Expanding shared governance beyond practice issues.

Expanding shared governance beyond practice issues reaps positive outcomes such as quality staff leadership, enhanced communication to all nursing staff and increased high-level decision making beyond practice issues. Decisions may take slightly longer than with one council, as the cycle-time through multiple councils is greater, but recommendations are made with greater staff input and have a greater opportunity for success. Because of current changes in skill-mix and patient-focused care systems, involving staff in management, education, and quality issues as well as practice ones helps staff to successfully implement new delivery systems.