Coaching & Leading Improvement
Coaching & Leading Improvement in Healthcare; is 80% Human and 20% Technical
Healthcare is complex and dynamic needing interactions between healthcare professionals, patients and other stakeholders. Additionally, healthcare professionals are often dealing with high levels of stress, pressure and emotional challenges as well as the daily challenges of clinical workload and organisational priorities.
In this context technical improvement skills are not enough and the art and science coaching, building relationships, understanding individual needs, and providing support are crucial in driving a positive sustainable change.
Improvement in healthcare is 80% human and 20% technical.
Margie Godfrey
It was her aim through her research with two different, national, professional, and interdisciplinary heath care teams (cystic fibrosis and intensive care nurseries) to understand what contributes to a successful coaching experience. From this she discovered the idea of 80 vs 20 and subsequently developed the Team Coaching Model – a powerful and dynamic tool to help other coaches and teams in their improvement work. The model has 3 interlinked, adaptive, and fluid elements. These are the pre-phase, action phase and transition phase.
The general progression through the model is from the pre-phase to transition but teams and coaches can be in multiple stages of the model at any one time.
The added details in the graphic below highlight the role taken by the coach in each of these phases.
The bold and starred elements are key coaching skills found in the research.
Pre-phase
Getting ready
*Context
~Review of the past improvement efforts and lessons learned tools used
~Preliminary system
review~
Micro/Meso/Macro
*Site Visit
~Resources
~Logistics
~Expectations
Clarity of aim
Leadership & Team discussions about roles and logistics
Action phase
Art & Science of Coaching
*Relationships
~Helping
~Keep on track
*Communication
~Virtual
~ Face2Face
~Available & accessible
~Timely
*Encouragement
*Clarifying
~Improvement Knowledge
~Expectations
*Feedback
*Reframing
*Improvement Technical Skills
~Teaching
Transition phase
Reflection, Celebration & review
Reflection on improvement journey
~What to keep doing or not do again
~Review measured results and gains
~Access team capability and coaching needs & create coaching plan
Celebration!
Renew and re-energise for next focus
Evaluate Coaching
Godfrey, MM (2012)
Edgar Shein the author of ‘Helping’ mentored Marjorie Godfrey and it is his work which underpins much of her approach to team coaching. Coaching is essentially a helping relationship. Considering the dynamics of helpful and unhelpful helping is essential to effective team coaching.
Coaches need the ability to draw on a variety of skills depending on the circumstance of the meeting and ‘where the team is at’. Coaching is often concerned with opening possibilities within teams to allow exploration of the issues under discussion and requires the use of perceptive skills, helping behaviours and solution-focused techniques.
Perceptive Skills: Listening versus telling. Sitting on hands– knowing when to intervene and when not to Observe versus doing Teaching opportunities.
Helping Skills: Knowing when help is being asked for and when to offer help. Helping others to help themselves. Recognising helpful and unhelpful helping. Appreciative and humble enquiry. Encouragement, Praise, Feedback.