collective wisdom in the dynamic setting of group interaction produces creative energy and leads to the development of commitment, ownership, accountability, and responsibility for the process and the outcomes of a shared governance model.

For more tips on how to initiative a shared decision-making model, visit the blog post “Shared governance: Implement a successful model” at

Editor’s note: Do you have a question for our experts? If you'd like us to consider your query for publication, please send it to associate editor Cameran Erny at



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