Two leadership models—“operations” and “dyad.” The operations model is the traditional and most effective model of leadership. The management structure on a team of supervisors, managers, and directors working together under the leadership of a vice president to coordinate and implement organizational initiatives. In essence, the supervisor reports to and is evaluated by their manager; the manager reports to and is evaluated by the director or vice president, and so on. In most business settings the preferred model is an operational one—a pyramid structure with clear lines of authority and accountability. This structure is efficient and straightforward. Authority increases as one moves upward and falls ultimately on one shoulders. The strength of this structure is the clear lines of accountability—the supervisor reports to the manager who both directs staff and evaluates success. Health care, however: has unique differences and a new model, the dyad model, has taken root (Baldwin, Dimunation, & Alexander, 2011). The definition of “dyad model” varies across health care organizations. In most health care systems the operations model remains intact the vice presidents are partnered with physician champions, who provided support for their recommendations. The dyad model provides physician engagement to build that trust. It opens communication between physician-nurse and physician-administration in a powerful way.
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