How Unit Practice Councils Benefit the Hospital and Clinical Staff

By , SVP Clinical Services October 8, 2019 Clinical & Quality, Operational Improvement

Smaller hospitals may use overall nursing councils, but unit-based shared governance councils are a newer concept. Also known as unit practice councils, or UPCs, these formal groups representing each nursing unit are designed to involve frontline clinical staff in decision making. UPCs uphold the belief that no one understands staff and patient-care challenges better than the staff members themselves; hence, no one is better positioned to offer solutions.

At the organizational level, the benefits of UPCs include:

  • Increased employee engagement and satisfaction
  • Improved patient care and satisfaction
  • Increased efficiency through process and practice improvement
  • Staff and point-of-service alignment with organizational goals
  • Improved financial results as patient care is better managed and coordinated
  • Meeting Magnet Recognition Program recommendations regarding shared leadership

Starting a Shared Governance Program

When Great Plains Health (GPH) in North Platte, Nebraska, decided to implement UPCs, the Chief Clinical Officer, Tamara J. Martin-Linnard, engaged CHC Consulting for help getting the program up and running. A year later, the UPCs are a proven success, and GPH’s shared governance model was presented at CHC’s annual CNO meeting. The series of developmental steps leading to GPH’s success can apply to other small hospitals, as well.

  1. Select members. UPC members can be selected, nominated or self-nominated. Identify and educate leaders for each unit. UPC membership should represent all stakeholders, not just nurses. (One of GPH’s most effective councils is led by a clerk.)
  2. Define roles and responsibilities. UPCs are more likely to succeed when members clearly understand their scope of responsibilities and level of authority for decision making.
  3. Establish ground rules. Set basic rules (how to run meetings and make suggestions) and bigger-picture guidelines (how to measure success).
  4. Develop training and ongoing education programs. Provide foundational education to unit leaders on running councils effectively.
  5. Set goals. Goals should be unit-specific and align with organizational goals. Many times, these goals are around evidence-based practices.
  6. Propose UPC projects. Projects should have action plans with assigned tasks to meet a specific goal.
  7. Measure and celebrate outcomes. Formally recognize successes and reinforce the importance and impact of shared governance.

UPC Success Stories

GPH’s successes demonstrate how decentralized decision making yields practical solutions through creative problem solving. Some projects sought to improve the work environment, while others targeted patient experience directly. For example:

  • The perioperative unit frosted SDS cubicle windows to eliminate the risk of infection posed by privacy curtains.
  • Behavioral health reinstated patient meal choice.
  • The ICU secured a grant for a children’s play area.
  • Vocera communications were used for better communication among staff members.

One indication of the program’s success not presented at the annual CNO meeting: The UPCs at GPH were so effective that some non-nursing departments want to implement unit practices, as well.

With real-world successes like this, it is clear that UPCs give clinical staff a means to improve their work environment and solve patient-care challenges.

By , SVP Clinical Services October 8, 2019 Clinical & Quality, Operational Improvement

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