In 2009, shared governance was introduced as a formal structure and processes at KHCC nursing department by having direct care nurses participate in decision-making in issues related to patient care and the work environment at KHCC. Early on, nurses put forth a recommendation to start implementing shared governance on the unit level leadership in order to introduce this model to both nurse leaders and unit nurses. In 2011, nurses expressed the need for a bigger departmental umbrella to oversee and coordinate all unit-based council activities, so shared governance was introduced into departmental level.
Shared governance in unit- level leadership
Each patient care unit started a unit-based council; these councils discuss nurse training, quality care, and nursing practice. Direct care nurses are chairpersons of unit-based councils. Each unit nurse manager facilitates the council formation and mentors the nurses in their new role as participating in decisions relating to patient care. Nurses are encouraged to communicate their questions, concerns and/ or issues with the chairperson to be discussed in the council. The nurse’s work at unit-based councils was guided by a model which was established by the nurses in cooperation with unit managers.
Shared governance in department- level leadership
Council representation is composed of nurse managers, direct care nurses and other KHCC departments representatives like human resources and training center.
The Coordinating Council was the first council to be established since it oversees the shared governance process. The Coordinating Council coordinates, integrates and oversees the activities of all the nursing shared governance councils and provides leadership and direction to all nursing councils. This council is composed of all shared governance council chairpersons as well as other selected members. The work of all the governance councils is reported on a regular basis as a means of sharing information, mediating unresolved issues, encouraging effective and efficient use of resources and achieving nursing strategic plan goals. The Coordinating Council acts as a liaison communicating the approved decisions or requests to and from the higher administration at KHCC and communicating their feedback to the nurses in the councils.
The Professional Development Council is a governing council which determines staff educational needs and facilitates direct care nurses professional development. The council enhances the process of nurses' certifications in various nursing specialties, identifies the leadership development needs. It also evaluates the effectiveness of career ladder in nursing.
The Quality Council oversees the quality management and patient safety activities. The council develops and revises the quality assurance plans in the Nursing Department, and assures they are integrated with overall KHCC organizational quality management plans. It endorses and monitors both departmental and unit-based improvement plan, and collaborates with other departments to monitor standards compliance and makes recommendations to enhance continuous quality improvement. The council reviews and evaluates the performance indicators trends and does benchmarking with other cancer centers in regards to nursing sensitive indicators.
The Nursing Practice Council is responsible for establishing and maintaining clinical practice standards. All nursing practice policies and procedures are revised in this council, and any recommendation from direct care nurses to modify a standard of care goes to this council for final recommendations. The core responsibility of this council is to develop peer review strategies in addition to designing the care delivery systems.
The Nursing Advocacy Council is another departmental shared governance council which is responsible for organizing, maintaining the recruitment, retention, rewards for the nurses. This council is responsible for assuring visibility of nurses' participation and outcomes of excellence in nursing care. It also cooperates with the professional development council to revise nurses' career ladder.
The Nursing Research Council is responsible for integrating research and evidence based - practice at point of care. Members of the council are from all KHCC-related departments including the Research Office, Training Center and Medical Library in addition to academic faculty from Jordanian universities with nursing doctoral degrees. This KHCC-based council was the first of its kind in a nursing department at a Jordanian hospital. Nurses' participation in evidence-based practice is assured by establishing the Program of Evidence-Based Registered Unit Nurses (EB- RUN). These nurses receive education on the nursing research and evidence based practice model at KHCC, and they work on the unit level and report their projects to the council for approval.