Date of Award


Document Type

Restricted Access Thesis

Degree Name

Master of Arts in Nursing (MAN)




Health care is changing rapidly and there is increasing demand to find efficiencies and improve outcomes through healthcare innovation. Engaging nurses who care for patients at the bedside is a vital way to design safer, more efficient care. This project describes a shared governance model incorporating performance improvement methodology to be implemented in a group of four medical surgical units at a large urban hospital in the upper Midwest. The unit councils will utilize performance improvement (PI) coaches or clinical nurse specialists (CNSs) to coach the councils in performance improvement tools and techniques. The resources available for the project as well as the roles of the CNS, PI consultant, patient care manager, and patient care director in supporting the unit councils will be described in the implementation of a shared governance model. Watson's Caritas Processes #4 and #7 as well the concept of intentional presence serves as the nursing theoretical foundation of the project. Performance improvement goals for the unit councils will be to decrease falls, increase patient satisfaction, and improve pain management scores on the units. A variety of performance improvement tools such as scorecards and project logs will be used to measure success of this shared governance structure.