Structural empowerment
Structural Empowerment demonstrates our commitment to a robust practice environment. It signifies there are structures and processes in place to support nurses to be the absolute best they can be. Nurses are active in professional organizations, are encouraged to develop professionally and have a voice in decisions that affect their work.
Children’s Health encourages nurses to be deeply engaged in their practice, starting with our nurse residency programs and extending to nurses who work beyond the bedside.
Our success in 2024 is demonstrated by:
The launch of Nursing Professional Governance, which empowers nurses with accountability, authority and autonomy over their practice.
A growing nurse residency program.
An increase in nursing certifications following nurse-led efforts focused on supporting and encouraging certification.
A robust recognition program.
Children’s Health nurses laid groundwork for Nursing Professional Governance launch
The Nursing Professional Governance (NPG) team at Children’s Health spearheaded a culture shift from shared governance to professional governance. The goal: empower nurses to own their practice.
A comprehensive analysis revealed five critical areas for improvement:
Aligning Core and Unit Practice Council (UPC) goals to strategic priorities
Enhancing nurses’ ownership in decision-making
Engaging clinical nurses in nurse-sensitive indicator data analysis and improvement
Increasing clinical nurse unit representation
Boosting leadership engagement
To address these gaps, the NPG team developed a new structure that supports clinical nurse and nurse leaders’ accountability, autonomy and authority in decision-making to achieve empirical outcomes. The NPG team also created training sessions – “training camps” – designed to shift the mindset of Children’s Health nurses and encourage their active participation in the new governance structure. More than 300 nurses were educated on professional governance.
Sessions focused on:
Ownership of quality, practice, competency and knowledge at all nursing levels
Differentiating between the roles of the nurse leader and clinical nurse in NPG
Leveraging the new NPG council structure in decision-making
Promoting a culture of professional nursing
Membership on the Core Councils and UPCs was restructured, ensuring all units had clinical nurse representation. The new structure also focused on including nurse leaders at varying levels and subject matter experts – like clinical nurse specialists and clinical educators – to serve as active council members. All council meetings were aligned on a singular day to strengthen the communication and collaboration of nursing processes and decision-making. A specialized data workshop was conducted to equip nurses with the skills to locate and utilize data effectively, establishing a foundation for evidence-based practice improvement work. Additionally, the team launched UPC evaluations and provided training on standardizing processes.
This comprehensive approach aims to create a collaborative, data-driven culture where nurses are fully empowered to lead and shape their practice.
New Nursing Professional Governance Council Day improves collaboration, engagement
Children’s Health launched a monthly Nursing Professional Governance (NPG) Council Day, providing nurses with dedicated time to focus on governance work apart from clinical duties. The initiative, backed by key leadership and stakeholders, ensures clinical nurses can actively participate in shaping their practice.
Each Council Day begins with a virtual General Session open to all nurses, not just those directly involved in governance councils. The session provides a time each month for nurses to connect with the Chief Nurse Executive, nurse leaders, clinical nurses and nurses beyond the bedside. Attendees hear about nursing updates, NPG council initiatives and upcoming professional development opportunities throughout the system. Since its debut, the General Session has drawn more than 350 nurses monthly.
The new structure fosters communication and collaboration among clinical nurses by strengthening unit, departmental and core councils while ensuring involvement of nurse leaders. All nursing roles – including inpatient, ambulatory, beyond the bedside and more – are represented in core councils, promoting an inclusive approach to professional governance. A new Coordinating Council was formed – made up of all governance chairs – with a purpose of providing a mechanism for the communication, integration and coordination of NPG. By offering dedicated time and enhancing engagement, Council Day has become a cornerstone of our efforts to empower nurses and improve nursing culture organization-wide.
Nursing Professional Governance principles empower nurses to own their practice
Children’s Health nurses have reached new milestones in professional governance, with significant improvements in practice ownership and engagement across the organization. For the first time, the Nursing Professional Governance (NPG) Coordinating Council assisted in finalizing the bylaws that were officially approved by the Quality, Credentials and Appointments Board in December, marking a pivotal step in standardizing and elevating nursing practice.
The adoption of NPG principles has led to measurable progress. Council membership has increased by 113%, with average attendance for members increasing by 65%. Councils have also created measurable goals to align with nursing strategic priorities. These changes have strengthened collaboration and fostered a culture of shared decision-making, bringing value to the nursing profession.
