The Dyad Leadership Model: Elevating Hospital Care Management

BY ZACHARY LENERT, MSN, RN, NEA-BC, ACM, CEN

The evolving landscape of healthcare continues to highlight the indispensable role of medical social workers and nurse care managers in hospital settings. As hospitals tackle increasing regulatory pressures, complex discharge planning and addressing the social drivers of health (SDOH), the dyad leadership model emerges as a necessary innovation to improve patient outcomes, drive compliance and enhance operational efficiency.

Defining Dyad Leadership

A dyad leadership model is a co-management structure in which two leaders—typically from different professional backgrounds—share responsibility for strategic and operational oversight. In Sharp HealthCare’s Integrated Care Management division, this model pairs medical social work and nurse care management leadership, establishing a multidisciplinary approach to patient care coordination, discharge planning, and SDOH interventions. Research supports the effectiveness of dyad leadership in enhancing collaboration, reducing siloed decision-making, and improving hospital efficiency (Ingels et al., 2023). Successful implementations of dyad models in hospital care coordination have demonstrated success in hospital care management.

Initiatives Driving Change

The Conditions of Participation (CoPs) for Discharge Planning, issued by the Centers for Medicare & Medicaid Services (CMS), require hospitals to ensure that patients are discharged safely with appropriate follow-up services (CMS, 2025). Furthermore, evolving regulatory mandates necessitate that hospitals screen for and intervene in SDOH factors influencing health; reinforcing the critical role of medical social work in meeting standards aimed at addressing health equity gaps (Federal Register, 2024).

Hospitals are also managing complexity in discharge planning with compounding factors such as:

• Shorter inpatient stays requiring rapid transition planning.
• Greater emphasis on value-based care models that penalize avoidable readmissions.
• Rising patient acuity and complex psychosocial barriers impacting safe discharge.
• Challenges in timely authorization for post-acute care transitions from managed care organizations.

Traditional models of care management no longer suffice. Hospitals need leadership structures that strengthen both care management and social work, ensuring specialized expertise, professional governance in decision-making, and strategic alignment. A dyad leadership model accomplishes exactly that.

Dyad Leadership Model: System Implementation-to-Hospital Integration

At Sharp HealthCare, the Dyad Leadership Model has been designed to enable care management and medical social work to operate within a framework that promotes equity in leadership representation, efficiency and systemwide alignment. Through careful integration of system support, clear roles, and structured responsibilities, SHC is transforming care management into a collaborative leadership model that enhances both patient care coordination and operational effectiveness.

Standardizing Excellence – System Education Specialists:

To support professional development, program development and education, SHC established system education specialists dedicated to both care management and social work. These specialists serve as a conduit between system strategy, program development and frontline operations by:

• Championing best practices and ensuring teams stay ahead of evolving priorities.
• Developing customized training programs that enhance competency and system standardization.
• Leading strategic initiatives that address critical challenges in care management and social work, ensuring that both teams are equipped to meet regulatory and hospital-based expectations.

The Dyad Model: Leadership Integration for Hospital and System Success

Hospital care management leadership, when predominantly nurse-driven, limits representation and multidisciplinary decision-making. To address this, SHC redesigned its leadership model to enable parity between nursing and social work within care management. The dyad model implementation at SHC established two distinct leadership roles:

• Manager, Inpatient Care Management – Overseeing care coordination, hospital throughput and case management operations.
• Manager, Medical Social Work – Managing psychosocial complexities, SDOH driven discharge barriers and community-based coordination.

By embedding both roles into the hospital’s operational structure, SHC ensures discharge planning, patient transitions and hospital care coordination are approached from both a medical and psychosocial perspective. This approach fosters collaboration, innovation and alignment with both hospital and systemwide strategic goals.

Senior Specialist Roles: Expert Team Member & Leader Support

Recognizing the growing complexity of hospital-based care management, SHC introduced senior specialist roles to support both care management and social work teams. These specialists provide:

• Expert oversight for complex cases, process improvement, and regulatory compliance.
• Real-time support for managers, ensuring adherence to quality initiatives and regulatory mandates.
• A structured career pathway that enhances staff retention, professional development and leadership readiness.

Investing in Care Management

As expectations continue to evolve in value-based care and post-acute outcomes, hospitals must proactively invest in care management innovation. The Dyad Leadership Model is not just a theoretical framework—it is a solution that strengthens workforce sustainability, optimizes patient outcomes and enables hospitals to meet the demands of value-based care, ahead of regulatory requirements.

References

Centers for Medicare & Medicaid Services. (2025). CY 2025 Medicare hospital outpatient prospective payment system and ambulatory surgical center payment system. Retrieved from https://www.cms.gov/newsroom/fact-sheets/cy-2025-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center-0

Federal Register. (2024). Medicare and Medicaid programs and the Children’s Health Insurance Program: Hospital inpatient regulations. Retrieved from https://www.federalregister.gov/documents/2024/08/28/2024-17021/medicare-and-medicaid-programs-and-the-childrens-health-insurance-program-hospital-inpatient

Ingels, D. J., Zajac, S. A., Kilcullen, M. P., Bisbey, T. M., & Salas, E. (2023). Interprofessional teamwork in healthcare: Observations and the road ahead. Journal of Interprofessional Care, 37(3), 338–345. https://doi-org.sharphealthcare.idm.oclc.org/10.1080/13561820.2022.2090526

Zachary Lenert, MSN, RN, NEA-BC, ACM, CEN, vice president, Integrated Care Management, Sharp HealthCare, has over a decade of healthcare and leadership experience in nursing, case management, population health, and value-based care. A dedicated advocate for innovation and quality outcomes, Mr. Lenert leads initiatives aimed at transforming healthcare delivery, improving patient outcomes and redesign care coordination.

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