Nurses at the Clinical Center are active participants in the development and management of clinical practice through a proactive Nursing Shared Governance structure that has been in place since the mid 1990's. The shared decision-making model, initiated in 1994, remains vibrant and strong under the guidance of the Chief Nurse and with support of clinical research nurses. The Shared Governance structure provides forum for nurses in a variety of roles to critically review nursing clinical practice against regulatory community standards and performance improvement data. Shared governance facilitates opportunities for clinical nurses to continually improve practice while developing leadership skills.