Structural empowerment

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 taskforces, 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.

Recognition program gives voice to nurses systemwide

Nurses across the organization collaborated to create a recognition program based in “gratitude science” that focuses on the implementation of meaningful recognition activities. All internal nursing awards programs have been transitioned to selection by peer reviewers, giving all nurses a voice in the recognition process.

An author recognition program celebrates the success of nurses who publish their work, and new awards and engagement opportunities continue to be added frequently. One example is the introduction of the DAISY Educator Award, presented during the annual May Smith Nursing Excellence Awards, celebrating our nurse educators’ mentorship.

Additionally, nurses are now highly engaged in planning celebratory events. The Nursing Professional Development Council planned and executed Nursing Excellence Fairs on both campuses during Pediatric Nurses’ Week in celebration of the pediatric nursing specialty. On both campuses, the Night Shift Forum planned and hosted Glow with Flo events (named after nursing pioneer Florence Nightingale) as part of Nurses’ Month on the night shift. Recognizing the professional commitment of nurses who have achieved nursing professional board certification, nurses now display their status as a “Certified Nurse” with an ID badge hangtag, boosting recognition of this professional milestone and fostering awareness of the accomplishment and enhanced skill. Additionally, nurses who have graduated with advanced degrees were formally recognized at a graduation celebratory breakfast during Nurses’ Month.

Recognition of nursing engagement, development and professional growth helps foster our flourishing healthy work environment. Nurses are committed to helping the program grow.

In 2024:

• More than 40 of our nurses proudly walked the stage at the American Nurses Credentialing Center (ANCC) Magnet Conference, celebrating our fourth- consecutive Magnet designation – an honor we initially marked together in November 2023 but officially shared with more than 14,000 nurses from across the nation in October 2024.
• Vice President of Nursing Excellence Brennan Lewis, DNP, APRN, NEA-BC, PCNS-BC, accepted the Prism Award at the American Organization for Nursing Leadership (AONL) Inspiring Leaders conference. The Prism Award recognizes an organization exhibiting leadership in advancing diversity and inclusion within the nursing profession, health care organization or community.
• In ceremonies on Sept. 5, the Dallas Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU) received their Silver Beacon plaques from the American Association of Critical-Care Nurses (AACN). Beacon honors high-quality patient care in a healthy work environment. Children’s Health is the only pediatric health care organization in North Texas to earn two Beacon Awards.
• Since 1980, Penny Williams, MS, BSN, RN, Senior Director, Care Continuum, enhanced care and mentored nurses throughout Children’s Health. Her colleagues honored her with a celebration and a DAISY Lifetime Achievement Award as she prepared for retirement.
• A tireless, compassionate advocate for patients and families, Susan Lepkowski, BSN, RN, received the DAISY Lifetime Achievement Award at her May 30 retirement celebration after 41 years at Children’s Health.
• Thao Vu, MPH, BSN, RN, CPN, received the DAISY Educator Award. She was recognized for launching CPN study circles across the organization, inspiring multiple nurses to become CPN Champions.
• Robin Bragg, Patient Care Technician on the Dallas Clinical Resource Team and Fiona Kennedy, Patient Care Technician from the Plano ED, were awarded the first-ever Recognizing Achievement and Dedication in Assistance of Nursing Care and Excellence (RADIANCE) Awards. The RADIANCE Award recognizes the commitment of unlicensed staff to providing excellent patient care. This award recognizes individuals who demonstrate outstanding dedication, compassion and professionalism in their role.
• The Transition to Practice Team won the “You Belong Award: Diversity, Equity & Inclusion in Action” from the Pediatric Nursing Certification Board. This award recognizes a pediatric-focused team that has implemented strategies to address barriers for nurses who identify with an ethnic or culturally diverse background, racial diversity, gender diversity, disability or who are otherwise a member of a historically marginalized community within the pediatric specialty.

See a full list of awards and recognition.