Development and Implementation of an Ambulatory Care Nursing Professional Governance Council

The purpose of this work was to research, develop, and implement an ambulatory care nursing professional governance council (ANPGC) in support of the pursuit of Magnet designation within an ambulatory primary care-based organization. The organization is comprised of over 115 practices located throughout eight counties affiliated with five acute care hospitals. Literature supports professional governance as a mechanism to increase nurse engagement and nurse retention, improve patient outcomes, and promote partnership between front-line nurses and administration. Nursing professional governance is a pillar of the American Nurses Credentialing Center (ANCC) Magnet culture and a critical component of Magnet designation.
The organization's nursing leaders, also serving as ANPGC advisors, developed the foundation to support meaningful execution and implementation of an effective structure, ensuring adequate representation of the organization's nurses. The ANPGC advisors supported and empowered the organization's nurses throughout the implementation process. Essential to success was evaluation of the perceived baseline governance style within the organization and nurses’ understanding of professional governance.
The ANPGC advisors identified the Index of Professional Nursing Governance (IPNG) survey, an evidence-based tool, to establish baseline understanding of nurse perceptions around professional governance. The initial survey was sent to 513 ambulatory care nurses. 108 nurses responded in part with 85 completing the full survey. Demographics of respondents were collected and included education level, years in nursing, years in current specialty and years of service with the organization, age, and number of specialty certifications.
The survey response rate was 21.1%. The organization scored 1.8 on the Likert scale, indicating the presence of a traditional governance style. Council advisors shared these results with representatives during the implementation phase. Advisors harnessed this opportunity to educate council representatives on the components of transformational leadership to inspire and support their vision for change. Council representatives were empowered to promote a culture of shared decision-making through collaborative strategizing, open communication, and mutual trust. These factors served as the vehicle to promote nursing’s agenda with leadership.
The key principles of professional governance include partnership, equity, accountability, ownership, empowerment, team building, leadership, and innovation. These key principles will drive sustainable action planning into the future toward improvements to process, quality, and outcomes that are essential for continued success. Council evolution requires revision of the current structure to allow for representation of ambulatory care specialty nurses, improving alignment with ambulatory care nursing specialty councils and the continued development of cyclical communication across the organization. Maintaining a focus on leadership development through the active engagement, participation, and empowerment of nursing representatives is another key to future success. Tracking and monitoring quantitative progress towards a state of transformational leadership using the IPNG survey is another critical component suggestive of meaningful change.
Implementation of an ANPGC has launched a structure for professional governance in the ambulatory care setting. The ability to measure and benchmark nurse perceptions surrounding professional governance in the ambulatory care environment provided the organization with meaningful information to help drive improvements and positioned the organization to achieve initial Magnet designation in July 2022.