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Shared Governance

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Our culture of Shared Governance supports the principles of decentralized decision-making, shared accountability, and partnerships among all staff to deliver exceptional patient care, improve quality of care, and enhance work life. We are committed to helping direct caregivers have an active voice and participation in improving their professional practice in collaboration with their leaders.

Learn more about Shared Governance.

What is Shared Governance?

Q. What is shared governance?

A definition of shared governance by Tim Porter-O'Grady is: a professional practice model, founded on the cornerstone principles of partnership, equity, accountability, and ownership that form a culturally sensitive and empowering framework, enabling sustainable and accountability-based decisions to support an interdisciplinary design for excellent patient care.

A simpler definition that all staff and leadership may relate more easily to is one that the Shared Governance Task Force developed in 2004: a dynamic staff-leader partnership that promotes collaboration, shared decision-making and accountability for improving quality of care, safety, and enhancing work life.

Q.  Does a person have to be employed within "Nursing" to participate in shared governance? 
No. Though Nursing was among the first professions to adopt the philosophy and structure of shared governance, and Vanderbilt Nursing was among the pioneers implementing this model in the nation 30 years ago, shared governance is as much a specific leadership style as anything else. It incorporates commitment to the value of facilitative leadership and shared decision-making among key stakeholders about issues that affect one's work. Decentralized decision-making and everyone having a "voice" can be practiced in almost any setting, even those outside of healthcare.

Q. How do we implement shared governance? 
There are many ways to implement shared governance. Salient features of a shared governance model include: partnership between staff and leadership; inclusion of input from all impacted stakeholders; aiming for consensus decisions but having a back-up plan if you cannot reach consensus; being facilitative rather than directive; listening to all perspectives as much as possible; shared accountability; team ownership; flexibility within boundaries. Examples of shared governance "vehicles" are: unit and clinic boards, committees, councils, task forces, Nursing Staff Bylaws, even surveys seeking your input. Evidence tells us that the most successful shared governance bodies are those that have at least 6 structural elements:

  • a charter, including outlining the boundaries of decision-making;
  • collaboration between staff co-chairs and the area manager;
  • regular meetings with a formal means of communication to all staff;
  • mutually planned agendas (co-chairs and manager) distributed before the meetings;
  • ground rules of how to work together, be it in-person meetings or online meetings;
  • striving for consensus decisions, meaning that everyone agrees to support them after having discussed the options.


Shared governance may look different in different settings but the outcomes are the same: a feeling of having been heard and included in decisions that directly impact us whenever possible.

Q. What are some other terms that might mean the same as shared governance? 
Other terms seen in the literature include: shared leadership, shared decision-making, decentralization, decisional involvement, collaborative governance, professional governance. Some Vanderbilt forums that reflect shared governance are: unit or clinic board, staff councils, focus groups, task forces, process improvement teams, operations councils, practice committees, etc.

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