Cardiovascular Rounds

Leverage your governance structure to engage physicians in AMC leadership

By Andrew Hresko

Having robust physician leadership is a hallmark of academic medical centers (AMCs). At many times, physician involvement in administrative decisions is a definitive strength for academic medicine; at others, the difficulty of coordinating between multiple highly-respected academic department leaders can be a significant struggle. This challenge is exacerbated in CV services, where as many as five academic departments may have influence.

One solution to this problem is to instill an effective, inclusive, and collaborative governance structure for the CV service line. A governance structure encompasses the committees through which leaders develop initiatives to advance the service line, being comprised of, at minimum, an executive committee to set the service line strategy and an operations committee to implement it.

Easier said than done?  Below, learn how Wake Forest Baptist Medical Center, in Winston-Salem, NC, implemented an innovative strategy for its governance structure to engage physicians in collaborative service line leadership.

Executive council bridges academic silos

Wake Forest is in the midst of transitioning its clinical services from a traditional academic department structure to an integrated service line model including cardiac, vascular, and CT surgery. Realizing the potential benefits of a multidisciplinary structure to support strategic decisions and bridge siloes across the former department model, the physician and administrator dyad leading the service line proposed a new Heart and Vascular Executive Council.

In addition to CV administrative and physician leaders, they also invited key leaders from departments outside the service line, such as the chairs of internal medicine, IR, radiology, and surgery departments. Including these leaders has helped ease the transition to the service line model, as traditional academic department leaders still are engaged in decision-making.

Related: University of Vermont Medical Center’s path to savings

Defined relationships among key governing bodies

Wake Forest was also strategic in designing the structure of the additional committees that support the Executive Council. Instead of creating a sprawling structure of committees, the service line leaders limited the governance structure to a Quality Committee and unit-specific operational committees.

The executive council, which reports to the physician and administrator service line leaders, communicates strategic priorities to the Quality Council, which in turn designs improvement initiatives to address these priorities. In each unit, the operational committee is responsible for executing the initiatives set by the Quality Council.

As a result of this structure, Wake Forest is able to make and execute strategic decisions in a timely manner, with multidisciplinary input from both administrative and physician leaders.

Looking for more information on addressing AMC challenges?

Curious to learn more about how AMCs are tackling challenges around service line structure, coordinating between physician leaders, and expanding networks? Register now for our webconference on Feb. 10, 2015, the "National Meeting Round-Up for AMCs."

In the webconference, we’ll explore our most engaging and relevant research for academic medical centers from our current national meeting series, including AMC-specific benchmarks and profiles from innovative programs.