Shared Governance Research Articles

Rehabilitation of the Constructive Dimension of Conflict as the Foundation of a Political Research Program for Shared Governance of the Enterprise

Research into corporate governance could benefit from a clearer recognition of the constructive role of conflict in democratic regimes. With a critical perspective, the current study seeks to demonstrate the political implications of the idea of shared governance in enterprises, which often gets reduced to a technical question in studies that adopt contractual or disciplinary views of corporate governance. In contrast, shared governance of an enterprise may require an implemented culture of conflict, as central to the productive organization. Such a culture can encourage complementarity among the personal projects prioritized by various stakeholders and the social union that they form. This orientation also enables a critical view on the evolution of corporate reform, which in turn raises new questions that can inform a research agenda capable of grappling with the polemogenic atmosphere surrounding and shaping the functioning of enterprises in the 21st century.

The Capital Market and Economic Growth in Nigeria

The capital market offers access to a variety of financial instruments which are very essential for government and private businesses in need of long-term funds. The objective of this study is to determine the effect of capital market on economic growth in Nigeria being an alternative source of finance for investment. The data used for the study were obtained from the Central Bank of Nigeria Statistical Bulletin and World Development Indicators, spanning 1985-2021 and, analyzed using Auto-regressive distributive lag (ARDL) on Eviews. Value of transactions, all share index, government stocks, corporate bonds, equities and inflation rate; were the independent variables, while economic growth proxied by gross domestic product was the dependent variable. The results obtained showed that equities and all share index had positive and significant effects on economic growth in Nigeria. We therefore, recommend that the Securities and Exchange Commission should come up with measures that will boost investors’ confidence in the Nigerian capital market and make it a veritable alternative source of finance for businesses.

A new approach to a wicked problem: development of a cross-sector community-centered learning network to tackle childhood food inequity.

Food insecurity is a complex societal problem that disproportionately impacts households with children and those led by minoritized populations, with negative impacts on health across the life course. System to Achieve Food Equity adapted the learning systems model, used to address similarly complex problems, to tackle food insecurity at a neighborhood level. SAFE, born out of the COVID-19 pandemic, leverages a family-centered, community-based, cross-sector network fundamentally aimed at changing the food system so that all children in Cincinnati have the food they need to thrive. Through the following principles, Community-Led Network, Co-Production with Community, Equitable Sustainability, Learning to Learn Together, Distributing Leadership and Power, and Shared Data and Governance, SAFE has grown to over 300 individuals and 100 organizations, funded 9 novel interventions, distributed over 270,000 meals, and created a collaborative of motivated like-minded stakeholders. Future work includes improved data collection and sharing, support for increased stakeholder engagement and greater distribution of leadership and power, advocacy for policy change, refining measurement tools of network maturity for community settings, and collaboration with other efforts that contribute to food security indirectly.

Integrated Place-Based Primary Interventions: Levers and Tensions Related to Multilevel Governance for Community Integrated Pathways, A Multiple Case Study.

Integrated Place-Based Primary Interventions (IPPIs) are considered an innovative response to the challenges and complex issues faced in disadvantaged areas where traditional institutional services have difficulty reaching people in vulnerable situations. IPPIs are an innovative approach to the delivery of in services, conceived as an original community-based local care and service pathways. However, these intervention practices require adaptive modes of governance. In this article, we explore how and to what extent the mode of governance of IPPIs influences the performance of community-integrated pathways. To this end, using a qualitative exploratory multiple-case study design (observation and semi-structured interviews), we describe 4 IPPIs in 3 territories in Quebec. This includes an examination of the levers of action and tensions related to their governance and the performance levels of the community-integrated pathways. We conclude that collaborative and shared multilevel governance, despite its demanding nature, appears to contribute to the longevity of the actions and benefits of IPPIs and could prevent their relevance from being questioned.

Shared health governance, mutual collective accountability, and transparency in COVAX: A qualitative study triangulating data from document sampling and key informant interviews.

