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Dyad Leadership Model Improves Communication, Cooperation

 |  By Jennifer Thew RN  
   April 07, 2015

To better adapt to changes in the healthcare industry, Lakewood Health System adopted a dyad leadership structure pairing administrative and clinical leaders.


Teresa Fisher, RN, MA, BSN

If you think farm fields, cows, red barns, and silos are synonymous with the Midwest, a conversation with Teresa Fisher, RN, MA, BSN, will change your mind. Since joining Lakewood Health System in Staples, MN, a year ago, Fisher has been committed to getting rid of silos—the organizational kind, that is—through use of a dyad leadership structure.

A siloed organizational structure—defined in this case as clinical leaders heading up clinical operations—"works very well in traditional healthcare models, but it does not work when you're trying to move as a system and be system-thinking," says Fisher, COO/CNO at Lakewood, a small, independent health system comprising a 25-bed critical access hospital and five clinics.

To be successful in today's fast-changing healthcare landscape, healthcare organizations must embrace a culture of cooperation and move away the insular and narrow perspective that silos foster.

"You can't do it on your own," she says of tackling the challenges presented by healthcare reform, changing payer expectations, and new quality requirements.

Instead, an organization's executive leaders, physician partners, and other stakeholders must follow a unified vision and strategic plan. The dyad leadership structure, which pairs an administrative leader with a clinical leader, can help facilitate the partnership and cooperation needed to achieve shared goals.

A modest proposal: moving to the dyad structure

Before coming to Lakewood in March 2014, Fisher worked at Centura Health in Denver where a dyad leadership structure had been in place for three to five years. She had seen how this leadership model could help an organization adapt to the cascade of changes brought on, in part, by healthcare reform, and she thought Lakewood could benefit from implementing a similar leadership structure.

"The dyad model really allows that administrative team, along with the physician team, to be equally represented in decision-making," she says.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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