A 2018 report published by the American Hospital Association argued that clinical partnering between physicians and nurses can help undo professional silos and power dynamics that get in the way of effective collaboration.
“Historically, we’ve been operating in silos, with medicine and one side and hospitals and nursing on one side with no alignment in making progress on quality and safety,” said Mo Kasti, CEO and founder of CTI Leadership, which helps train physician leaders.
“If (a dyad) is done right, it has many positive outcomes because there is better engagement, a feeling their voices are heard and that they are co-creating a business together.”
Leaders interviewed by the AHA about their CMO-CNO dyads claimed it had a “positive impact” on achieving goals, including excellence in patient care, increased performance metrics and staff engagement.
Leaders also cited better decision-making, higher job satisfaction, and an ability to implement changes more quickly.
For example, BSWH had to “completely rebuild” the employee health command center in response to the COVID-19 pandemic. “If we hadn’t taken that process by the reins as system leaders, each entity would have had to create their own employee health outreach and testing protocols, and we had 46,000-plus employees we had to protect,” Walker said.
Less than 1% of staff caring for COVID patients tested positive for the virus, according to BSWH.
Bringing in a CNO ensures nurses are always at the table for decisions that impact themselves and patients and it helps establish better collaboration and communication between nurses and physicians, who have had a historically tense relationship.
“The whole system realized these guys are working so closely and they’re understanding each other. When Janice is speaking, everyone knows she’s speaking on my behalf and vice versa,” Arroliga said. “When both of us are working together, the product we generate at the end is going to be better than what I would have generated by myself.”
It sends an important message to front-line workers that “in order to take care of a patient, you need a team—and the product is going to be better,” Arroliga added.
“We’re trying to make sure the front lines understand we need each other in order to create something better for our patients,” Walker said.