To facilitate global COVID-19 vaccine equity, the World Health Organization, the Coalition for Epidemic Preparedness Innovations, the Global Alliance for Vaccines and Immunizations, and the United Nations Children's Fund supported the COVID-19 Vaccine Global Access (COVAX) partnership. COVAX's goals may have best been pursued through shared health governance - a theory of global health governance based on six premises, in which global health actors collaborate to achieve a shared goal. Shared health governance employs a framework for accountability termed "mutual collective accountability", in which actors hold each other accountable for achieving their goal, thus relying on transparency with one another. We conducted a multi-method qualitative study triangulating document analysis and key informant interviews to address the question: To what extent did COVAX employ shared health governance, mutual collective accountability, and transparency? We thus aimed to explore the governance structures and accountability and transparency mechanisms in COVAX and determine whether these constituted shared health governance and mutual collective accountability. We identified 117 documents and interviewed 20 key informants. Our findings suggest that COVAX's co-convening organisations were governed by their individual formal governance mechanisms, while each was formally accountable to its own leadership team, resulting in challenges when activities and decisions involved collaboration between organisations. Furthermore, COVAX's governance lacked transparency, as there was little public information about their decision-making processes and operations, including information about the algorithm with which they make vaccine allocation decision, possibly contributing to its inability to achieve its goals. The COVAX partnership only achieved four of the six premises of shared health governance. Since actors involved in COVAX did not hold one another accountable for their role in the partnership, it did not employ mutual collective accountability, while also lacking in transparency. Although these results do not entirely explain COVAX's shortcomings, they contribute to evidence about the roles of good governance, transparency, and accountability in large global health initiatives and underscore failures of the current global governance system.

Co‐evolution of governance mechanisms and coopetition in public‐private projects

AbstractOne important question in public‐private (PP) projects is how to manage coopetition—simultaneous cooperation and competition among project members. Prior studies on the governance of PP projects showed the importance of governance mechanisms to deal with major events such as technical or organizational disruptions but paid limited attention to the management of coopetition. At the same time, research on the management of coopetition mostly focused on industrial coopetition, whereas PP projects also entail public‐private coopetition. Seeking to better understand how governance mechanisms may help manage coopetition in PP projects, we conducted an in‐depth study of Galileo—a large PP project aimed at delivering Europe's own satellite‐based navigation system. The findings show how three core aspects of project governance—(i) mechanisms (joint vs. separate use of contractual and relational mechanisms), (ii) form (lead organization vs. shared governance), and (iii) goals (to promote cooperation and/or prevent competition)—jointly explained the emergence and (mis)management of knowledge‐ and value‐related coopetitive tensions. In turn, these tensions prompted a series of adaptations in the governance of the project. Our study contributes to a co‐evolutionary understanding of the governance of PP projects and offers implications for practitioners seeking to (re)design PP project governance.

A Nurse-Led Implementation Science Specialist Program.

A well-known challenge in health care is integrating evidence into practice. Implementation science (IS) is a growing field that promotes the sustainable application of evidence-based practice (EBP) to clinical care. Health care organizations have an opportunity to support sustainable change by creating robust IS infrastructures that engage nurses in the clinical environment. Integrating IS into a nursing shared governance model is an ideal vehicle to empower direct care nurses to sustain EBP. Importantly, an IS infrastructure may also promote nurse retention and increase interdisciplinary collaboration. This article, the first in a series on applying IS, describes how a multisite health care organization developed a systemwide nurse-led IS Specialist program within a shared governance model.

