WHA: Coaching for Improvement Series

Session One: A Coaching Mentality

Thomas Kaster: WHA Quality CoordinatorMBA, CPHQ

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WHA: Coaching for Improvement Series

Session One: A Coaching Mentality

Thomas Kaster: WHA Quality CoordinatorMBA, CPHQ

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•Please put your phone on mute. *6 to mute *7 to un-mute

•How to chat!

Early Poll Question• How many people are in the room

participating with you?– Just me– 2-3– 4-5– More than 5

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Webinar Series Plan

• Session 1: A Coaching Mentality• Session 2: Engaging Hearts and Minds• Session 3: Effective Coaching Interactions

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Today’s Objectives• Defining Strong Coaches• Leadership activity vs. Management activity

• Balancing positive and constructive feedback• Judging vs. Coaching• Developing Feedback Loops

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Early Poll Question Results• How many people are in the room

participating with you?– Just me– 2-3– 4-5– More than 5

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Chat Box Conversation:Inadequate Coaches

Think back to a coach or boss that you have had in the past that you felt was not effective…

In the chat box, share the characteristics that you feel made that person ineffective.

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What is Coaching for Improvement?

Steven Covey: 7 Habits of Highly Effective People

Lead People, Manage Things

“You lead (empower) people. You manage and control things.”

(The 8th Habit, p 101)

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Leadership/Coaching vs. ManagementLeadership/Coaching

Activities• Empowering teams to make

improvement• Removing perceived barriers• Asking questions to find

solutions • Understanding the internal and

external environment • Finding the solutions from those

who do the work • Helping teams overcome

obstacles • Coaching for improvement

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Managing Activities• Measuring outcome• Reporting / monitoring data • Scheduling meetings• Determining ROI• Identifying evidence based

practices• Identifying opportunities for

improvement

Chat Box Conversation:Exceptional Coaches

Think back to a coach or boss that you have had in the past that you felt really helped to grow and achieve…

In the chat box, share the characteristics that you felt made that coach highly effective.

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Characteristics of Good CoachesCommonly identified characteristics of great coaches include: – Great listeners– Very knowledgeable – Pulls rather than pushes– Creates an open environment and withholds judgment – Focuses on leadership and cooperation as opposed to top

down hierarchical position– Values individuals as crucial parts to each team – Seeks to create an effective team that works together to

produce positive outcomes

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Leadership/Coaching vs. Management

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Have you ever had…

… a manager or coach that was very organized, really knew their stuff, never missed a detail but did not

have the heart of the team?

Or,

… a manager or coach that was great with the team, really understood the personalities, but was

disorganized, inconsistent and lost the team’s confidence?

Leadership/Coaching vs. Management

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Have you ever had…

… a manager or coach that was really good at pointing out deficiencies in data but was not able to help the team improve?

Or hopefully,

… a manager or coach that understood that the data results were part of the system and worked with the team to find solutions for improving?

Leadership/ Coaching vs. Management

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Both hats are important, but need to be warn at the right time. There is a balance.

Poll Question:

Which of the following best describes the balance of your influencing activities?

a) I do more management (numbers focused etc..) than Leadership (Coaching for Development)

b) I do more Leadership than Managementc) I feel I have a healthy balance of bothd) This is the first time I ever thought about the

difference

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Get the Numbers UP!!!!Wisconsin HCAHPS

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Average

Patients ranked hospital

high

Definitely recomme

nd hospital

Doctors always

communicated well

Nurses always

communicated well

Patients always

received requeste

d help

Staff always

explained medicatio

ns

Pain always

well controlle

d

Always

quiet at

night

Room alway

s clean

Staff provided discharge

instructions

National Average

70 71 81 78 67 63 71 60 73 84

State Average

74 74 83 82 72 68 72 63 79 88

State Benchmark

83 83 88 88 82 75 78 72 88 92

The Math Behind Coaching

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Quality of a Solution

Acceptance of a Solution

Effectiveness of a Solution

X =

More Coaching Math

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Removing the Perceived Level of Burden Increases the Likelihood of Compliance

Poll Question Results:

Which of the following best describes the balance of your influencing activities?

a) I do more management (numbers focused etc..) than Leadership (Coaching for Development)

b) I do more Leadership than Managementc) I feel I have a healthy balance of bothd) This is the first time I ever thought about the

difference

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Eliminate the Blame Game

Essential Key to Quality Improvement Coaching

Understanding that the system causes the outcomes, not just the individuals in the systems.

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Positive Cycle

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Providing Feedback On Improvement

• It is commonly known that people respond more favorably to positive reinforcement than negative reinforcement.– It is very difficult to lead improvement by only

pointing out deficiencies– People are not going to make sustainable change

just because they are told their numbers are bad• Yet in most systems, the majority of feedback

only comes when there is an issue

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Keys to Providing Feedback

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• Provide positive feedback publically and constructive feedback privately

• Provide timely feedback – Catch them doing something right

• Understand that feedback is not a one directional communication channel

• Understand that most of our systems are designed to analyze negative trends

• Make a goal to provide more positive feedback than constructive– Actively look for opportunities for positive feedback

Example of Positive Reinforcement ….

