CHICAGO — To provide guidance on best practices for reimagining traditional relationships between physicians and hospital executives, the American Medical Association (AMA) and American Hospital Association (AHA) today released a new set of guiding principles for bringing clinical skills and business insights together at the leadership level to foster more collaborative and cohesive decision-making at hospitals and health systems.

Integrated Leadership for Hospitals and Health Systems: Principles for Success provides a guiding framework for physicians and hospitals that choose to create an integrated leadership structure but are unsure how to best achieve the engagement and alignment necessary to collaboratively prioritize patient care and resource management.

The Principles were sparked by the evolution of our nation's health care system and the challenge of profound structural reforms to the delivery of and payment for care. The transformation to a high-performance health system can be enabled by coordinated leadership and governance between physicians and hospital executives to achieve and sustain the desired outcomes for our nation's patients and communities. The Principles are the result of more than two years of work between the AHA and AMA.

"To lead the changes needed to move the health care system forward, many physicians and health care organizations may contemplate options for greater alignment and strong relationships to cultivate an environment centered on teamwork," said AMA President Robert M. Wah, M.D. "The new Principles support having more physicians in the boardroom and in key roles at the executive level so hospitals can succeed in the reformed models for health care delivery and payment."

A common thread for successful health care organizations is integrated health care leadership between physicians and administrative colleagues that involves a functional trust-based partnership. According to the Principles, "to accomplish this goal, it is paramount that all management decisions related to the new structure's quality improvement and population health agenda are made jointly between the physicians and the hospital/health system managers."

"The changing landscape of health care requires hospitals and physicians to become true partners, providing the best care for their patients," said Jonathan B. Perlin, M.D., Ph.D., chairman of the AHA Board of Trustees and president of clinical services and chief medical officer at HCA (Hospital Corporation of America). "Care coordination is critical as health care continues to evolve, all leading to better outcomes for patients and providers alike. As health care is fundamentally a team-based activity, we believe that organizational collaboration models the increasing necessity for inter-professional collaboration."

In addition to the guiding principles, the new framework outlines key elements and challenges for creating and instituting integrated health care leadership between physicians and hospitals. Not all physicians or hospitals are seeking integration, but for those seeking to re-evaluate their approach to the delivery of coordinated care, the Principles offer useful information for exploring new levels of collaboration and partnership.