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Shared governance strategic planning retreat: A best practice

Guanci, Gen, MEd, RN-BC; Medeiros, Marky, MSN, RN

doi: 10.1097/01.NUMA.0000542296.59754.61
Feature: SHARED GOVERNANCE SPOTLIGHT

Discover how a strategic planning retreat can unite councils around a shared purpose and direction while supporting the development of individual council goals and the achievement of measurable outcomes.

Gen Guanci and Marky Medeiros are consultants at Creative Health Care Management in Minneapolis, Minn.

The authors have disclosed no financial relationships related to this article.

Figure

Figure

In Lewis Carroll's Alice's Adventures in Wonderland, Alice, having lost her way, happens upon the Cheshire Cat:

“Would you tell me, please, which way I ought to go from here?”

“That depends a good deal on where you want to get to,” said the Cheshire Cat.

“I don't much care where,” Alice replied.

“Then it doesn't matter which way you go,” said the Cheshire Cat.

In our work with shared governance councils, we often see that councils lack clear direction and are ultimately guided by the whim of whomever “assigns” work to them. It may even be true that when the councils began, there were identified responsibilities; yet as time goes on, and members come and go, these original responsibilities can become nothing more than words written on a page. We hear time and again that councils are struggling to come up with projects. These councils are often lacking in clear direction, frequently pulled in many directions, or stagnated to the point where members have lost interest. If this is the case, an organization should invest time in shared governance strategic planning to maximize council success.

The proactive group activity of strategic planning provides direction by establishing priorities. Through this process, resources, such as people, time, and money, are refocused to maximize council operations and ensure consistent direction that ends in measurable outcomes. Strategic planning for councils answers the questions: “Where are we? What do we have to work with? Where do we want to be? How do we get there? How will we know when we're there?”1 The American Organization of Nurse Executives (AONE) has identified strategic management as a core competency for nurse managers and, indeed, it's critical to the success of shared governance councils.2

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The plan for the planning

When planning a strategic planning retreat, consider the following questions:

  • Who will participate?
  • Where will the retreat be held?
  • Who will facilitate?
  • What should be on the agenda?
  • What education or developmental support do the councils need?
  • What are the desired outcomes of the day?
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Who will participate?

Although it would be wonderful if everyone participating in shared governance could attend the retreat, we know this isn't realistic. Regardless of how important the retreat is, the fact remains that clinical staff members are needed to care for patients. At a minimum, it's essential for the chairpersons and cochairpersons of your shared governance organization-level and unit-level councils to participate. Additional council members who can attend are also welcome and can act as representatives of their councils and units. Retreats help those who participate in shared governance as mentors, advisors, or facilitators to become better coaches and mentors to staff leaders as they execute the identified plan over the course of the coming year.

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Where will the retreat be held?

The advantages of holding a retreat onsite include reduced costs and being in a familiar environment. However, disadvantages may include participants' inability to be fully present because the close proximity to their unit may draw them back to work. Checking in on the unit at break time is tempting, and unit leadership can easily call them out of the retreat to staff the unit. These potential scenarios may result in participants breaking their commitment to the process and perhaps choosing not to return. Investing in an off-site location to help decrease extraneous distractions underscores the event's importance, and an off-site location can even be used to reward commitment to shared governance.

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Who will facilitate?

The retreat facilitator should be someone who can take participants through the developed agenda while ensuring that group dynamics and decision-making processes are attended to. Facilitators must be skilled at moving a group toward consensus while remaining neutral themselves.3 Often, an educator, organizational development specialist, Magnet® program director, or an individual responsible for shared governance assumes this role. It's important to avoid having the facilitator be anyone who's perceived to be in a position of control or power. Sometimes, through no fault of the individual perceived to be in a position of control, communication can be stifled, and the group may acquiescence to that facilitator's expressed desires. For this reason, the CNO and directors should avoid taking on the facilitator role.

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What should be on the agenda?

Before developing an agenda, answer the following questions:

  • What's the purpose of the day?
  • What's the desired outcome(s) of the day?
  • What do we need to achieve our desired outcome(s)?

A sample agenda may look like this:

  • welcome/icebreaker
  • overview of the day
  • CNO's state of the union
  • nursing department review
    • – mission, vision, values
    • – strategic plan
  • shared governance at (organization name)
    • – where we've been
    • – where we are now
  • review of council charters/by-laws
    • – are they still reflective of the council's specific work?
    • – what should remain?
    • – what should be removed?
  • goal-setting presentation
  • council goal development
    • – individual council activity
    • – council report out
  • wrap-up/where to go from here.

