Nursing Governance Structure

Shared Governance Model

The Nursing Shared Governance Model is the vehicle that guides and drives the operational, professional, educational, and research process for nursing practice at LC. The structure has continued to evolve since the year 2000 to include councils for decision making based upon internal and external forces that impact nursing practice. Under the direction of the CNO, nurses from all areas in LC are encouraged to participate in the governance process for all nurses to have a voice and a venue to actively participate in nursing practice.

Lahey Clinic Nursing Shared Governance Model 

Nursing Governance Councils

Unit Based Councils

The shared governance structure has evolved to include the Unit Based Practice Councils (UBPC) that includes the Nurse Practitioner Committee and Certified Registered Nurse Anesthetists. The Unit Based Practice Councils were integrated into the Shared Governance Structure in 2006. They meet regularly and identify opportunities for improvement in nursing practice in their respective units that enhance excellence in patient care. The Unit Based Practice Council structure is the essential process for staff nurse decision making in operational and professional practice issues at the unit level.

Central Councils The following is a description of the 11 Shared Governance Central Councils and their functions. These councils include nursing staff from all areas in nursing and focus on processes for relationship building and mutual collaboration and the development and promotion of policies, guidelines, and standards of practice that enhance professional nursing practice and promote quality in patient care.

  1. Nursing Practice Coordination Council - The purpose of this council is to provide a forum for shared decision making in nursing practice and best practice initiatives across the organization by representatives from the UBCs and central shared governance councils. All councils will share best practices and solve nursing practice problems creating linkage across ambulatory and tertiary care.
  2. Clinical Practice Council - The purpose is to review all policies and nursing practice guidelines and insure that they conform to current standards of care, are evidenced-based, incorporate research and reflect interdisciplinary collaboration as appropriate.
  3. Ambulatory Clinical Practice Council - The purpose of this council is to review all ambulatory policies and practice guidelines and insure that they conform with current standards of care, are evidenced based, incorporate research and reflect interdisciplinary collaboration as appropriate.
  4. Nurse Physician Partnership Council - The purpose of this council is to create a partnership between nurses and physicians to jointly manager and problem-solve to provide a forum of shared ideas, discuss issues and disseminate new information that will enhance patient outcomes.
  5. Nursing Research Council - This council provides the scientific foundation for nursing practice, dedicated to the support of nursing research and evidence based practice at LC. The council's objectives include educating staff about the research process and evidence based practice, providing resources and research consultation that facilitate the conduct of nursing research, disseminating research findings from organization, local, and national meetings, and facilitating the use of research findings to improve patient care.
  6. Nursing Quality Safety Council - The purpose of this council is to review data related to quality and safety initiatives including National Patient Safety Goals, Core Measures, and FMEA results. This council makes recommendations that promote and maintain a nursing environment where the best practices in safety and quality are able to be provided for patient care.
  7. Patient Care Technology Council - This is a multidisciplinary council that facilitates the implementation of departmental and organization objectives related to technology to enhance patient care. This council develops guidelines and protocols for technology initiatives, ensures that clinical applications reflect standards of care and nursing practice and solicits input and feedback from end user.
  8. Professional & Educational Council - The purpose of this council is to facilitate a culture where learning is viewed as a life long process, which is essential to the growth and development of all nurses at LC. This council develops and reviews all staff education materials, the nursing practice guidelines, oversees the process of incorporating evidence based practice and nursing research into patient care practices and supports professional development through Pathways to Expertise and Certification.
  9. Coordination and Review Council - The purpose of this council is to review, revise and standardize job descriptions, streamline documentation, approve and revise clinical administrative policies as necessary for accurate nursing functions and process.
  10. Nursing Ethics Council - As voted by the Nursing Practice Coordinating and Review Council in February 2008. This council is designated as a central council where staff nurses participate in identifying strategies and educational initiatives to improve the staff nurse knowledge on ethical principles and problem-solving processes.
  11. Interdisciplinary Patient Care Leadership Council - The purpose is collaborative discussion and shared decision-making on operational patient care issues and updates on current patient care initiatives, including Joint Commission Readiness and a review of the status of initiatives related to the organization's strategic plan. This council is incorporated in the shared governance structure and allows collaboration with other disciplines who are invited to discuss organizational initiatives and strategies and seek broad nursing input for the most comprehensive approach to address patient care and operational concerns.