Network governance in Healthcare, a systematic literature review

The typical structure of the healthcare sector involves (specialist) intertwined practices co-occurring in formal or informal networks. These practices must answer to the concerns and needs of all related stakeholders. Multimorbidity and the need to share knowledge for scientific development are among the driving factors for collaboration in healthcare. To establish and keep up a permanent collaborative link, it takes effort and understanding of the network characteristics that must be governed.
 It is not hard to find practices of Network Governance (NG) in a variety of industries. Still, there is a lack of insight in this subject, including knowledge on how to establish and maintain an effective healthcare network. Consequently, this study's research question is: How is network governance organized in the healthcare sector?
 A systematic literature study was performed to select 80 NG articles. Based on these publications the characteristics of NG are made explicit. The findings demonstrate that combinations of governance style (relational versus contractual governance) and governance structure (lead versus shared governance) lead to different network dynamics. Furthermore, the results show that in order to comprehend how networks in the healthcare sector emerge and can be regulated, it is vital to understand the current network type. Additionally, it informs us of the governing factors.

Impacts of Shared Governance on Ambulatory Nursing Engagement

An ambulatory shared governance program was initiated in an outlying location of a large academic hospital to evaluate the impact on engagement, process improvement, and safety event reporting. Shared governance led to improvements in engagement, empowerment, and autonomy. Although the impact of shared governance has been evaluated in inpatient settings, there is a paucity of evidence evaluating the impact in ambulatory settings, specifically clinical care centers in outlying locations. Clinically significant findings were noted, including increase in staff involvement in shared governance initiatives, involvement in institutional changes and quality improvement related to submissions, and leadership growth.

Shared Governance: A New Age

This narrative provides how an organization transformed their model of shared governance to enhance communication, meaningful feedback, innovation, and idea generation with clinical nursing. The organization completed an analysis of the current state of shared governance and provided recommendations for change, leading to enhanced nurse engagement. Nurse engagement has consistently become more difficult to achieve with multigenerational barriers, remote technology, and the difficult workload of clinical nurses. The clinical nurse’s voice needs amplified. Although there are still opportunities to evolve and transform, utilizing different approaches of shared governance can enhance nurse engagement, even virtually.

Rejuvenating Meaningful Recognition Through Shared Governance.

As majority stakeholders in healthcare systems, direct care clinical nurses are accountable for professional practice, including meaningful recognition. A sustainable recognition program can be established through structural empowerment and shared decision-making within a healthy, clinical nurse-led governance structure. This article describes the journey of rejuvenating meaningful recognition across 27 hospitals and more than 500 sites of care, with the aim of positively impacting nurses and strengthening connection to purpose.

The ELEVATE Study: Evaluating the Impact of Educational Professional Governance Workshop on Nurses' Perceptions of Shared Decision-Making.

The ELEVATE study evaluated whether an educational workshop would improve the perceptions of shared decision-making of nurses in an organization as demonstrated by an increase in Index of Professional Nursing Governance (IPNG) score. Available literature insufficiently links educational interventions to improvements in shared professional governance. Six hundred ninety-one participants' IPNG scores were analyzed before and after an educational workshop was administered to formal administrative leaders and registered nurse (RN) RN council leaders every 6 months during a 2-year research study. Index of Professional Nursing Governance scores were higher for RNs participating in nursing councils than scores for those who did not. The organization's IPNG scores remained stable from 2019 to 2021. Secondary analysis may suggest that council members were more resilient during crisis. Further investigation is needed researching the relationship between professional governance education and RNs' perception of shared decision making.

Model innovation construction of social work participation in grassroots community governance based on fuzzy comprehensive evaluation model

Abstract Grass-roots community governance is a large volume in China, the “last mile” for implementing national policies, and has a special status in promoting the construction of China under the rule of law. Guided by the theory of the rule of law government, governance and good governance theory, competence-based theory and system theory, this paper constructs a model of grassroots community multi-governance. And by using the theoretical knowledge of the fuzzy comprehensive evaluation model and the Delphi method, we analyzed the factors influencing the rule of law competence of grassroots cadres and focused on constructing an index system of the grassroots cadres’ rule of law competence and establishing a multi-level evaluation model. The results show that: through the empirical analysis of the grassroots community multi-level shared governance model, the KMO values are 0.728 and 0.851, respectively, which are greater than 0.7 and pass the KMO test. The approximate chi-square values are 415.127 and 1254.23, respectively, and the significance level sig is 0.000, which passes Bart’s spherical test and has good sexual validity. The grassroots community pluralistic shared governance model proposed in this paper improves the comprehensive service capacity of urban and rural communities in China, complements the governance shortcomings at different levels, and takes multiple measures to improve the governance level of urban and rural communities China.

