When the success of leading organizational change is predicated upon healthy connection and communication between clinical and non-clinical teams, dyadic relationships become essential for advancing effective collaboration. Tom Tull, Vice President and Chief Experience Officer at Ballad Health, knows firsthand what this effort looks like as he has strategically incorporated coaching and development tips from the Clinician Experience Project in both his dyadic partnership and leadership initiatives.
Dr. Stephen Beeson, CEO and Founder of the Clinician Experience Project, spoke with Tom about how he’s created a mutually impactful dyadic relationship with his colleague, Jeff Merrill, MD, Lead Physician, The Clinician Experience Project at Ballad Health, and about what they’ve done together to form a culture that reflects and advances the core values of Ballad Health.
Vice President and Chief Experience Officer
Johnson City, TN
Dr. Beeson: Start by telling us a little bit about Ballad Health and your role.
Tom: Ballad Health is a newly created organization that formed approximately 18 months ago by the merger of two regional health systems. Prior to that, we spent about three and a half to four years planning for this new healthcare entity. As we put this new organization together, I was named Chief Experience Officer, and I get to impact the development of culture. I work with patient and family engagement, team member engagement and our physician engagement. I have had the good fortune of being part of one of the legacy organizations for more than 28 years. I know the culture, the people and the medical staff and how we’ve operated, where we had successes and where we had opportunities in which we wish we had taken a different approach.
Dr. Beeson: How does a communication in a healthy dyadic relationship—leading side by side—help you in terms of your partnership with physicians and fellow administrators or nurses and getting work done?
Tom: In our organization, we’re attempting to build teamwork through dyadic relationships. So, if you think how communication and teamwork make a difference in these relationships, it means that we share a common purpose. It means we don’t get stuck in our silos, but instead, we realize that everyone brings something different to the table.
And as our dyadic relationships evolve, close communication becomes critical—it’s everything from those formal meetings where we start to think about how we launch and share information and how we become a more effective dyad. Over time, those dyad partners can learn how to be accountable with one another—through routine phone calls, routine meetings, text messages, keeping your dyad partner in the loop or just running things past each other. And as we rally around a common purpose or shared vision, the dyads are going to communicate a little differently. The physician voice and administrative voice are both important and can help cast a unified, compelling voice to our teams. To make that voice impactful, we need to ensure those dyads understand their shared purpose as they move forward.
Dr. Beeson: How has the physician dyad relationship helped to improve both physician engagement and patient experience?
Tom: The dyadic relationship has enabled us to identify an opportunity or identify an issue and then collaborate on how we approach it. We’ve involved more individuals in the potential solutions or in the root cause analysis, rather than telling different departments to “just fix this.” The collaboration of a physician and administrative angle has raised our effectiveness and unified us as leaders.
Particularly in our case, we have a clinical council that’s formed with physicians represented from across the organization from each of our acute care facilities. It’s the first time we’ve attempted to pull such a group together. They have very specific goals with improving the clinical quality of healthcare in our organization.
One of our subcommittees is the patient, family and provider experience subcommittee. Dr. Jeff Merrill, my dyad partner, and I are both involved with other physicians on this committee as we identify activities to support all constituents. So, Jeff and I routinely talk to a combination of team members—physician groups or physician groups with nurses or nurses with administration—and use the united front to help folks understand this is not a, “I’ll take this, you take that” trade off, but rather, “together, we’ll solve whatever issue we need to solve.”
Dr. Beeson: There is a set of skills that make for a more collaborative, lower authority gradient dyad partnership that really gets good results together. How have you used skill building particularly from the Clinician Experience Project to help you become a better dyad partner yourself and for fellow leaders?
Tom: When Jeff and I started our journey together as dyadic partners, we decided what we needed to do was look at what was available in The Clinician Experience Project. So, the first thing we did in our dyadic partnership was to learn from the tip series that’s in the project and what makes for a successful partners and what are those attributes and actions. And I’m very blessed: Jeff is an incredible physician partner and an incredible learner. We routinely talk about the things that create an environment for successful dyadic partnerships.
Every Monday, we have a partnership conference call. We text and talk to each other throughout the week on various topics. We’re finding ourselves increasingly attending various meetings together. And we’re very overt about this. It’s because we want to model the dyadic partnership between administration and our clinician leaders, so we’ve been very intentional about leading in that way.
We also have a Physician Leadership Academy in which we take 30 physicians every 12 to 14 months, and they go through a yearlong learning journey together. We’ve integrated the Clinician Experience Project in this learning journey. Many times, we’ll start with the dyad tips or leading change tips inside the project because we want physicians to find an administrative dyad partner on their own, whether it’s formal or informal, and start the conversation.
When you can use a resource like the Clinician Experience Project to introduce the topic, it becomes a conversation about how you approach your work, as opposed to “let me tell you how to do it.”
Dr. Beeson: Describe your position in a dyadic-friendly culture vs. going it alone. What’s the difference?
Tom: What I’m getting from dyadic partnerships is easier buy-in from the practicing clinician side, because we are together presenting information and having conversations. You’re seeing another physician, not an administrator, carry some of the messaging. It allows us to have conversations about an issue and start to solve some issues collectively and collaboratively. So, for me, it’s much more enjoyable to have a simple conversation, instead of trying to do the tap dance to get around the resistance.
I think that dyadic relationships teach you greater empathy for people and an understanding of one another. We have been on a journey in which we’ve started to look at resilience, and the dyadic partnership enables you to humanize another group of folks within your organization, whether it’s nursing or physicians or respiratory therapists or whomever. It humanizes the other person because you’re in this together. We will know we’ll be successful if we’re successful together. Being empathetic to your colleague tends to aid in the resilience because you have someone with whom you can celebrate with, exchange ideas with, or just pick each other up.
Dr. Beeson: In what ways has growth mindset impacted different departments and teams supporting each other in their work as leaders and in dyads?
Tom: We elected to focus on growth mindset early in the process. As we continue to develop our new culture, it’s very easy to fall into the trap of “I don’t like change” or “I don’t want to change,” so I’m going to adopt this very closed mindset. That happens on the clinician side, and it happens on the administrative side. And so, one of the things that we’ve attempted to do is start to use the nomenclature of the tips we have been watching in the Clinician Experience Project so our teams begin to use a common language in their everyday conversation.
It’s a very covert way to put it out there, and people start launching the process and start to see it. We’ve actually loaded the Ballad Health values into our customized page, and when folks go to that page, there’s curriculum that’s linked to either Ballad Health values in general or to skills from the project, such as physician-nurse rounding. I’d like for them to realize that “Tom’s not trying to tell us how to practice,” but rather use the skills together to figure out how they can get the environment right, so it will be successful. My next step is to use the patient experience curriculum and start with physicians to lead the way.
Dr. Beeson: In the spirit of mentorship and reflecting on your experience, what type of tip would you recommend to those who have an emerging dyadic leadership commitment?
Tom: Understand that a dyadic relationship is an evolution. You’ll lay out some of the ground rules up front, but every dyadic relationship is going to evolve a little differently. And everyone’s going to need to reach a stride that works for them. Decide what your shared vision is and the common goals. Then you can determine which skills from the project would help you work effectively together and achieve your goals.
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