Collaborative Decision-making through Shared Governance

Collaborative Decision-making through Shared Governance

In the contemporary medical world, the concept of collaborative decision-making through shared governance faces resistance by nurse leaders due to its demerits such as time wastage and delayed decision-making. Despite its flaws,shared governance possesses immeasurable benefits that one ought to consider. For instance, shared governance results in decisions that all members of the organization can own up and remain fully committed to their realization (Porter-O’Grady, 2009). As such, there is need for the institutionalization of this form leadership. In essence, this paper aims at analyzing the observed decision-making process employed by a quality improvement committee of a community health center during a meeting. With such an analysis, determination of the consistency of the observed decision-making process with the one employed in shared governance is inevitable.

Function of the Committee

Primarily, the committee has several functions that are worth highlighting. For instance, the committee has the responsibility ofadvocating for quality improvement projects within the community health center. It achieves this function by championing for institutionalization of evidence-based practices that contribute to the improvement ofthe quality of care. Moreover, the committee has the function of approving the EBP project proposals of the staff nurses interested in improving the quality of care within the organization. Finally, the committee has the function of monitoring and evaluating the implementation of quality improvement projects within the health center for the ascertainment of their efficacy.

Roles of the Committee Members

Of particular interest are the roles played by the individuals that attended the committee meeting. The individuals that attended the meeting included the continuous quality improvement (CQI) nurse, middle-level nurse managers andCQI representatives. The role played by the CQI nurse is that of a chairperson, whose responsibility isto coordinate the meeting’s proceedings. As for the middle-level nurse managers, they act as champions for quality improvement within their departments. On the contrary, the CQI representatives act on behalf of the CQI nurse across various departments of the community health center.

Observations of Interactions

From the observation of the interactions between the committee members during the meeting, it was possible to make variousdeductions that are worth highlighting. A befitting example of thenoted elements is the dependence on consensus in the decision-making process of this committee. Marquis, and Huston, (2015) is of the opinion that this approach entailssparing of time by individuals for hearing all perspectives of a proposed option and agreeing wholesomely to institutionalize it. In the absence of a consensus, the committee members had a back-up plan of yes-no voting that enabled them to settle on a decision amicably. Finally, the role of the CQI nurse, the chairperson of the meeting, was that of facilitating rather than directing the committee members’ actions. Such an action of the chairperson fostered a collaborative decision-making within the committee.

Congruency of Decision-making Process with Shared Governance

Going by the key findings of observation of the committee members’ interactions, it is beyond doubt that the decision-making process adopted by this committee is a form of shared governance. That is for sure because the adopted committee’s decision-making process entails various elements of shared governance. For instance, the reliance on consensus decision-making, having a back-up plan if consensus is unattainable, listening to all perspectives and facilitative approach by the chairperson of the committee are all aspects of shared governance (Marquis, & Huston, 2015).  As such, the adopted decision-making process is a form of shared governance.


Concisely, this paper aimed at analyzing the observed interactions of a quality improvement committee of a community health center,and determining their congruence to shared governance. In essence, the discussion has achieved these objectives and it is beyond question that the interactions of the committee members during theirmeeting are reflective of shared governance. An implication drawn from the analysis is the need for institutionalizing shared governance in the contemporary organizations if realization of its advantages is to become a reality. In the absence of such consideration, however, the current problems of lack of commitment and ownership to decisions made are certain to persist for the unforeseeable future.




Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application.Philadelphia: Wolters Kluwer Health.

Porter-O’Grady, T. (2009). Interdisciplinary shared governance: Integrating practice, transforming health care. Sudbury, Mass: Jones and Bartlett Publishers.

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