Shared governance and shared leadership: meeting the challenges of implementation.

New forms of leadership are required if staff are to be effectively engaged and involved in decision-making and promoting clinical effectiveness. One such mechanism is shared governance and shared leadership to ensure practice is both practitioner owned and organizationally supported. Empowering staff is a great challenge requiring effective planning, preparation and commitment. Establishing the process of shared governance requires effective leadership, implementation of a suitable framework, multidisciplinary working and examination of the organization's structure and culture. This paper discusses the challenges of implementation, preparation of staff, and alignment with the organizational agenda. It emphasizes that shared governance is an ongoing and fluid process, requiring continual assessment and re-evaluation in order to be flexible and responsive to an ever-changing environment. The Christie model provides a sustainable framework for moving practice forward and successful implementation has led to greater coordination of practice development and sharing of best practice.