MIDDLEBURY — Porter Medical Center is adopting a new leadership structure that will invite more physicians input into management of the county’s hospital, nursing home and a dozen affiliated provider practices. It’s a move that Porter administrators believe will lead to smoother operations and better services for patients.
And PMC’s switch from a hierarchical management system to a team-based model will be closely watched by University of Vermont Health Network officials, who could choose to replicate the new system if it pays dividends for Porter. PMC is an affiliate of UVM Health Network.
Leading the revamp is PMC’s top administrator, President Tom Thompson. Prior to his arrival at Porter one year ago, Thompson had worked at other hospitals that possessed a collaborative leadership style with good results.
“The more people we can engage with what we’re doing and how we’re doing, the better we’ll be as a care system,” he said during a recent Zoom interview that included PMC Chief Medical Officer Dr. Anna Benvenuto.
“A vast majority of the quality and value decisions affecting health care delivery are directed by physicians, so you need to have physicians and other providers at the table for how we design our health care system for the future.”
Thompson and Benvenuto explained PMC’s current leadership structure is limited in its ability to coordinate operations and improve value for customers — in spite of good staff giving great effort. Porter’s three distinct service centers — Helen Porter Rehabilitation & Nursing, the hospital and affiliated health care providers — could use better coordination, officials said.
“The understated piece of this is the culture of the organization — how do you create a great workplace where folks are knowledgeable and embedded in our mission and see it from the same perspective — as in ‘one Porter,’ not just the particular area you’re in,” Thompson said.
“For efficient coordination and communication, you want to have all your parts working in sync.”
At the core of the new leadership structure is the creation of “physician-administrative leadership dyads” to assist physicians, provider practices, nursing care, and other clinical and support functions. A “dyad” is a physician and administrator working together as a pair to solve problems and improve operations in their particular sphere, whether that be general surgery, pediatrics, palliative care or another of the many categories of PMC services.
This dyad leadership model isn’t new to health care. For example, the Mayo Clinic has operated in a dyad model since 1908.
If it functions the way it’s supposed to, the new management style will result in:
•  Integration of work and care techniques across PMC’s health care continuum, from its birthing center to the palliative care suites at Helen Porter.
•  An improvement in decision-making and implementation of health care policies.
•  Increased support and expertise for leaders and teams across the organization.
•  The creation of a single Porter culture.
•  Above all, improved services for patients.

BIG PROJECTS
Benvenuto said the dyad leadership model will also help PMC better deal with future crises and big projects.
For example, Porter will go live this year with a new Epic electronic medical records system for the hospital, radiology, lab and Helen Porter.
As reported in last week’s Independent, Porter has created a Diversity, Equity and Inclusion council to ensure the campus is welcoming to employees and patients of all walks of life.
The organization is on the cusp of redesigning its primary care system into a team-based model, to “create a more nimble and responsive health care team,” Benvenuto said.
All of this is not to say Porter has failed under its current leadership structure. PMC has maintained critical services during the COVID-19 pandemic and a cyber attack.
“I’m really excited about the ability to have a partnership-based leadership model that will allow us all to play to our strengths and support our workforce,” Benvenuto said.
The new leadership structure won’t result in job losses, but some will see their titles and/or assignments change a bit, according to Thompson. The new model will:
•  Create a director of Human Resources, replacing the vice president for HR and Support Services position.
•  Establish a new Vice President/Chief Medical Officer role that serves as a dyad partner of the President/COO and combines and builds on elements of the existing Regional Physician Leader and Chief Medical Officer roles.
•  Establish new Associate Vice President and Senior Physician Leader roles, which will replace the former Medical Director for Ambulatory Care and Medical Director for Hospital Services roles.
•  Redesign of the Chief Nursing Officer/Vice President for Patient Services role to focus on nursing standards, practice, and operations across PMC’s care continuum. Non-nursing patient care departments currently reporting to this role will transition to dyad leader relationships once those dyad roles are established.
Benvenuto said her fellow physicians are generally pleased with the new management concept.
“Especially for providers who have been at Porter for many years, there’s a sense that having high-level provider leadership is a benefit,” she said.
Thompson believes Porter Medical Center is now pointed squarely in the right direction.
“Our strategy map is all directed toward continuously improving our care, improving the value we deliver to our community and (fortifying) an environment of trust,” he said. “We want to be the trusted resource. We might not do it all here, but we’ll get you to where you need to be.”
Reporter John Flowers is at [email protected].