The American Hospital Association (AHA), American Organization for Nursing Leadership (AONL, then AONE) and AHA Physician Alliance joined with the American Association for Physician Leadership (AAPL) to bring together chief medical and nursing officers to identify effective approaches for collaborative executive leadership in complex systems; develop a shared understanding and common language for clinical leadership and decision-making to be used by other executives; share partnering challenges and peer-to-peer approaches to those challenges; and identify the resources needed to support ongoing efforts for collaborative leadership and executive development.
After a discussion with chief medical officers and chief nursing officers, it was clear that these teams’ efficacy came not from a perfect blend of titles or tenure, but the collaborative relationships forged from shared commitment – finding better outcomes for their patients, families and hospitals. A common theme emerged: On the surface, it was as simple as hand washing, but at its core, it was as complex as the Medicare code. The work of building a successful dyad requires true partnership.
Some dyads began with symbolic-yet-simple logistics such as placing offices side by side. Others made the leadership roles interchangeable with both parties addressing clinical issues involving nursing or medical staff – sometimes both. The work of sustaining a successful dyad required leadership and communication, trust, mutual respect and a deep belief that each member “has the other’s back.” One thing all had in common: a shared vision and clear goals to help staff teams see the partnership in words and actions.
While each organization took a different path to develop this dyad-leadership model, all used three key questions as the base of all decisions:
- Does it help the patients?
- Does it help our team?
- Does it move our organization forward?
Each team maintained individual roles as CNOs and CMOs yet were able to move their organization beyond silo management often found in health care. Best practices include joint strategy planning, speaking with one voice by co-presenting and co-rounding, shared accountability, emphasizing dyad language, and getting to know one another as friends as well as colleagues.