Appointing a Professional Practice Council is a structured process that allows collaboration among nurses to influence the delivery of care by empowering the council members to discuss clinician challenges and participate in decision making around clinical standards and policy formation, while enhancing professional accountability which leads to improved patient clinical outcomes. Through participation in the practice councils, nurses are able to mature and grow professionally as they acquire confidence in adopting evidenced-based practices, secure their commitment to nursing excellence, and heighten organizational pride as they celebrate successful outcomes of their efforts.1

"Nurses are in the optimal position to communicate current trends, identify barriers to care delivery, and promote best practices."

In 2015, the Excellence in Medical-Surgical Nursing program asked HCA facilities to establish a Professional Practice Council to align with future initiatives. HCA partnered with Tim Porter-O'Grady Associates to provide foundational shared governance education for Chief Nursing Officers and Medical-Surgical Directors.

Reference; 1. Porter-O'Grady, T. Implementing Shared Governance Creating a Professional Organization. Retrieved from: http://www.tpogassociates.com/SharedGovernance.htm

St. Lucie's best practices include creating leadership councils that cover all the bases

HCA's caregivers are astutely aware of the important role strong communication has in providing outstanding patient care.

But in the current fast-paced and complex hospital environment, identifying who knows what and how to best share information can sometimes be difficult.

By creating six Shared Leadership Councils that purposefully meet routinely, nursing at St. Lucie Medical Center in Port St. Lucie, Fla., has addressed many of these communication difficulties.

"St. Lucie Medical Center developed a Nursing Professional Practice Council in 2006. Early membership included the CNO, nurse directors and managers, but we also quickly asked staff nurses, charge nurses and others to join in as well," says Nancy Hilton, CNO. "On each council we have representatives from every nursing department. We developed the structure, the ground rules and even added a processing component. Processing of a meeting occurs the last few minutes of every meeting and gives each member an opportunity to be honest and provide constructive feedback. This helps the team to build trust and improve communication."

In addition, HCNs new Excellence in Medical-Surgical Nursing Unit of Distinction program requires all facilities to establish a Professional Practice Council to align with future clinical initiatives, says Sammie Mosier, AVP, Nursing Practice, adding, "Nurses are in an optimal position to communicate current trends, identify barriers to care delivery, and promote best practices among their colleagues. A council allows collaboration to influence the delivery of care by empowering the council members to discuss clinician challenges and participate in decision making around clinical standards, all of which enhances professional account-ability and leads to improved patient clinical outcomes."

Everyone has a voice, and a duty

The effort has been so successful that now, in a hospital of about 350 nurses, more than 100 serve on at least one council. In addition, nursing representatives from Infection Control, Quality, IT&S, Risk and other departments serve as well.

"The nurses have a strong voice both on their unit as well as across the hospital," Hilton says of participants. The councils meet monthly and in an effort to keep the lines of communication open, an update from each council is provided at the beginning of each meeting. This update ensures that the right council has the support needed to implement strategic initiatives."

During the year, reports are prepared for nursing and hospital leadership, so that additional clarity is provided for projects in the works, as well as other needs. Bulletin boards throughout the hospital also feature updates on activities, and are kept current by each area council representative. And finally, there's a communication tree that further connects council members to the unit staff and allows everyone to have input.

Shared leadership is an asset when tackling complex nursing initiatives such as improving the Patient Experience. Each council has a role in implementing strategies to ensure success.

"Every council can approach HCAHPS, or any initiative, with the perspective that it is a priority," Hilton says. "The councils are very effective in this way, but they also give staff a representative voice, and when they see results from their ideas, it is very satisfying to them."

The St. Lucie Councils Include:

  • Nursing Leadership
  • Nursing Professional Practice
  • Nursing Professional Development
  • Nursing Quality
  • Clinical Nurse Leader
  • Nursing Research and Evidence-Based Practice
  • Unit Practice