Leadership Coaching to Improve Nursing Unit Practice Councils Effectiveness

Nursing shared governance (SG) provides an opportunity for alignment between frontline team members and nursing leadership. A department of nursing had a mature SG program with many thriving departmental-based SG groups. However, structural processes and guidance for unit-based SG groups were lacking and demonstrated a need for improvement. The General Theory of Effective Multilevel Shared Governance framework provided an opportunity to refocus and improve unit practice councils (UPC). Results demonstrated that UPC leadership competencies can be improved through focused 1:1 leadership coaching by identifying a UPC area of opportunity and utilizing evidence-based tools and resources.

Relationship between nurses’ perception of professional shared governance and their career motivation: A cross-sectional study

ObjectivesThis study aimed to investigate the level of professional shared governance and career motivation and their relationship among nurses in Egypt. MethodsA cross-sectional survey was conducted. A total of 724 nurses working in inpatient medical, surgical, and critical care units in Alexandria Main University Hospital were recruited from May to August 2022. The Index of Professional Nursing Governance (IPNG) version 3.0 and the Career Motivation Scale were used for evaluation. ResultsThe IPNG version 3.0 total score was 109.18 ± 22.76, that nurses perceived had a low level of professional shared governance; the access to information dimension achieved the highest average mean score (2.81 ± 0.76), followed by the ability to set goals and conflict resolution dimension (2.75 ± 0.53). On the other hand, the dimension of participation in the committee structure achieved the lowest average mean score (1.65 ± 0.37). The total score of career motivation was 69.82 ± 9.70 this reflects that nurses perceived a moderate level of career motivation. The career insight dimension achieved the highest average mean score (3.56 ± 0.34), while the career resilience dimension achieved the lowest average mean score (3.07 ± 0.49). Male nurses, less than 30 years old, had a bachelor’s degree in nursing sciences, and worked in the ICU had higher total scores of the IPNG and career motivation (P < 0.001). There was a positive correlation between the IPNG version 3.0 score and the Career Motivation Scale score (r = 0.239, P = 0.003). ConclusionsThe study’s findings can serve as a theoretical foundation for nursing managers to re-plan the management model and develop appropriate methods to give better career planning for nurses.

Research Initiative Supporting Excellence at the University of Cincinnati (RISE-UC): A Program to Develop and Support Research-Active Faculty Members.

A combination of forces have markedly increased challenges to research-active faculty achieving sustained success. This article describes how one department at the University of Cincinnati College of Medicine (UCCOM) implemented a strategic plan, the Research Initiative Supporting Excellence at the University of Cincinnati (RISE-UC), to promote the research activity of its research-active faculty, fiscal year (FY) 2011-FY 2021. RISE-UC was implemented and regularly updated to address evolving needs. RISE-UC supported faculty members pursuing research via fiscal and administrative services to grow a critical mass of investigators; establish a shared governance model; create pathways for developing physician-scientists; develop discrete and targeted internal research funding; establish an Academic Research Service (ARS) unit (as infrastructure to support research); enhance faculty member mentorship; and recognize, celebrate, and reward research success. RISE-UC was informed by shared governance and resulted in substantial increases in total size of the faculty and external funding. More than 50% of Physician-Scientist Training Program graduates are active researchers at UCCOM. The internal awards program realized a return on investment of ~16.4-fold, and total external direct cost research funds increased from ~$55,400,000 (FY 2015) to ~$114,500,000 (FY 2021). The ARS assisted in the submission of 57 grant proposals and provided services faculty members generally found very helpful or helpful. The peer-mentoring group for early-career faculty members resulted in 12 of 23 participants receiving major grant funding (≥ $100,000; spring 2017-spring 2021) from sources including National Institutes of Health awards, Department of Defense funding, Veterans Affairs funding, and foundation awards. Research recognition included ~$77,000/year in incentive payments to faculty members for grant submissions and grants awarded. RISE-UC is an example of a comprehensive approach to promote research faculty member success and may serve as a model for other institutions with similar aspirations.