“Being a part of NPG has been a pivotal point in not only my career as a nurse, but also my overall experience at Children’s Health. I have found a place where my voice is not just heard; it matters and has impact. The new NPG structure has empowered me to own my practice and foster a deeper sense of collaboration and advocacy. I am so proud to be part of this incredible team.” – Diana Sarmiento, BSN, RN, CPN, Ambulatory Council Chair
“I have enjoyed being a part of Nursing Professional Governance and Unit Practice Council because it keeps me informed, engaged and able to help make positive changes on my unit. I love that NPG creates an environment for bedside staff and leaders to work together to form a culture of accountability, autonomy and authority in decision-making that helps develop staff and follows our mission of making life better for children.” – Maci Wilbanks, MSN, RN, CCRN, Critical Care Services Unit Practice Council Secretary
“When questions or concerns arise during our UPC meetings, I can provide answers or follow up with the members in real time. The team have all expressed feeling leadership’s support and commitment due to my new role on the UPC.” – Angela Stief, BSN, RN, Unit Practice Council Clinical Manager Liaison
“My experience with NPG has been rewarding. I have connected with some incredible people who are intelligent, driven and inspiring. Throughout my involvement across multiple councils, serving in various positions, I have seen and been a part of actual change. From brainstorming solutions to issues or barriers, creating task forces, looking at the research, implementing trials and rolling out practice changes, I am consistently motivated to make life better for children and nurses. Day in and day out, NPG influences me to be the solution.” – Courtney Kessler, BSN, RN, CPN, Quality Safety Council Chair
"Being involved in Nursing Professional Governance has opened my eyes to many different aspects of nursing. I have learned to invest in myself through certifications and seeking out opportunities to train in new areas. I discovered a passion for helping other nurses explore educational and organizational opportunities. I gained the courage to voice my ideas and learned there is support available to bring these ideas to completion. Lastly, I learned I do not have to wait until I am out of the Nurse Residency Program to do these things. – Kandiss Hayes, BSN, RN, CPEN, February 2024 Nurse Resident – Professional Development Council Member
Transition to Practice program leads the way in empowering Children’s Health nurses
The Children’s Health Nurse Residency Program achieved record growth and retention rates in 2024, thanks to initiatives designed to empower and engage graduate nurses (GNs). In July, the largest cohort in the organization’s history graduated, with 105 residents completing the program across both the Dallas and Plano campuses. With 93.8% of residents staying in our workforce, the cohort’s retention rate far exceeds the national benchmark of 71.3%.
Key drivers of success have been engagement strategies, including the Nursing Professional Governance (NPG) initiative for GNs. Historically, new nurses were not involved in governance until they gained experience. Now, leaders introduce NPG to GNs in the first six months of the program, and the cohort nominates peers to represent the group on core councils. Every core council includes at least one Children’s Health nurse resident from each cohort, ensuring the new nurses’ voices are represented. Approximately 8% of core council members are now residents, with 100% of those involved choosing to stay at Children’s Health after completing the program.
For residents needing extra support, Individual Learning Plans (ILPs) offer tailored, one-on-one guidance with transition-to-practice managers. Early results show promising outcomes in retention and performance. Additionally, a “residency rescue” algorithm helped identify nurses at highest risk of leaving, with 66% completing the program and retained to the organization. Collaboration with clinical leadership, clinical educators, preceptor coaches and preceptors were instrumental to success.
The RN Fellowship restructured this year and increased enrollment by 100%. The fellowship is a six-month program designed to equip experienced nurses with skills to support their transition to pediatric care. Early program outcomes show a 26% boost in one-year retention.
Finally, by preparing for changes in nursing licensure examination requirements and academic criteria, the organization continues to lead in supporting graduate nurses.
Nurse-led initiatives boost certification rate
Children’s Health reported an almost 7 percentage point increase in the number of certified nurses this year, driven by a series of nurse-led initiatives aimed at supporting and encouraging certification.
At the start of 2024, nurse leaders from Nursing Excellence and Clinical Talent Advancement established a certification champion group comprising 32 certified nurses who mentored 74 peers actively pursuing certification. The group offers personalized guidance to help nurses navigate the certification process.
In March, Children’s Health celebrated Certified Nurses Day, recognizing nurses who achieved certification. During the event, Chief Nurse Executive Tammy Webb highlighted certification’s value in validating nursing expertise, enhancing patient care and advancing nursing careers. Nurse leaders also organized a certification fair, where certified nurses shared insights and recruited interested colleagues.
Another successful nurse-led initiative included organized study circles and review sessions that provided nurses with resources and tips to prepare for testing. Study circles and review sessions included support for certifications, including:
Critical care
Pediatric nursing
Nurse executive leadership
Nursing professional development
Neonatal nursing
Pediatric oncology nursing
To boost engagement, a certification roadmap competition launched in the fall, motivating nurses to work in teams and earn points for certification progress. The quarterly competition will continue in 2025.
These efforts reflect enhanced collaboration among clinical nurses and nurse leaders to foster professional growth and elevate care quality.
