Beyond the Page Podcast ~ Revolutionizing Leadership Structures: Harnessing Dyad Partnerships and Coaching in Healthcare

Get ready to revolutionize the way you perceive leadership structures with Sara Kagarise and Cory Colton. The authors of the article, "The Strength of Two: The Dyad Partnership and Coaching," are here to unravel the intriguing concept of dyad partnerships in healthcare. Prepare to be engrossed as we discuss the power of nurturing meaningful dialogues between clinical and administrative leaders, how such partnerships spur successful outcomes, and the various challenges and triumphs associated with implementing this structure.

Sara Kagarise is an Industrial and Organizational Psychology Practitioner and serves as a Senior Leadership Consultant and Coach for Carilion Clinic’s Institute for Leadership Effectiveness. Sara holds credentials as a Professional Certified Coach through the International Coaching Federation, a Project Management Professional through Project Management International, and a certified ROI Professional through the ROI Institute.

Cory Colton, Senior Director of Carilion Clinic’s Institute for Leadership Effectiveness, is passionate about helping leaders and teams excel with joy, energy, and authenticity. Cory has over 20 years of experience in organizational learning and leadership development across multiple industries: hospitality, financial services, telecommunications, automotive, and healthcare.

How about a leadership structure that goes beyond traditional roles and responsibilities, promoting a culture of wisdom and gratitude? Sara and Cory delve into the challenges linked to setting up a dyad structure, encompassing vital aspects like fostering communication, building trust, and striking the right balance of power. They also spotlight the potential benefits of dyad leadership and coaching, including increased collaboration, improved decision-making, and better outcomes. This episode is a must-listen for anyone keen on understanding the intricacies of dyad leadership in healthcare and beyond. Join us on this enlightening journey!

Watch the full interview by clicking here

Find the full article here: https://bit.ly/BTP1SKCC

Grab your free issue of choice Magazine here - https://choice-online.com/
 
In this episode, I talk with Sara Kagarise and Cory Colton about their article published in our September 2023 issue.

Transcript

Garry Schleifer: 0:08

Welcome to the choice Magazine podcast, Beyond the Page. choice, the magazine of professional coaching, is your go-to source for expert insights and in-depth features from the world of professional coaching. I'm your host, Garry Schleifer, and I'm thrilled to have you join us today. In each episode, we go, like we say, beyond the page of articles published in choice Magazine and dive deeper in some of the most recent and relevant topics impacting the world of professional coaching, exploring the content, interviewing the talented minds behind the articles and these, if the screen shows, I've got one on each side and uncovering the stories that make an impact.

Garry Schleifer: 0:47

choice is more than a magazine. For over 20 years, we've built a community of like-minded people who create, use and share coaching tools, tips and techniques to add value to their businesses and, of course, make a difference with their clients. That's what we're all in it for, right. In today's episode, I'm speaking with Sara Kagarise and Cory Colton, who are the authors of an article in our latest issue and for those of you who are watching, I got mine, Humanizing Healthcare Courageous Coaching at a Crossroads. Lots of C's in that one, just like in Cory Colton. The article is entitled The Strength of Two the Dyad Partnership and Coaching. It can be found on page 34. I want to tell you a little bit about our authors today.

Garry Schleifer: 1:32

Sara Kagarise is an Industrial and Organizational Psychology Practitioner and serves as a Senior Leadership Consultant and Coach for Carilion Clinics Institute for Leadership Effectiveness. In her role, Sara creates and facilitates leadership development programming and coaches senior and executive leaders to leverage their most authentic and effective self, as we all do. Sara's recent focus has been on creating sustainability and well-being within Dyad leadership teams, as well as creating sound measurement processes to showcase the organizational impact of coaching. She has a goal to improve the work environment for an organization's most important asset. Any guesses? it's human capital. Sara holds credentials as a professional certified coach, the International Coaching Federation. Welcome to the club. A Project Manager Professional through Project Management International and this one I love, by the way Sara, Certified ROI Professional through the ROI Institute. No one's going to argue with your results. She holds a BS in health science and health administration from Old Dominion University and an MA degree in industrial organizational psychology from Adler University. It's interesting to have Adler Coaching School here in Toronto.

Garry Schleifer: 2:51

Our other author, Cory Colton, Senior Director of Carilion Clinics Institute for Leadership Effectiveness, is passionate about helping leaders and teams excel with joy, energy and authenticity. He believes that we should help leaders leverage their best qualities and the leadership development is not a moment in time experience but a continuous process of learning and expansion. You will love to hear my close out on this podcast, Cory. Cory has over 20 years experience in organizational learning and leadership development across multiple industries: hospitality, financial services, telecommunications, automotive and healthcare. We've been on the same path, I don't know.