Associations and Predictive Pathways Between Shared Governance, Autonomy, Magnet Status, Nurse-Sensitive Indicators, and Nurse Satisfaction: A Multisite Study.

Evidence is limited to the effects of shared governance (SG) and autonomy on nurse-sensitive indicators (NSIs). To explore the effects of SG, autonomy, and Magnet status on nurse and patient outcomes. A cross-sectional survey study was conducted using a convenience sample of 404 nurses from 4 hospitals. Descriptive analyses of variance (ANOVAs), and path analysis were conducted to identify hypothesized associations and predictive pathways among study variables. Nurse managers reported higher perceptions of SG, autonomy, and satisfaction than staff nurses. SG and autonomy were significant predictors of patient falls and hospital-acquired pressure injuries. Nurses' autonomy, SG, and Magnet accreditation were significant predictors of nurse satisfaction. Leadership support of SG and autonomous practice are key strategies to improve nurse satisfaction and NSI outcomes.

Accelerating systemness through shared vision and culture

As health systems across the United States consolidate, tremendous potential exists to expand and optimise their breadth and depth by integrating services so that patient care is coordinated, supportive and equitable. The financial pressures and workforce crisis resulting from the COVID-19 pandemic have further exacerbated the need for fiscal discipline and operational efficiencies that can come from effective, system-wide integration. Yet many health systems continue to fall short of achieving the promise of post-merger integration and the value it can create for the diverse communities they serve. This paper explores one health system’s journey from ‘operational synergies’ to full ‘systemness’ enabled by a shared vision laser focused on a commitment to frictionless, patient-centred care through enabling care teams to do their best work, accelerating integrated operations and building an inclusive culture. It will explore the journey of a system in name only (Wellforce) to a unified team with a single brand (Tufts Medicine) and a shared commitment to the future with a mission to empower people to live their best lives. This case study will describe how the system evolved, starting from the development of a transformational Strategic Vision, through the shared trials of the COVID-19 pandemic and its effect on patients and providers. Having a shared vision is an essential first step to building systemness. Bringing that vision to life requires significant discipline and culture change. It requires a systemic approach and unwavering leadership, rooted in a shared philosophy, deep commitment and aligned behaviour. The case study will continue with an exploration of the path system and entity leaders took to identify shared priorities, adapt organisational and governance structures, and engage more than 14,000 clinical and administrative staff and physicians in building an inclusive culture with a clear and actionable commitment to anti-racism. It is a story about moving from words and ideas to action and removing the barriers that impeded progress.

Enhancing Patient Outcomes through PeriAnesthesia Clinical Leader Engagement, Development and Unit-Level Shared Governance

Enhancing Patient Outcomes through PeriAnesthesia Clinical Leader Engagement, Development and Unit-Level Shared Governance

Couples’ Joint Holdings and Real Earnings Management

The involvement of affinity in corporate governance will affect the strategic decision-making of enterprises. Based on the shareholding data of Chinese A-share-listed family firms from 2008 to 2021, this paper explores the impact of couples’ joint holdings on real earnings management. The study founds that compared with the family firm with a single shareholding of husband or wife, couples’ joint holdings positively affect real earnings management. Further analysis shows that in the case of poor company growth and two-job mergers, couples' joint holdings will exacerbate real earnings management; higher capital appropriation by major shareholders and higher management expense ratio contribute to the positive correlation between couples' joint holdings and real earnings management. This study has particular reference significance for the family firm to optimize the governance structure and improve accounting information quality under the husband-wife shared governance mode.