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Research has shown that nurses who participate in shared decision making (SDM) have more control over their practice and greater job satisfaction, and hospitals that have instituted SDM have lower rates of nurse turnover and better patient outcomes. The purpose of this article is to describe the implementation of an SDM structure at a pediatric hospital. The hospital's chief nurse officer charged a group of nurses with developing SDM guidelines to outline the purpose, structure, and function of unit councils. A targeted, multifaceted approach to the implementation of these guidelines led to the successful standardization of nine existing unit councils and the expansion of the SDM unit council structure to all other hospital units. Work continues with guideline refinement in response to the real-life circumstances nurses encounter on the units, and the original group of nurses continues to review literature on SDM best practices. In addition, professions other than nursing, including multidisciplinary teams in dialysis, cardiovascular surgery, respiratory therapy, and child life, have adopted the guidelines for use in their departments.

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