In the spirit of continued dialogue, we challenge Tim Porter-O'Grady's response 1 to our recent article, The Value of Collaborative Governance/Staff Empowerment, 2 in particular that shared governance cannot be researched or its impact measured. Our article clearly illustrated that Massachusetts General Hospital's (MGH) collaborative governance structure is influencing staffs' sense of empowerment. Committee members' empowerment scores were significantly higher after one and two years compared to baseline, and committee members scored significantly higher than did nonmembers.
Empowerment is only one outcome of our collaborative governance structure. Structures always have products...products can be evaluated. We've seen the positive effects of collaborative governance beyond empowerment in areas such as increased systems learning; organizational connections; enhanced personal autonomy; control over practice; accountability; responsibility and authority to make and carry out decisions; advancement to leadership roles within the organization; increased communication between and among collaborative governance members and other groups; and an increase in the number of publications and papers presented at national and international meetings-to name a few.
Porter-O'Grady argues that, "shared governance really has no substance, does not stand alone, and does not represent an exacting or definable set of characteristics upon which any particular or disciplined research can be based."1 As a structure in and of itself, that may be true. But, collaborative governance at MGH is more than an isolated structure-it is one of nine elements within a model of professional practice. It is integrated into the MGH organization and can be evaluated as an independent element within a larger whole. We feel strongly that the impact of collaborative governance can be measured and is worth studying. We encourage the JONA readership to learn more about the tremendous and measurable impact collaborative decision making can have on professional development and quality patient care.
Jeanette Ives Erickson, MS, RN
Dorothy E. Jones, PhD, RN, FAAN
Marianne Ditomassi, MSN, MBA, RN
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