Depending on how much time is allotted, some organizations with a professional practice model (PPM) will also spend time evaluating and revising the model as needed. This helps ensure that the PPM is reflective of how nurses practice, communicate, collaborate, and develop professionally.4 You can also discuss challenges associated with the current model, including whether it's still representative of your organization's current state, whether staff members are able to speak to how this model plays out in their daily work, and whether any revisions are needed to enhance their ability to do so.

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What education or developmental support do the councils need?

A critical outcome of strategic planning is to develop clear, concise goals. Councils are often unsure about what a goal is or how to set goals effectively. These lessons are essential to council success, so be sure to include the following key points:

  • Goals state an intended and desired outcome with an identifiable deadline.
  • Goals must be clearly stated. Remember, they exist to give councils directions and provide a purpose for the council's work.
  • Council goals must align with the strategic priorities of the organization; in most instances, it's beneficial for them to align with nursing strategic priorities and/or unit goals.

Consistent with the AONE nurse manager competency of strategic management, throughout the strategic planning process, and later while councils are solidifying goals and actions, leaders assist council members in creating measurable goals in alignment with their organization's strategic priorities.2 Leaders share strategic priorities and vision with council members to ensure that goals align and, ultimately, work toward improvement in prioritized outcomes.

Council goals are best when they follow a SMART format: specific, measurable, attainable, realistic, and timely.5 Confirming that goals follow this or a similar format, and providing guidance in the goal-setting process, is actively supported by the retreat facilitator. This is essential for the council's success and overall unit improvement.

Here are examples of SMART goals for four councils:

  • Practice council: Develop our PPM by the end of the second quarter.
  • Professional development council: Increase the number of certified nurses by 3% by the end of the fourth quarter.
  • Quality council: Decrease the organization-wide catheter-associated urinary tract infection rate to below the National Database of Nursing Quality Indicators® all hospitals mean by the end of the fourth quarter.
  • Emergency department unit council: Decrease the “left without being seen” rate by 10% by the end of the year.

After the retreat, consider the fact that no goal is complete without a solid plan. In addition to setting goals, councils must develop action plans to make attaining the goals a real possibility. Council members and leaders must be aware of their roles in goal development and the associated action plan. Council members who are present at the retreat are responsible for sharing goals with all council members. They should also work with members and leaders on an action plan to ensure goal achievement.

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What are the desired outcomes of the day?

Although some may consider this the final step in planning the retreat, we believe that the agenda development process should be guided by your desired outcomes. In The 7 Habits of Highly Effective People by Stephen Covey, Habit 2 is “Begin with the end in mind.”6 If you don't know where you want to be by the day of the retreat, you may never get there. You may end up somewhere else. Be clear: If, by the end of the day, you want the council goal creation process to be fully understood and for goal-setting to be underway, state that. If you want every group to have fully developed goal statements by the end of the day, be clear about that from the start. Everything on your agenda should move the group toward your end goal(s). If you discover that any item on your agenda doesn't move the group toward its goal, delete it.

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Know where you want to go

Strategic planning retreats support high-functioning, engaged councils. Although they require thoughtful development; attention to process; and a significant investment in the resources of people, time, and money, these retreats unite councils around a shared purpose and direction while supporting the development of individual council goals and the achievement of measurable outcomes.

We wonder what might have become of Alice had she known where she wanted to go.

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REFERENCES

1. Guanci G. Feel the Pull: Creating a Culture of Nursing Excellence. 3rd ed. Minneapolis, MN: Creative Health Care Management; 2015.
2. American Organization of Nurse Executives. AONE Nurse Manager Competencies. Chicago, IL: American Organization of Nurse Executives; 2015.
3. Bens I. Facilitation at a Glance!: Your Pocket Guide to Facilitation. 4th ed. Methuen, MA: Goal/QPC; 2016.
4. American Nurses Credentialing Center. 2019 Magnet Application Manual. Silver Spring, MD: American Nurses Credentialing Center; 2017.
5. Doran GT. There's a S.M.A.R.T. way to write management's goals and objectives. Manage Rev. 1981;70(11):35–36.
6. Covey S. The 7 Habits of Highly Effective People. New York, NY: Free Press/Simon & Schuster; 2004.
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