“I was noticing Sue, that whenever I see you come out of a patient room, I always see you cleaning your hands. I really appreciate you keeping patient safety in mind. Thank you.”

vs.

“Sam, caught you again. You need to wash your hands or you will spread infection. Why can’t you remember?”

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Chat Box Conversation

• In the chat box, please list examples of positive reinforcement you have given or received recently.

• Or list negative feedback you have given or received lately.

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Constructive Feedback Judging vs. Coaching

When coaching for improvement it is easy to get trapped into judging.

Example of Judging: “Sue, I do not think you completed hourly rounding fully any day last week.

You know it is essential for reducing falls and our new goal. Next week I want to see you do this.”

Do we know…• What legitimate obstacles Sue may have ?• If Sue fully understands the process?• Why Sue feels she is having difficulties?• What Sue’s perceived obstacles are?

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Constructive Feedback Judging vs. Coaching

Example of Coaching: “Sue, I have noticed that you may be having difficulties completing your hourly rounding. I

know you understand how important this is for our patients. If you are struggling others might be as well. What can we do to help you and others find more time to do this?”

Notice the technique:• First the opportunity is identified• Then it is openly acknowledged that Sue is doing the best she can• Direct blame is differed by explaining that others might be struggling• Then Sue is asked how she can improve her environment so she can meet this

important goal

We will be practicing these strategies and more in session 3

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Judging vs. Coaching What can be judged What can be coached

Outcome Data How the team can improve the outcomes

Inventory Levels How the team can institute an inventory organization program

Efficiencies How the team can help uncover waste in processes and increase value added time

Prevalence of Processes How best known practices can work in the system

Adoption of Evidence Based Practices How the team can incorporate evidence based practices into their system

Management Activities Leadership activities

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Other Considerations when Giving Constructive Feedback

• Always realize that this is an opportunity for you to build trust with a valued employee

• Position the feedback as a flaw in the system that may be causing the difficulty for them and others.

• Ask yourself: How would you want your staff to give you feedback?

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Other Considerations when Giving Constructive Feedback

• Make it safe by making yourself a coaching example– Share stories about when you made a mistake– Talk about what you did to learn from it– This models for staff how to take accountability

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Developing Feedback LoopsFeedback Types:

– Formal Feedback – Informal Feedback

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Informal Feedback

In quality improvement, informal feedback is essential– More impactful because it is just in time– More impactful because it is personally delivered– It supports rapid improvement through small tests

of change

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Informal Feedback Examples • Hallway or elevator quick conversation

– How is xyz going? Are you experiencing obstacles? What type of help do you need?

• Quick e-mail / instant message from individuals to coach– I am stuck here can you help me?

• E-mail chain distribution within improvement team– We are experiencing this… XYZ happened, how can

we learn from that?• Quick phone call etc…

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Formal Feedback

• Useful for project development and planning • Useful when scheduled and consistently attended • Great to evaluate progress at specified

milestones • Is not intended to drive rapid improvement • Too often improvement is halted because teams

are waiting for a formal meeting to move forward

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Ideas for Formal Feedback Structure• Surveys or E-mailed survey links• Idea boxes• Meetings• Data from patients and families• Shared Governance Council• Quality Councils• Board or Medical Staff Presentations

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Keys to Developing a Coaching Mentality

• Drop the blame game– Understand the system creates the outcomes

• Create safety• Assume best intentions • Balance Leadership and Management • Actively seek opportunities to provide positive feedback• Always remember, even the best coaches cannot win

without their team.

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Take-Away: Positive Feedback Brainstorm

Take 5 minutes to list as many opportunities that you can think of to provide positive feedback to those that you coach.– Do this in the next month– Consider teaming up with other coaches for ideas

Leadership vs. Management-Self Assessment

Your Leadership / Coaching Activities

• • • • • • •

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Your Management Activities

• • • • • •

Assessing your Feedback Take a few minutes to answer the following:

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Concept Yes or No

Thinking back on the my last several opportunities to give feedback, I feel like I have been able to balance between constructive and positive feedback.

If I were to ask those that I coach and support if I give enough positive feedback most would say yes.

I try hard to actively seek out opportunities to give positive feedback.

I feel like I am given a balanced amount of positive and constructive feedback from those that coach and lead me.

Most of my feedback pertains to data results.

The majority of my feedback is given when something is incorrect or not going well.

Coaching for Improvement Workbook

http://www.whaqualitycenter.org/PartnersforPatients/PfPTools/PfPWebinarstoolstemplatesCoaching.aspx

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Coaching for Improvement Series:

– Oct 31: Developing a Coaching Mentality – Nov 20: Engaging Hearts and Minds – Dec 18: Effective Coaching InteractionsNext month action items:Complete webinar #1 workbook, which includes goal

setting. “If you write it, it will come.”

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Closing Comments “Be a light, not a judge. Be a model, not a critic”

- Steven Covey, 7 Habits of Highly Effective People

Questions?

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