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hared governance is more than a committee structure. It’s a culture that empowers frontline nursing decisions that influence their practice, workplace, and patient outcomes. Shared governance can be key to job satisfaction, retention, and Magnet® recognition.
At Northwell Health, one of New York’s largest and most innovative healthcare systems, shared governance is a functional reality. Kathleen Casler, MS, RN, NPD-BC, Assistant Vice President of Clinical Professional Development and Research at Northwell, shared key insights into what makes their model successful and sustainable. Here are five practical tips based on her experience.
- Give Nurses a Voice in Real Decisions
At Northwell, shared governance is visible at every level of the organization. From unit-based to hospital-wide to system-wide councils, staff nurses are encouraged to step forward in leadership and collaboration.
Frontline nurses participate in changes to clinical workflows, quality improvement initiatives, and healthy work environment initiatives. The key to success has been ensuring nursing input goes beyond an advisory role and results in tangible actions.
Casler spoke about how shared governance is the heart of the Northwell organization, driving change and patient outcomes. She went on to describe how shared governance “looks” at this complex organization that employs 22,000 nurses across all campuses.
“Our shared governance structure is employed across the organization at the corporate and frontline levels. Each interprofessional, department-level council includes all roles that impact patient care. Nurses are leaders in these councils. Each of the co-chairs on the unit or department-based councils also sits on the hospital-level council. This allows them to share information from the unit to the hospital level.”
- Build Trust Through Transparency and Inclusion
Creating a structure is only part of the process. Nurses must feel their input leads to visible change and that their perspectives are not only welcomed but essential.
Shared governance thrives in a culture of trust. At Northwell, nurse leaders focus on open communication, consistent follow-up, and mutual respect to create a psychologically safe environment where all voices matter.
“Our culture makes a difference in patient outcomes and nurse satisfaction. There are two ways we build trust with our staff,” she remarked. “The first is honesty and transparency. We are a data-driven organization and believe we should empower our nurses with the data needed to drive change.”
“The second way our leaders build trust is to engage nurses in dialogue, listen to what our frontline nurses say, and turn it into action. Listening is only half of it. Our leaders listen, and then they act on it,” she added.
This kind of transparency helps nurses feel heard and builds long-term trust in the system. Trust also requires humility from leadership and a willingness to share power. That mindset shift is what distinguishes performative models from true shared governance.
- Invest in Structures that Support Nurse Leadership
Effective shared governance needs infrastructure, both in terms of councils and nurse preparation. Council structures must be tailored to the organization’s complexity, spanning bedside to system-wide levels.
But it’s not just about creating more councils. Northwell actively prepares nurses to lead within them. Leadership development workshops, mentorship programs, and role shadowing help nurses build the skills they need to participate confidently in decision-making.
“We believe wholeheartedly that the people who do the work should have a say in how the work gets done,” Casler commented. “Engaging frontline nurses in decision-making is crucial to our culture. We intentionally foster frontline nurses in a leadership mindset.”
These strategies also include integrating orientation materials in a central location, orientation to members and co-chairs supporting the adjustment, and peer mentorship between council co-chairs.
- Use Data to Drive Council Decisions
Data plays a central role in how decisions are made within a shared governance model. Whether it’s patient satisfaction scores or clinical outcomes, data equips nurses to identify problems, measure progress, and justify practice changes.
Rather than relying on anecdotal evidence, councils are trained to interpret and apply performance data to make meaningful improvements. For example, a unit might track fall rates and use evidence-based protocols to guide interventions, then measure whether outcomes improve over time.
This approach reinforces a culture of accountability and ensures that nurse-led initiatives are aligned with broader organizational and patient outcome goals.
- Avoid Common Pitfalls with Strong Foundations
Common challenges to governance models include an unclear line of leadership or a lack of leadership support. Casler talked about avoiding these pitfalls by clearly defining roles, aligning council goals with organizational priorities, and embedding shared governance into strategic planning.
Strong shared governance also leads to measurable gains in nurse satisfaction and retention. When nurses feel empowered and respected, they are more likely to remain engaged and committed to the organization.
For leaders preparing their organization for Magnet appraisal, Casler offers this advice: prioritize authentic engagement. Governance structures should be more than boxes checked—they should reflect a culture of partnership, where nurses are equipped, empowered, and trusted to lead.
“Don’t underestimate the value and power of small, quick wins as you’re starting a shared governance structure. You don’t have to tackle a large project immediately,” she said. “Consider low-hanging fruit that you might not feel has large clinical significance, but it could have large cultural significance within the team.”
“Address a point of frustration with the staff. We encourage our teams to address the pebble in your shoe first and not underestimate the value of addressing these frustrations, which also builds trust in the structure.”
Call For Assistance to Develop Your Shared Governance Model
Shared governance isn’t a one-size-fits-all formula. Used across systems, a few core principles stand out: engage nurses in decisions, invest in leadership development, use data to guide change, and build trust through transparency.
As Kathleen Casler emphasizes, when nurses are truly empowered through shared governance, the result is better care, stronger teams, and a more resilient system. When your organization wants support in developing or strengthening your shared governance structure and preparing for Magnet appraisers, call Tipton Health. We are here to help you improve patient outcomes and reduce nurse turnover.