Garry Schleifer: 3:30

Previously, Cory was executive director of learning and development for Vanderbilt Medical Center and director of learning operations for Cox Enterprises. Cory is also a professional certified coach, welcome to the club through the International Coaching Federation and also board certified coach through the Center for Credentialing and Education at Carilion. Cory leads a team focused on individual development programs for administrative and position leaders, dyad development, individual leader and group coaching, leaders coach programs, mentoring and nurse leader development. And in his spare time he sleeps. Thank you both for joining me today. I could say the same about both of you, wow. Well, I don't even need to ask the question why did you write this article? But what brought the two of you together to decide to write this article for this issue and welcome?

Sara Kagarise : 4:24

Thank you.

Cory Colton: 4:26

Thank you. I've been coaching out for a while, and so has Sara, and when we heard that there was going to be a health care edition of choice, we felt like we had something to say in the dyad development and coaching space, that we figured that other people might not have the experience to write. I think Carilion is ahead in a few places and dyad development is probably one of those, and I'll let Sara answer to because she might have a different perspective.

Sara Kagarise : 4:59

Yeah, you know, absolutely I agree with that, and I think for us we had an opportunity, sort of through COVID, to restructure our dyad program a little bit. We needed to tweak it in a couple of areas, and so the two of us worked very closely on doing that, and so we felt it was a perfect opportunity to showcase some of that.

Garry Schleifer: 5:21

Okay, and I'll be honest, until you guys presented this article, I had no idea what a dyad relationship was in this. In this context, Is this common amongst health care?

Sara Kagarise : 5:37

It is common amongst healthcare. However, even being in health care my entire career, so we're spanning on, you know, almost 20 years, it wasn't a language that I was incredibly familiar with. So I think the wording is understood, but what it actually entails is not.

Garry Schleifer: 5:55

I think that brings me to a really good point, because I'm reading the article and it's like okay, well, one of the two of you explained how it actually works. Like I get the outcome, I get the reasoning very clear in your article, like amazing, how does it actually work? Who's in the room?

Sara Kagarise : 6:12

Yeah. So in terms of the leadership structure itself, it's, it's really it's. I think people have this understanding that there's a clinical leader and they're sort of off doing their thing, and there's an administrative leader and they're off doing their thing. So what you end up having is still siloed leadership over one department. So what we're trying to do is bridge that gap and say, yes, there are clinical responsibilities for you and their administrative responsibilities for you, but there's a lot of crossover. So if there's things are actually happening together, leading in your silos isn't doing your department any favor. So it's really about getting those two individuals together to have more meaningful and impactful conversations on how they're leading.

Cory Colton: 6:56

And if we're talking to people who are not familiar with healthcare, when we talk about a department, we're talking about things like orthopedics or practices around family and community medicine, or departments in an inpatient hospital like rehab and physical medicine. So generally we have, like Sara said, a clinical leader over it for the physician side of it and administrative leader over for the. How are we doing, how's our throughput, what money are we making, what equipment do we need? Those kinds of things and, like Sara said, when there's not dyad leadership, the same people could be getting multiple messages and wondering how they're going to move forward.

Garry Schleifer: 7:40

And and when does the coach come in?

Sara Kagarise : 7:45

Well, we started because dyads have been around for career and for about a decade or so but there wasn't a real structure to them. We sort of started going in just these one off conversations we would, we were building the reputation for the Institute for Leadership Effectiveness and so we were getting some request and we would go into dyad leadership teams that were requesting our services, which sort of started to trickle in. We were doing just a couple of those a year and then we started to incorporate dyad development in our onboarding process. I think with coven we saw, like many organizations, some turnover which provided some opportunity for us. So now we include dyad development as part of that onboarding process for anyone who's in a dyad relationship.

Garry Schleifer: 8:31

It sounds a lot like a buddy system. it's like you know you're you're an expert in your area. But we can't coexist in isolation. We need to talk to each other and support each other, because when I got that, when you said the word onboarding, I'm thinking you're matching up with somebody right away from the get go that correct.

Cory Colton: 8:55

Yeah, we hope that it turns into a buddy system, without awareness sometimes it doesn't start that way, so you may have decisions made on the clinical side and then the staff get told they need to carry this out, but the administrative leader that leads that staff was not potentially in that process, or vice versa. So we want it to be a buddy system where people are doing shared leadership, shared decision making, shared change management.

