4 key thoughts on shared governance with Allscripts VP Allen Roeseler

Allen Roeseler, vice president of client delivery and solutions at Allscripts, shared advice on how hospital leaders can apply a shared governance model to improve outcomes during a presentation at the Becker's Hospital Review 7th Annual CEO + CFO Roundtable in Chicago Nov. 13.

Shared governance refers to a decentralized structure in which hospital leaders bring together members of different teams — including clinical, financial, quality and marketing — to collaborate on making decisions, setting metrics and developing goals for the entire organization. As an example, Mr. Roeseler said it can be helpful to employ shared governance when considering a new service line or technology.

Here are four key thoughts Mr. Roeseler shared on implementing a shared governance model:

1. Understand the role of shared governance in the hospital setting. "This idea of shared governance brings forward the practical reality that it takes a village," Mr. Roeseler said. "We often approach things as 'someone is going to make a decision, and from that decision we're going to spawn a stream of work, and from that stream of work we're going to have an outcome.' We need to switch that around, and say 'What are you trying to have as your outcome, and how do we switch the model to achieve that?'"

2. Bring everyone to the table. "The coordinating council should have members with equal voices at the table, including clinicians, ancillary services, finance, quality and marketing, and 20 others that need to be there," he explained. "It's bringing them together in a cohesive forum where they feel like they have a voice to speak, where they can have a vote at the table … It requires large coordination across a large group of people."

3. Review the principles of shared governance: partnership, equity, accountability and ownership among staff. "You need to have different levels of ownership, of accountability, that span beyond being told what task to go do," he said. "That partnership mindset, that idea that each one of us at the table are equally — maybe not equitably for the amount of responsibly — but equally sharing in the responsibility of the outcome is important, so that each of us can take pride in the measures of success."

4. Track success differently for each team, even when contributing to a single project. Here are a few ways to measure success for different areas of the hospital, according to Mr. Roeseler:

  • Clinical: improving outcomes and reducing variances
  • Financial: achieving operational and financial efficiencies
  • Infrastructure: optimizing capabilities and efficiencies
  • Resources: increasing retention and employee satisfaction

"Each individual that has an area of responsibility has a different measure of success," he said. "Each role has to understand what they have accountability for and what they're responsible for."

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