Beyond shared governance: restructuring care delivery for self-managing work teams

Nurs Adm Q. Fall 1994;19(1):12-20. doi: 10.1097/00006216-199401910-00005.


Shared governance organizations have been highly successful in empowering nurses for professional practice. They have been more uneven in their effectiveness for solving day-to-day operational problems, however. This article discusses limitations of the traditional approaches and describes a process to develop self-managing teams through patient care redesign. Milestones in the evolution of self-managing teams are illustrated through a description of experiences at Presbyterian Hospital of Dallas over the past five years. Practical suggestions for the transition to self-managing work teams are outlined.

MeSH terms

  • Decision Making, Organizational*
  • Hospital Restructuring / organization & administration*
  • Humans
  • Nursing Staff, Hospital / organization & administration*
  • Patient Care Team / organization & administration*
  • Total Quality Management / organization & administration