OO5

 

Shared Decision-Making OO5

 

Provide a description and the policies, procedures, charters, or bylaws of the organization’s shared decision -making structure.

  • Provide a description of nursing’s structural and operational relationship within the organization shared decision -making structure.

 

 

Shared Decision-making Structure

Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS) has an interprofessional shared decision-making structure through which clinical nurses, essential care partners, and administrators collaborate to make clinical practice decisions throughout the organization. This structure, called Interprofessional Shared Governance (ISG), comprises the Interprofessional Practice Council (IPC), Nurse Executive Council (NEC), specialty councils (Care Partner, PeriOp/Procedural, Medical/Surgical, Critical Care, Women’s Services, Emergency Department, Nurse Manager), unit-based councils (UBC), and task forces as needed. (Evidence OO5-1, ISG Visual with Description)

 

Structural Relationship

The ISG at CHI SVHS provides a framework for practice supporting the CHI SVHS mission, remaining consistent with the CHI SVHS vision. Under the laws and regulations of the State of Arkansas, nursing has a scope of practice which is the responsibility of professional nurses. Each nurse and care partner within CHI SVHS has a responsibility for their individual practice. Collectively, members of the CHI SVHS ISG hold aggregate accountability for the quality of practice in the institution. The discipline of nursing intends to establish and uphold its commitment to nursing excellence in accordance with the ANA Code of Ethics for Nurses. All coworkers intend to uphold a commitment to the core values of Inclusion, Collaboration, Integrity, Compassion, and Excellence.


Many departments at CHI SVHS have a UBC; these councils collaborate with interprofessional coworkers from all levels in the department in conjunction with the department manager to set goals, develop strategies, improve processes, and resolve issues to provide excellent quality care to patients on the unit. UBC chairs are elected every other year, with the current chair rotating out, the vice-chair becoming the chair, and a new vice-chair elected in.

 

The specialty councils (SC) collaborate with interprofessional coworkers of all skill levels in their specified specialty in conjunction with the executive sponsors to set goals, develop strategies, improve processes, and resolve issues to provide excellent quality care to patients in a specialty. SC chairpersons are elected every other year, with the current chair rotating out, the vice-chair becoming the chair, and a new vice-chair elected in.

 

The IPC is the organization-level, interprofessional governing body for professional practice. The IPC’s responsibility is to assist with establishing, evaluating, and revising standards of practice and patient care policies, and it is accountable for the implementation and revision of the Nursing Strategic Plan. The IPC chairpersons are elected every other year, with the current chair rotating out, the vice-chair becoming the chair, and a new vice-chair elected in.

 

The Nurse Executive Council (NEC), market and local, supports the development and implementation of mechanisms to promote comparable, as well as the highest quality of patient care across CHI SVHS. The NEC also serves as a forum for developing the strategic and operational direction of clinical practice, and it is accountable for strategic initiatives.

 

The CHI SVHS ISG structure provides a mechanism to establish and uphold values and standards subject to the authority of the chief nurse executive, vice president of patient care services, and the CHI SVHS IPC. (Evidence OO5-2, CHI SVHS IPC Bylaws)

 

Operational Relationship

The operational relationship for CHI SVHS’s four levels of governance includes a two-way communication system. Information goes to the UBCs, SCs, IPC, and NEC, and then back from the NEC to the IPC, SCs and UBCs. All practice and process changes and new and revised initiatives run through this communication system, enabling CHI SVHS to operate at a high level in the fast pace of healthcare.

 

The UBCs throughout CHI SVHS meet on the second and third weeks of the month. UBCs review and analyze data to make department-level decisions about unit operations. Recommendations about revising patient care policies/guidelines and practice changes involving other units/departments are forwarded to the SCs. UBC responsibilities include participating in selecting unit coworkers through the peer interview process, maintaining an effective and efficient care delivery model to meet patient needs, providing input into the unit’s staffing plan and scope of services, assessing and improving care processes to achieve quality care and a safe patient environment, and developing and providing department decisions to the SCs.

 

The SCs throughout CHI SVHS meet during the fourth week of the month to review and analyze data and make decisions about specialty-specific matters of practice. SCs forward issues about patient care policies/guidelines affecting practice outside of the specialty to the IPC for organization-level interprofessional feedback, endorsement, and/or decisions. The SCs are responsible for maintaining an effective and efficient care delivery model to meet patient needs, assessing and improving care processes to achieve quality care and a safe patient environment, and developing and providing consensual specialty department decisions to the IPC.

 

The IPC meets on the first week of every month. Its members include the chairpersons of the SCs, who bring nursing concerns to the IPC to discuss initiatives and solutions for the concerns. Other members of the IPC include clinical directors of nursing and appointed officers including the quality officer, communications officer, vice president of patient care services/assistant chief nursing officer (VPPCS/ACNO) (role of CNO), and chief nursing executive (CNE).

 

The duties of the officers and clinical nurse directors are to:

  • Procure and provide administrative support for the IPC’s activities
  • Receive and consider professional nursing concerns
  • Provide leadership in determining clinical and administrative goals for professional practice at CHI SVHS
  • Participate in determining functions and processes to achieve clinical and administrative goals
  • Serve as communication coordinators for the UBCs and SCs to establish oversight mechanisms for informing the IPC membership of the organization’s meetings, activities, and actions
  • Disseminating information about the IPC meetings, activities, and actions
  • Collaborating to maintain an accurate record and archive of the business of the IPC

 

The CHI SVHS NEC members include the VPPCS/ACNO (role of CNO) and the clinical directors of nursing. The NEC meets biweekly to continually discuss the CHI SVHS nursing strategic plan and nursing initiatives. (Evidence OO5-2, CHI SVHS IPC Bylaws)