D159: Shared Governance Implementation in Home Care Programs

D159: Shared Governance Implementation in Home Care Programs

Name

 Western Governors University

D158 Strategically Planning the Execution of a Healthcare Improvement Project

Prof. Name

Date

D159: Shared Governance Implementation in Home Care Programs

The project focuses on implementing a shared governance framework within the Home & Community-Based Care (HCBC) department at the Iron Mountain Veterans Affairs (VA) facility. Shared governance aims to foster greater staff engagement, professional accountability, and collaborative decision-making by actively involving frontline personnel in organizational processes. The initiative’s core objective is to empower staff through targeted education and active participation in performance improvement activities, thereby enhancing ownership and morale.

To measure the initiative’s success, the project team identified three critical data points. These include assessing frontline staff knowledge of shared governance before and after educational sessions, and tracking the number of performance improvement projects initiated by staff members. Collectively, these metrics offer both quantitative data on knowledge gains and qualitative insight into how well shared governance principles are integrated into everyday practice.

The first data element uses a pre-education survey to capture baseline knowledge among frontline staff. Since staff members come from varied professional backgrounds with different prior leadership experiences, understanding this baseline helps identify knowledge gaps related to shared governance. The second element involves a post-education survey designed to evaluate how effectively the educational interventions conveyed shared governance principles and whether staff can apply these in their roles. The third element tracks the initiation and progress of staff-led performance improvement projects, which serve as concrete evidence of shared governance integration.

Employee feedback mechanisms like surveys are essential tools in organizational development. According to Huebner and Zacher (2021), the greatest value of employee surveys lies not only in collecting data but also in the subsequent actions taken to translate feedback into meaningful organizational improvements.

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Data Management Plan

What is the source of data for the project?

The primary data source consists of digitally administered surveys distributed to frontline HCBC staff both before and after the shared governance education sessions. The pre-education survey establishes baseline knowledge and staff perceptions, while the post-education survey assesses knowledge gains and the practical relevance of shared governance concepts.

Structured data collection in healthcare settings is crucial for supporting workflow optimization, quality reporting, and incentive programs (Agency for Healthcare Research and Quality [AHRQ], 2020). Aggregated data at the practice level enables ongoing quality improvement, standardization of processes, and better patient outcomes. However, data must be systematically analyzed and incorporated into a quality improvement framework to yield actionable insights.

To ensure confidentiality and data integrity, all surveys will be conducted on an encrypted digital platform accessible exclusively via VA-issued computers. Survey data will be securely stored within VA systems and accessible only to the project team and authorized stakeholders.

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Key Performance Indicators (KPIs) and Deliverables

KPI Number	Description	Intended Outcome
KPI #1	Development and delivery of shared governance education	Increase staff knowledge, confidence, and engagement in shared governance councils, committees, and improvement initiatives.
KPI #2	Strengthening relationships between leadership and staff	Enhance shared decision-making, critical thinking, and communication demonstrated by staff participation in leadership forums.

The project’s success hinges on achieving measurable improvements in staff knowledge and an increase in staff-initiated problem-solving and performance improvement activities. These outcomes reflect shared governance principles such as empowerment, accountability, and professional ownership.

An internal benchmark has been set to achieve a 30% increase in shared governance knowledge by July 31, 2025. This benchmark helps ensure that educational efforts remain effective, relevant, and aligned with the department’s evolving needs.

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Data Collection and Analysis Methods

How will the data be collected and analyzed?

Data collection involves digitally administered surveys composed mainly of multiple-choice questions targeting core shared governance concepts. The pre-education survey also gathers input from staff about how they envision shared governance applying to their roles and their preferred educational formats, allowing for customization of the training approach.

Survey participation will be closely monitored to ensure sufficient representation and reduce bias. Pre-education survey results will inform the refinement of educational content to address specific knowledge gaps.

Data analysis will primarily utilize descriptive statistics such as percentages of correct responses, overall completion rates, and comparisons of pre- and post-education survey scores. Visual tools like bar graphs and pie charts will illustrate changes in knowledge and highlight themes emerging from staff-initiated improvement projects.

Houser (2023) emphasizes that effective data analysis supports informed decision-making, with different analytic methods suited to different goals. For this initiative, descriptive analytics are most appropriate to evaluate knowledge acquisition and participation trends.

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Potential Challenges and Mitigation Strategies

What barriers might impact the project’s success?

A potential barrier is low survey participation, which can undermine data validity and introduce response bias. Additionally, maintaining sustained commitment from leadership and frontline staff may prove challenging, especially amid organizational changes and uncertainties within the VA system.

To counter these challenges, the project will leverage strong leadership support and clearly communicate the benefits of shared governance to staff. Educational sessions will emphasize how shared governance fosters professional autonomy, enhances communication, and supports staff-driven change. Demonstrating the direct relevance to daily practice aims to boost engagement and participation.

Despite these potential obstacles, the initiative promises substantial organizational benefits by fostering staff ownership of professional growth and departmental improvement efforts.

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Dissemination of Results

Upon completing data collection and analysis, results will be shared with the Pathway to Excellence team to assess the feasibility of expanding early shared governance education to other departments. The High Reliability Organization (HRO) lead will be informed to promote staff participation in advanced process improvement training, such as Yellow Belt and Green Belt programs.

If outcomes are positive, the shared governance implementation strategy will be presented to additional department leaders to encourage replication throughout the VA facility.

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Project Closure and Sustainability

How will the project conclude and be sustained?

At project completion, frontline staff will receive small tokens of appreciation recognizing their participation in surveys and educational activities. Personalized thank-you messages will be sent to stakeholders and team members to acknowledge their support and contributions.

Long-term sustainability depends on ongoing shared governance development led by the Pathway to Excellence team. Continuous education for new employees and encouragement of participation in councils and improvement initiatives will be vital. The Nurse Practice Council will serve as the central structure for maintaining engagement, shared decision-making, and professional accountability.

Brennan and Wendt (2021) highlight that shared governance supports sustained practice excellence by fostering ownership, empowerment, leadership development, and innovation, all of which drive improved staff satisfaction and patient outcomes.

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References

Agency for Healthcare Research and Quality. (2020). Collect and use data for quality improvement. https://integrationacademy.ahrq.gov/products/playbooks/behavioral-health-and-primary-care/implementing-plan/collect-and-use-data-quality-improvement

Brennan, D., & Wendt, L. (2021). Increasing quality and patient outcomes with staff engagement and shared governance. OJIN: The Online Journal of Issues in Nursing, 26(2). https://ojin.nursingworld.org/table-of-contents/volume-26-2021/number-2-may-2021/articles-on-previously-published-topics/increasingquality-and-patient-outcomes/

Houser, S. (2023, October 9). Data analytics concepts for health information professionals. Journal of AHIMA. https://journal.ahima.org/page/data-analytics-concepts-for-health-information-professionals

Huebner, L.-A., & Zacher, H. (2021). Following up on employee surveys: A conceptual framework and systematic review. Frontiers in Psychology, 12, 696732. https://pmc.ncbi.nlm.nih.gov/articles/PMC8696015/

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