Promoting Nurse Engagement and Professional Development through the Implementation of Shared Governance Nursing Councils in the Ambulatory Care Setting

Shared governance nursing models emerged in acute care settings over 30 years ago as a method to increase nursing autonomy and professional practice. Hospitals with robust shared governance models report increased nurse retention, decreased costs, and improved patient outcomes. While this model is well established in many hospitals, its existence in the ambulatory care setting is not as mature. Shared governance and professional nursing councils are critical to advancing the role of the ambulatory care nurse.

A professional ambulatory care nursing council structure was developed at a large integrated health system with over 200 physician practices throughout Illinois and Michigan. The organization is split in five large geographic regions, with more than 15 unique markets covering metropolitan communities to rural health offices, primary care, and specialty practices.

Foundational work for this council structure began before the pandemic and through 2020 the importance of nurse engagement in the office became more evident. The charter outlined specific requirements for the council membership as well as how the nursing councils would have bidirectional communication between upper leadership structures and the frontline. Councils were implemented in all five regions with representation of all markets within each region, primary care, pediatrics, other service lines, and specialties. Each regional council was assigned a mentor to support the chair and co-chair with basic council leadership skills, goal writing, and participation. The journey to educate, recruit and start councils reignited in January 2021 with all five regions holding their inaugural council meeting in March 2021.

Early outcomes of council implementation has been the professional networking opportunity connecting ambulatory care nurses from different offices, sometimes hundreds of miles apart. This has allowed the members to share common challenges, align best-practices for quality, and professional mentorship. Future goals of the councils are to increase education and awareness of the role of ambulatory care nursing in quality patient outcomes, advance utilization of nurse clinic in the office, and promote the value of nurse-driven ambulatory care care to patients and families.