After our hospital set out on the Pathway to Excellence® Program of the American Nurses Credentialing Center (ANCC), leaders realized staff nurses were only minimally participating in committees and councils—the forums for making decisions about nursing practice and the work environment. Usually, just four or five staff nurses attended each meeting, even though our hospital culture encouraged participation.
While many of our nurses agreed it was important to be active in shared governance committees and councils, they had difficulty leaving their units and patients to attend meetings, even for an hour. Bay Park Community Hospital/ProMedica Health System in Oregon, Ohio, is small, with just 70 beds. So finding additional staff to cover a nurse who wanted to attend a meeting posed a challenge. Nonetheless, our frontline nurses sought to participate in changes occurring in the hospital. They wanted to have a voice.
In Feel the Pull: Creating a Culture of Nursing Excellence, author Gen Guanci provides a road map for organizations seeking guidance on the Magnet® journey and desiring cultural transformation. Bay Park nursing leaders sought to create such a culture. Feel the Pull provided a great deal of insight and information. In it, Guanci cites the work of shared-governance pioneer Tim Porter-O’Grady, who describes the value of creating an environment where shared governance thrives. Developing a strong foundation of shared governance, Guanci explains, promotes autonomy, enhances critical-thinking skills, and advances a learning environment.
But before we could transform our culture, we had to review staff feedback regarding their difficulty finding time to attend meetings. When brainstorming ways to support increased staff participation, we hit on the idea of establishing a specific day each month to consolidate all meetings. Our solution—“Meeting Mondays”—resulted from leaders’ willingness to listen to staff concerns. Our chief nursing officer gave moral and financial support to the concept. This was important, as implementing the initiative would strain the budget.
How Meeting Mondays works
All nursing meetings are held on the third Monday of each month, with one meeting held every hour starting at 9 a.m. and continuing until 4 p.m. Lunch is provided at the professional nurse council (PNC) meeting held at noon.
Each unit has a unit practice council (UPC), where staff members can take up issues for discussion and resolution. If these issues can’t be resolved through discussion with the director of the acute care or the medical/surgical intensive care unit (ICU) or with the patient care supervisor, the UPC chair brings them to the PNC. A process map showing the pathway to the proper committee or council for issue resolution is available to all nursing staff.
A boost in meeting attendance
Since Meeting Mondays began, staff nurse attendance at meetings has risen significantly. Regular attendance has grown from an average of four to five staff nurses to an average of 20 to 25. All nursing units have been represented on all key committees (PNC, medication task force committee, inpatient satisfaction council, and emergency center throughput committee, to name a few).
Nurses are happy with the consistency of their meeting times. (See Rave reviews from nurses by clicking the PDF icon above.) If a staff member is working on the day a meeting will be held, additional support is scheduled so she or he can attend that meeting. Nurses not scheduled to work that day are compensated financially if they attend voluntarily on their day off. With the support of the chief nursing officer, chief financial officer, and chief executive officer, unit directors have built this meeting time into the budget.
Nurses as change agents
Today, our frontline staff nurses are more responsive to the idea of being change agents. They’ve been increasingly involved in educating peers about committee activities and projects, new equipment, and implementation of new evidence-based practices. What’s more, we’ve had positive feedback on our Meeting Mondays initiative from ancillary departments and other hospitals in the ProMedica Health System.
Increased participation in Meeting Mondays has led to greater buy-in from staff, reducing resistance to change. The success of Meeting Mondays has helped shift our culture from one where staff were encouraged to attend meetings to one where staff are expected to attend. We now review staff nurses’ committee involvement in their annual evaluations. The hospital has provided additional education to frontline staff, which helps them develop their negotiating and consensus-building skills.
The Meeting Mondays program has done more than just increase staff nurse participation in committee and council meetings. It has boosted staff satisfaction, encouraged nurses to find their voice and speak up, and empowered our frontline workforce to become positive change agents. It continues to provide the venue for frontline staff to provide feedback and maintain engagement in our shared governance councils.
In 2009, our hospital received the Ohio Partnership for Excellence Gold Level Award, which is based on criteria from the Malcolm Baldrige National Quality Award. Our staff’s involvement in decision-making helped us achieve this award. Currently, Bay Park is working toward obtaining the Ohio Partnership for Excellence Platinum Level Award—the highest state-level quality award.
Guanci G. Feel the Pull: Creating a Culture of Nursing Excellence. Minneapolis, MN: Creative Health Care Management; 2007.
When this article was written, Jeanne Drouillard was chief nursing officer and vice president of Patient Care Services as Bay Park Community Hospital/ProMedica Health System in Oregon, Ohio; Sandra Sutter was the hospital’s Magnet® Program Coordinator. Currently, Ms. Drouillard is a specialist master for Deloitte Consulting LLC; Ms. Sutter is an educator and direct-care provider in the postanesthesia care unit at Bay Park.