When it comes to executive leadership, our system is a firm believer that gaining a different perspective can provide the advantage needed to successfully steer an organization through any amount of change. Sometimes we all need another mind, another set of hands, eyes or ears, to identify the appropriate solution.
That's one goal behind Ascension Healthcare's move to the “dyad” leadership model, which brings together medical and operational experts to make patient care the best it can possibly be.
The idea is that two-person leadership teams—a clinical professional such as a nurse or physician, paired with an executive or administrative leader—will make better decisions together than they would separately. The two have equal responsibility, with each bringing a unique perspective to every decision and action.
As a part of Ascension, the nation's largest not-for-profit health system, St. Thomas Health recently recruited neurologist Dr. Greg James as our chief clinical officer and Paul Cleckner as our chief operating officer to align our clinical services with the strategy and operations of the health system. While the primary role of chief medical officers is to engage medical staff at their facilities, our chief clinical officer is paired with the COO to manage overall strategies and operations of our entire system. The dyad model respects that operational and clinical strategies are not independent of one another, which results in “medical thinking” inserted into the way we run our operations, and vice versa. This alignment of operations and clinical services is key to our clinically integrated system of care.
Traditionally, physicians and nurses have had primary responsibility for directing all aspects of day-to-day patient care, with executives and administrators overseeing operational and longer-term strategic planning for a hospital or health system. While the two disciplines certainly have communicated and worked together, lines of responsibility and authority were distinct, each group operating within its own silo. In addition to creating obstacles to coordination, these silos often obscured the strategy and thought process behind decisions, leading to an environment in which one group might never know what the other was thinking or why they were making changes.
Today, however, we have entered a new era in healthcare—the result of sweeping changes in the field over the past decade. St. Thomas Health and all of Ascension are moving to a more integrated care-delivery system focused on prevention and early detection as well as treatment.
Notably, hospitals and health systems now are moving to being paid by the value they provide patient populations—not just by the volume of services they provide—meaning more than ever before we must have more clinical leaders at the table to ensure that every decision we make supports our commitment to compassionate, personalized care.
That means striving to keep patients healthy and out of the hospital rather than basing most of our services there, as we've done in the past. Alignment of our clinical services and medical staff relationships with our strategic and operational priorities is vital as we establish of the type of clinically integrated system of care that those we serve both expect and deserve.
The dyad approach has expanded throughout St. Thomas, reaching the leadership of physician practices, clinical service lines and more. Strong medical and operational alignment supports our goal to deliver exceptional health outcomes, an exceptional experience for the people we serve, and an exceptional experience for our providers, at an affordable cost.
Ascension is working to bring together the best in clinical thinking with the best in executive thinking, for the best in patient care. More healthcare systems will need to move to this model as part of the changes in the national landscape. After all, integration of clinical and operational leadership perspectives is imperative to success in a healthcare setting. We believe this is the right approach to break down silos and deliver what our patients need most—compassionate, individualized care for all, with special attention to people living in poverty and those most vulnerable.
