title: Beyond shared governance: restructuring care delivery for self-managing work teams.
abstract: 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.
authors.forename: M J
authors.initials: MJ
authors.lastname: Perley
authors.forename: A
authors.initials: A
authors.lastname: Raab
mesh_terms: D003659:Decision Making, Organizational; D006754:Hospital Restructuring / Q000458:organization & administration*; D006801:Humans; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration*; D017749:Total Quality Management / Q000458:organization & administration