Garry Schleifer: 9:24

What are the biggest impacts? You see ROI. I'm going to point to Sara.

Sara Kagarise : 9:32

Yeah, a lot of it's. At this point, we've done a lot of qualitative research into the impact of some of this. But what I tend to see in this work is these leaders have never sat down to have strategic conversations. It's been very much I'm clinical side here's my scorecard items or I'm administrative here's my financial responsibilities but there were never times where they were coming together to say how can we help each other meet these things that were ultimately responsible and accountable for? So there's been a lot of changes in how these leaders are leading the people underneath of them, how they are communicating with each other so they're able to more collectively and collaboratively meet goals and support each other in meeting the goals that they have under their direct responsibility. There, I think, teams are, in general, communicating more effectively. So staff with clinicians, even outside of those direct leadership roles, are not feeling quite as siloed as they had before, where they sort of I have this one leader I'm going to go to for these things and that's it. It seems like it's a much more collaborative environment.

Cory Colton: 10:44

Yeah, I might also add that and we're doing some analysis now because we just got through our recent engagement survey but we are believing that we're seeing an improvement in retention for those departments and an improvement in the engagement scores. So Sara's actively working with our workforce intelligence folks to validate that workforce intelligence.

Garry Schleifer: 11:11

The spies, the engagement spies. Yes, all good. Sorry, Sara.

Sara Kagarise : 11:17

No, it's fine, it's just perfectly that. Yeah, early on we did see in a couple of the teams we had gone in they had compared to other departments of similar size and structure they had higher engagement scores after going through the program.

Garry Schleifer: 11:30

So that's great, that's great. So then then begs the question so you're talking let's just say C-suite, for lack of a better term but the leader, leadership. How far down does the Dyad System, you call this system operate?

Sara Kagarise : 11:47

Yeah, it can go down all the way through the ranks of leadership. So our focus has really been at that director level and then at the chair level. But we have also had some conversations with leaders looking at even unit director level, so working it down even further. So it's really just about the structure that you have in place to make it happen. And where does it make the most sense to have, if our two leaders actually needing to have those types of conversations and that structure to make things work, how much responsibility do they individually have? And then what does it look like collectively?

Cory Colton: 12:27

Yeah, and I would say our team, including me as a team of six, right and so when we talk about working with dyads for development and coaching, which is when working with individual dyads it's quite a heavy lift from an hour's perspective for them and for us. We're looking at ways we can scale this into a workshop format for next calendar year. But we try and focus on dyads where there is significant impact to patient outcomes or quality or revenue or engagement and retention. So probably more impactful for us to work with a dyad pair where there's a large span of control and a lot of need to improve outcomes, rather than working with a dyad in a small department where there might be five staff members and a couple of doctors.

Garry Schleifer: 13:22

Right, yeah, so we don't take dyad literally like two, one on one, like two people it can be dyad, as in a group of let's say that example of seven people can work as a dyad to work together on issues related to both clinical and administrative.

Sara Kagarise : 13:44

So we have been working from the literal sense of dyad and we have triads. So what we've seen recently is when we think about expanding some of these departments we'll have maybe in the one instance we have one clinical leader over a very large clinical department and two administrative leaders. So the three of them are functioning as a triad. In other cases we try to leave it at that dyad level, to make it thinking about their roles and responsibilities, to make it as equal as possible across the board. So we wouldn't want to pair someone who has very expansive responsibilities with someone who maybe doesn't have that same sort of control or authority over certain things. But as a group together there is a larger group. So if you say a department in medicine, you could have five or six dyad or triad pairs within a department.

Cory Colton: 14:37

Yeah, we, literally we do work with the two. We start there to establish the leadership foundation before we then move in potentially to work with the teams beneath them who may have experienced chaos, misfiring, maybe even trauma, and so we work with the dyad leadership and then we may send in somebody else on our team who actually does team affecting this consulting, to then work with the team to improve. But we've got to establish the foundation of the dyad leadership to start.

Garry Schleifer: 15:10

Well, let's peer behind the curtain a little bit. What are the common issues that arise in dyad leadership? I can just picture, you know, because we all have this image of from the shows, where the doctor is like their gods and you do what I say, or you know, there's held a pay and blah, blah, blah, and the nurses are like oh, yes, sir, yes sir, I know that's over exaggerating, but not always.

