You are the supervisor of a surgical services department in a nonunion hospital. The staff on your unit have become increasingly frustrated with hospital policies regarding staffing ratios, on-call pay, and verbal medical orders but feel that they have limited opportunities for providing feedback to change the current system. You would like to explore the possibility of moving toward a shared governance model of decision making to resolve the issue and others like it but are not quite sure where to start.

Title: Implementing Shared Governance Model in a Nonunion Hospital to Address Staff Frustration


Shared governance is a participatory management approach that aims to empower healthcare staff by involving them in decision-making processes. By decentralizing authority and allowing front-line workers to contribute to organizational decisions, shared governance can enhance job satisfaction, collaboration, and overall quality of care. In this context, this paper examines the potential benefits of implementing a shared governance model in a nonunion hospital’s surgical services department to address staff frustrations regarding staffing ratios, on-call pay, and verbal medical orders.

Defining Shared Governance:

Shared governance is a management philosophy rooted in the principles of equity, partnership, and shared responsibility. It involves creating structures and processes that enable healthcare professionals, including nurses and surgeons, to participate in decision-making at all levels of the healthcare organization. The model emphasizes collaboration, accountability, and respect for expertise, with an emphasis on open communication and goal alignment.

Benefits of Shared Governance:

Shared governance in healthcare has been associated with numerous positive outcomes, including increased job satisfaction among staff, improved patient outcomes, decreased turnover rates, better utilization of resources, and enhanced professional development. The empowerment and engagement of frontline staff can lead to increased ownership and investment in organizational outcomes, resulting in improved performance and reduced staff frustrations.

Barriers to Implementing Shared Governance:

Implementing shared governance in a nonunion hospital may present unique challenges. Key barriers may include historical resistance to changes in power dynamics, apprehension among management regarding relinquishing control, lack of staff knowledge or awareness about shared governance, and potential conflicts with existing policies and procedures. Overcoming these barriers requires a carefully planned approach that involves education, organizational support, and clear communication.

Implementation Strategy:

1. Organizational Assessment:
The first step toward implementing shared governance is to conduct an assessment of the hospital’s readiness, culture, and existing decision-making structures. This assessment will provide valuable insights into the potential barriers and identify areas of improvement. It may involve reviewing existing policies, analyzing staff satisfaction surveys, and conducting focus groups or interviews with stakeholders to understand their perspectives and concerns.

2. Education and Training:
To ensure successful implementation, staff members need to understand the concept of shared governance, its goals, and the potential benefits it can bring. Education and training programs should be developed to provide an overview of shared governance principles, highlight successful case studies, and foster a sense of ownership among staff members. This can be accomplished through workshops, presentations, online modules, and mentoring programs.

3. Formation of Governance Structures:
Shared governance requires the establishment of formal structures that facilitate staff engagement in decision-making processes. These structures may include unit-based councils, department committees, or multidisciplinary task forces. The creation of these structures should be guided by clear guidelines and well-defined roles and responsibilities to promote transparency and accountability.

4. Clear Communication:
Effective communication is crucial for the successful implementation of shared governance. Regular updates, staff meetings, newsletters, and online platforms can be used to foster an open dialogue between management and staff. Clear channels of communication and mechanisms for sharing ideas, concerns, and suggestions should be established to ensure that all staff members feel heard and valued.


Implementing a shared governance model in a nonunion hospital’s surgical services department can provide a platform for addressing staff frustrations and facilitating collaborative decision-making. By promoting staff empowerment, accountability, and engagement, shared governance can lead to improved job satisfaction, better patient outcomes, and a more efficient and effective healthcare system. A carefully planned implementation strategy involving organizational assessment, education, formation of governance structures, and clear communication can pave the way for successful adoption of shared governance principles in the hospital setting.