Shared Governance Facilitates Collaborative Decision Making

The concept of shared governance is one of the most misunderstood in institutions. Accountability, process ownership, equity, and partnership are characteristics of shared governance. The healthcare industry is extremely sensitive since it directly deals with human life and health, necessitating greater caution when making critical decisions. The Accreditation Association for Ambulatory Health Care is a remarkable example of good shared governance through committees (AAAHC).

There are various characteristics that distinguish committee decision making. To begin with, decision-making is often decentralized. As a result, there are numerous voices that do not stem from a single source. AAAHC states that it takes the issue of cooperation as one of its core values (McLane, 2007).

In connection to this, there is no arbitrary decision making. AAAHC prefers a well-defined process of making decisions and not a group vote. This ensures that the process is more rational and embedded in a through the exchange of ideas (Meisenheimer, 1997).

Second, delegation plays an important role in the decision-making process. AAAHC does an annual review in order to monitor the dynamic technology. The review is done through a high level of delegation where key actors are assigned specific objectives. Another important thing with delegation is that it allows a smooth running of the organization when a key employee or administrator leaves the office for one or another thing.

Third, the decision-making process includes hearing the dissident voices. Such voices are not viewed as a threat to the organization but rather a democratic right that everyone is entitled to. After all, in most cases, such dissident voices arise from genuine concerns (Church & Berry, 2008). Moreover, AAAHC makes a decision on what party or institution to award accreditation on the basis of a strong quality methodology. For example, when Premise Health Tennessee was accredited by AAAHC a number of issues that had to be solved arose before the accreditation was finally awarded thereby reconciling the dissident voices.

Lastly, shared governance does not entail a consensus by the committee only. In addition to that, it does not leave it to the administration to make the implementation alone. On the contrary, it entails the involvement of all the members of the health organization. In other words, such committees carry out representation (Meisenheimer, 1997).

Critique and Recommendations

When decisions are made, their implementation requires legitimacy. Such legitimacy only comes through making sure that the subjects see the transparency of the decision and can accept it. Unfortunately, some committees have imposed decisions on the governed people. Others have presented proposals in committees as fait accompli. In some cases, members of the committee make decisions basing on their personal interest.

Committees are advised to follow the laid down rules and regulations if they want to have a competitive edge. Instead of imposing ideas on the members, they should carry out thorough communication of the issues at hand and do dialogue. If the dissidents are convinced to change their mind, then it becomes a more effective strategy than imposing on their members.


The process of arriving at healthcare decisions in the healthcare organization is shared governance. Ensuring that committees use shared governance is going to create a sustainable environment for work. Overall, committees should be tools of shared governance in order to ensure quality service delivery.


Church, J.A., Baker, P., Berry, D.M. (2008). Shared governance: A journey with continual mile

markers. Nursing Management, 39 (8).

Mclane, D. (2007). Aaahc-joint commision-cms crosswalk: A side-byside comparison of

ambulatory care requirements. London: Rutledge.

Meisenheimer, C. G. (1997). Improving quality: A guide to effective programs. Rockville, Mar:


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