Sara Kagarise : 15:35

No, I would say there we still encounter hesitation, I think, and an understanding of thinking about the two roles as equals. So that's definitely something that we might have to work on. I think that the challenges can be sort of to Cory's point earlier is because if you're thinking about a dyad structure, each member that dyad reports to someone else in a dyad. So you have two leaders that you're working with who also report to two different leaders. Depending on how deep you dig, you might start to really find some inconsistencies as you go back, some of those layers of leadership.

Cory Colton: 16:15

Yeah, sometimes to Sara's point where we are coaching the wrong level of dyad right, so we coach level dyad and we find out the actual miscommunication and misfiring of consistent messaging and leadership is actually one up. It's the next level of. That's a challenge. I think we had a couple of those within the last year. The organizational structure does not always support clear dyad relationships. So when Sara was talking about, you might have one physician leader who has three different administrative dyad partners in different, for instance, ambulatory, or you might have one administrative VP who has three or four different physician leaders that they all right, I didn't even think about.

Cory Colton: 17:01

Yeah, yeah, so when they come to us and ask for dyad coaching and development, we're like which leader are you talking about? Yeah, so there's some of that. Yeah, those are the big man.

Garry Schleifer: 17:18

Tell me a little bit more about the coaching and how it impacts the dyad, Like do you coach some logistics? Do you coach each person individually and then together? How does it work?

Sara Kagarise : 17:31

Sure, well, the only thing they do separately we use what we mentioned in the article, that prison assessment. So once they've taken that a debrief individually with a coach, we come together for all of the rest of the sessions. So we provide that structure, the framework of what we're there to talk about in each section. But each time we meet it's really that coaching conversation where we're just showing up, we're being really curious about the things on the page and most of the time we're finding they really haven't talked about being in these things. Some of the things just happened to fall in place and things are working, but they've never said are we meeting enough? Are we talking about the right things when we're meeting? Are we, you over-crossing responsibilities? So it's usually pretty interesting.

Garry Schleifer: 18:17

Do you consider it relationship coaching sometimes?

Sara Kagarise : 18:22

Absolutely.

Cory Colton: 18:24

Yeah of course, go ahead. No, no, no, no. Yeah, marriage coaching might be appropriate, right, the way we structure it is, it's more coaching than not. So when we redevelop the toolkit, we will send parts of that out as pre- work for them to think about and work on, and then, when they come together, it's really a coaching based program. You know, what did you find, what stood out for you, what did you not realize was happening or not happening? And then we helped to coach them through that. Sara does most of the dyad work on the team. That's shifting a little bit for the next calendar year.

Garry Schleifer: 19:00

Wow, how many. Okay, so just again a little bit of logistics. How big is Carilion? Is it multi location, multi like thousands of people?

Sara Kagarise : 19:13

We have roughly right under 15,000 employees. It might be around 14 right now. Just with everything was COVID, so about 14,000. We have multiple community hospitals and hundreds of ambulatory sites.

Garry Schleifer: 19:28

And how many dyad? What do you call them pairs?

Sara Kagarise : 19:34

Dyads are going on right?

Garry Schleifer: 19:36

Are you two the only ones coaching them, developing how many people in your team?

Sara Kagarise : 19:42

Yeah, was me for a little while and now, like Cory said, we're sort of expanding that. I'm working with another co-worker to make this an in person program, hopefully, where we can get more people together at the table and put more people through this program, rather than the way we've been doing it, which is all. This team needs help. We'll go in with this team. Oh, we hired someone new. We'll go in with this team. In terms of the total number of pairs oh gosh.

Garry Schleifer: 20:10

Hundreds of pairs, wow, wow. And you said how long has this been going on with Carilion? You said it's been around for 10 years. It's been around.

Sara Kagarise : 20:21

The concept of dyad has been around that long. ,our work ideally was created right at the beginning of 2020. And so some of that work had sort of started there, and so over the last three years we've restructured a little bit and then really focused on it.

Garry Schleifer: 20:37

You have anybody asking to be in a dyad or they forced into it? Not forced, but it's part of the leadership journey you're matched up.

Cory Colton: 20:47

Yeah, I think we've got both.

Sara Kagarise : 20:50

Yeah, I think so. Some are very curious about who they can work with and what that? Might be, and as we are hiring and we're bringing in different talent, I think it gives us a good perspective from what they get at other organizations as well. So yeah, I think it's a little bit of both. There's some uncertainty, but it's never. In most cases it's not hesitation around, not wanting to do it, it's just not knowing.

