Anesthesia Leadership: Building a Strong Local Team and Culture

By Epix Healthcare

By Tim Adams, M.D., President and Chief Medical Officer

In today’s rapidly changing healthcare environment, physicians can no longer afford to act as independent decision-makers—whether they like it or not.

In fact, in The Physicians Foundation’s 2016 biennial survey of more than 17,000 providers, respondents rated “erosion of clinical autonomy” as one of the top two least satisfying factors about medical practice.

Another survey, conducted by the Deloitte Center for Health Solutions, found that most U.S. physicians are “concerned” about the future of the profession. The report concluded: “A transparent business relationship built on mutual respect and trust, with incentives appropriately aligned, is key.” It continued to define the elements of an effective relationship with and among providers, including: “Integration of physicians in team-based models where…clinical autonomy is balanced between managing inappropriate variation and adherence to evidence-based practices,” and “an organizational culture that reflects mutual respect for the profession and the entities with whom physicians affiliate or partner.”

In an era of value-based, patient-centered care—when events across the entire care continuum may directly affect physician and hospital reimbursement—it is more critical than ever to establish an effective team built on trust, accountability and an attentiveness to results. Yet, despite the importance of high-functioning teams in today’s healthcare landscape, few clinicians have received any formal training or education regarding team-building, positive leadership or effective communication.

The following are three important steps to develop a successful team to improve patient outcomes, OR efficiency, and patient and surgeon satisfaction:

Establish an accountability framework

The first step toward developing an effective team is to establish a framework of accountability. While physicians may be unaccustomed to working in such a framework, healthcare is transitioning to a patient-centered care model and health system needs are evolving. Hospital administrators now require reliable departments consisting of team players willing to collaborate to optimize patient care and OR efficiency.

Within this framework, it is important to clearly define team members’ individual roles as well as who they report to. By establishing a hierarchy of authority, teams can remain organized, and team members can communicate effectively.

Identify a team leader

While the surgeon or attending physician is often viewed as the “captain of the ship,” it is important to identify a team leader who is responsible and held accountable for the overall trajectory of the anesthesia team. Within the hierarchy established in the accountability framework, members should select—and the hospital should vet—an individual who is well-respected not only for his or her clinical ability, but leadership skills as well.

This person must accept the additional responsibilities and duties involved in coordinating quality improvement efforts and managing staff and patient expectations. The individual should help establish the team’s culture and core values and communicate them to staff effectively.

Develop a scorecard

A scorecard can serve as a concrete manifestation of a group’s core measures for success. It can provide an additional layer of accountability, and can help track a group’s progress over time in achieving its desired outcomes.

The scorecard can be organized into various sections, including quality of care, staffing model, clinical leadership, financial health, and satisfaction among patients, surgeons and other clinical staff. Team leaders can rate various activities within each of these categories, and provide feedback regarding improvements to be made or other quality initiatives to pursue in the future. By measuring and tracking results over time to improve clinical operations, members of the anesthesia department can demonstrate proactive leadership and commitment to the health system and community they serve.

To learn more about establishing a strong team and culture within the anesthesia department, please email