Tuesday, October 31, 2023

The Dyad Partnership and Coaching

We are pleased to share an article entitled  “The Dyad Partnership and Coaching”  written by Sara Kagarise, ACC &
Cory Colton, PCC, BCC

Dyad leadership models, which pair physician and administrative leaders, are critical in healthcare delivery, and essential to the achievement of a health system’s mission. The dyad relationship model taps into the unique skill set of each partner and supports the alignment of administrative and clinical responsibilities. Effective dyad partnerships result in synergistic, shared decision-making, aligned goals, consistent communication, and delivery of outstanding patient care.  Collaborative and balanced dyad relationships result in effective department functioning and interactions, whereby the system scorecard can be met while still improving patient outcomes and experience.

Dyad leadership addresses administrative and clinical needs, helping to foster higher levels of physician and administrative engagement and retention. Strong, interdependent dyad leadership helps to overcome challenges, remove barriers, and lead confidently in healthcare’s new frontier.

Self-Awareness and the Use of Coaching

Self-awareness for leaders is essentially “the extent to which a leader is aware of his or her strengths and limitations, how others perceive the leader, and the ways in which he or she makes an impact on others” (Bozer and Joo, 2015, p.39). Higher degrees of self-awareness leads to deeper understanding and utilization of strengths, clarity around gaps, and improved emotional intelligence. 

Focus is traditionally placed on the singular aspect of leadership development through coaching, meaning, if a single leader becomes more self-aware and increases their effectiveness, positive results can be experienced within that department.  With dyad coaching, results include two leaders with increased self-awareness, a deeper understanding of how to leverage each other’s strengths, acknowledgment of deficits, collaborative decision-making, spread of accountability among the team, and improved holistic understanding of department functioning along every step of a patient’s journey.  Dyad coaching results in authenticity, vulnerability, strength, and increased well-being for both partners and the teams they lead.

Considerations for Successful Dyad Coaching

How does your organization view coaching, as more developmental or correctional? A focus on coaching as developmental contributes to the endeavor’s success.

How is coaching viewed differently by administrative vs. physician leaders? Administrative leaders may have positive experiences coaching in the context of training and promotion; physicians often rise to leadership without the benefit of development and coaching. Additionally, physician training may create confusion between modes of mentoring, coaching, and advocacy.  

The coaching competencies of reflection and inquiry align with how physicians learn and helping both leaders to understand the technology of dyad coaching will reduce potential anxiety and ensure open lines of communication.

Coaching Approach

Carilion Clinic’s Institute for Leadership Effectiveness (ILE) recognized an opportunity to enhance dyad leadership development through the addition of focused individual and dyad coaching. The goal was to create a regenerative leadership outcome with improved well-being, self-awareness, and interdependent “community” functioning.  

This model has shown to be effective because partnering strong, collaborative, and authentic administrative and clinical leaders to focus on achieving a shared vision is a critical model for achieving a highly successful, truly integrated healthcare system. Dyad coaching helps leaders align personal and organizational values and goals to ensure that patient care remains the focus of everyone’s work, while promoting an understanding of how every action and interaction lifts or diminishes patient and team outcomes. 



The Carilion Clinic ILE model includes both a robust psychometric assessment, Prism® by SurePeople, and a “dyad health” assessment that examines individual contributions and perceptions of the dyad within five categories (see chart above). The pre-assessment is followed by eight coaching sessions over four months targeting the above assessment categories, in addition to four focus areas: Role Clarity and Expectations; Dyad Communication; Shared Decision Making; and Leading Change. All sessions are facilitated by an internal ICF accredited coach, and a physician coach to provide additional context to the physician leader.

Impact of Dyad Coaching

At the time of publication, Carilion Clinic has implemented this model with multiple dyad leadership teams. While each team presents unique challenges, common themes do emerge. Interestingly, most dyad leaders indicate confidence in their abilities to lead as a dyad; paradoxically, they are unclear as to exactly what the role entails. This finding reinforces the need to develop dyad leaders together with a focus on collaborative leadership. A coaching approach to dyad development helps to address the unique challenges of each dyad, while helping to create a consistent framework of joint leadership for the system.

Evaluation thus far indicates significant improvement in the ability to flex personality preferences to improve communication, make better decisions, create achievable shared goals, and maintain the focus on the patients and families.

Feedback from participants includes:

Physician Leader: “The dyad coaching helped improve communication between us. We were able to develop joint goals for the department that we can focus on and work towards.”

Administrative Leader: “Going through the dyad coaching program has assisted both leaders (clinical and administrative) to have a better understanding of collaboration in the respective areas…what areas of overlap exist and how they can be successfully addressed together. Each leader has key focal points but it’s good to think about the other leader’s perspective and responsibilities in the dyad. The coaching program has further helped improve that understanding and leadership in the section.”

Ensuring effective and cohesive delivery of care through a dyad leadership model can only be accomplished when both leaders increase self-awareness, and leverage individual and collaborative strengths. While structured learning can provide fundamental growth, the incorporation of coaching into dyad development provides the opportunity for the leaders to explore their individual motivations, preferences, reactions under pressure, leadership shadow, and to build trust and trustworthiness

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