Cory Colton: 21:16

Knowing that the program exists, which is another thing. So we've been very careful about how we advertise it out, given that we have few resources, which is why we want to scale, I would say that. So we're now starting to figure out that there are some people who are in purely administrative departments, you know, like finance, quality technology, other places where they have another person who does the other half of the work, and so we're starting to do some dyad coaching and development, where it's not clinical and non non- clinical. Is both non-clinical because they're really in a dyad marriage.

Garry Schleifer: 21:56

There we go. Well then, thank you, because my next question was going to be what other? So you've already found other places within your industry, but what other industries could you see benefiting from dyad, leadership and coaching?

Sara Kagarise : 22:12

Oh well, I would think any industry where you have you know, especially matrix organizations, where you're thinking about how much people have to work together.

Cory Colton: 22:23

Yeah, so for my old world. I would think there are some companies with sales and marketing where this would be a propo or marketing and product design In financial services. I can see it where you know you may have somebody in a retail bank who has a customer that's also doing commercial business. You know how do those leaders work well together. Yeah, customer.

Garry Schleifer: 22:48

Yeah, well, yeah, I mean now I'm, you know for myself, I'm like thinking about where else could this work and retail, so many retail areas and sales and marketing. For sure, they've never really been on the same page, and I think that's the most in most cases. Oh my gosh, this has been absolutely fabulous. What would you, what do you want our audience to do as a result of the article in this conversation?

Sara Kagarise : 23:17

That's a great question I think just be curious about. Does a dyad model work for where you are? Does it need to be created? What benefit could it serve, even outside of like we've just talked about clinical versus administrative? Where could it maybe make sense? Where are their silos, where maybe they don't need to be?

Garry Schleifer: 23:38

Yeah, from what I'm hearing from this conversation, I would say if you see silos, consider an opportunity.

Cory Colton: 23:46

Yeah, absolutely. And also, you know, dyad development and coaching is really a form of group coaching, right? And so how can we, as coaches, support our clients, or the companies that are paying for our services, with more impact if we actually start looking to scale the coaching experience for them, as opposed to focusing on individual leader contracts?

Garry Schleifer: 24:11

Yeah, I could see a group, you know doing a group of like six pairs right, so kind of reaching more people at the same time. You know we talked about what are. We didn't really get too far into what are the common issues, but if you had common issues or you made it like a mastermind, if you would that kind of thing as well, like best practices, this happened to us. And then they explain it and break it down and then others can see what, how they operate, what they oh, my goodness, it's just like yeah.

Cory Colton: 24:44

Yeah, one of the obstacles for us. And so we have a physician leader academy. That is nine-month a non cohort program and we don't think we have enough physician leaders to do it again whole cloth this next calendar year. And so what we're proposing is actually doing a workshop version of the dyad development and coaching, where each department chair nominates one dyad so that we bring them all together and might have 12 to 14 groups doing this work, so that we'll have more impact in the organization.

Sara Kagarise : 25:15

I think that's the biggest opportunity. And, to your point, around some, some constraints or some issues we run into, you know we're there from the coaching perspective. So when there are those hard questions where they they really don't know the answer and they're having trouble figuring it out, being able to have their network appears to brainstorm would just, would really amplify the entire program. So we want to get them in one room together.

Garry Schleifer: 25:38

To use a publishing analogy to get them on the same page. Sorry, that was a dad joke, or off the page. Let's get the bad ones off the page and the good ones on the page. Thank you to so much. This has been so interesting. Like I said, when I first saw this article come across our desks, I was like I had what's this thing? So I'm really glad to have you have written this and for us to publish it. What's the best way to reach you if our listeners or readers want to know more?

Cory Colton: 26:13

So you can email us at our Carilion email addresses. Mine is CSColton@carilionclini. org and we'd be happy to talk.

Sara Kagarise : 26:24

Absolutely, and mine is sgkagarise@carilionclinic. org.

Garry Schleifer: 26:36

Thank you so much for joining us for this Beyond the Page episode and for sharing your wisdom. That was brilliant, loved it, learned so much, which is, you know, hidden secret to the listeners. This is why I do this, because I get to learn more, so I hope they do too. Thank you both, Sara, Really appreciate it.

Cory Colton: 26:55

Well thank you for having us.

Garry Schleifer: 26:58

That's it for this episode of Beyond the Page. For more episodes, subscribe via your favorite podcast app. If you're not a subscriber yet, you can sign up for your free digital issue of choice magazine by going to choice- online. com and clicking the sign up now button. And here's the one for you, Cory, I'm Garry Schleifer. Enjoy the journey of mastery.

Cory Colton: 27:24

That's great.