Partners for Patients Coaching for Improvement A Coaching Mentality

1. Partners for PatientsCoaching for ImprovementA Coaching Mentality Stephanie Sobczak: WHA Quality Manager Thomas Kaster: WHA Quality Coordinator

2. Overall Objective The objectives of this series: • Help you self identify your personal coaching style and opportunities for growth • Help you analyze your personal work environment to identify opportunities for effective improvement coaching • Provide you with the best known skills, resources and practice for leading effective improvement coaching interactions

3. Series Webinar Plan • A Coaching Mentality • Finding Time to Coach • Effective Coaching Interactions

4. Today’s Objectives • Defining Strong Coaches • Leadership activity vs. Management activity • Balancing positive and constructive feedback • Judging vs. Coaching • Adaptive Coaching • Delegation Strategies • Developing Feedback Loops • Coaching for Improvement using Influence Leadership

5. Poll Questions: Characteristics of Coaches Think back to a coach or leader you have had in the past that you felt really reached you and helped you grow. Which of the following characteristics did that person display?(Choose 2) • Really listened to me • Communicated in a way that did not make me feel inferior • Helped guide me to the correct solutions • Valued me as an individual • Always had all the answers and gave specific directions on the way things should be done • Was always firm and did not waver from their point of view • Would really chew me out when things did not go well • In their eyes they were always correct

6. Characteristics of Good Coaches • Commonly 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

7. Poll Questions: Characteristics of Coaches Think back to a coach or leader you have had in the past that you felt really reached you and helped you grow. Which of the following characteristics did that person display?(Choose 2) • Really listened to me • Communicated in a way that did not make me feel inferior • Helped guide me to the correct solutions • Valued me as an individual • Always had all the answers and gave specific directions on the way things should be done • Was always firm and did not waver from their point of view • Would really chew me out when things did not go well • In their eyes they were always correct

8. What is Coaching for Improvement? • Steven Covey: 7 Habits of Highly Effective People • Lead People, Manage Things “You lead (empower) people. You manage and controlthings.” (The 8th Habit, p 101)

9. Leadership/Coaching vs. Management Managing Activities • Measuring outcome • Reporting / monitoring data • Scheduling meetings • Determining ROI • Identifying evidence based practices • Identifying opportunities for improvement Leadership Coaching Activities • Empowering teams to make improvement • Providing guidance and support • 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

10. Leadership / Coaching vs. Management 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?

11. Leadership vs. Management 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?

12. Leadership/ Coaching vs. Management Both hats are important, but need to be warn at the right time. There is a balance.

13. Leadership and Coaching for Improvement Essential Key to Quality Improvement Coaching Understanding that the system causes the outcomes, not just the individuals in the systems.

14. Leadership vs. Management-Self Assessment Your Management Activities Your Leadership / Coaching Activities

15. 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

16. Keys to Providing Feedback • Provide positive feedback publically and constructive feedback privately • Provide timely feedback • 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

17. 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?”

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

19. 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?

20. 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 improvement her environment so she can meet this important goal We will be practicing these strategies and more in session 3

21. Judging vs. Coaching

22. Other Considerations when Giving Constructive Feedback • Always realize that this is an opportunity for you to build trust with a valued employee • Ask yourself: How would you want your staff to give you negative feedback?

23. Other Considerations when Giving Constructive Feedback • Make 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

24. Take Away#1: 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

25. Adaptive Coaching • Is everybody coached the same way? • Does everybody take feedback the same way?  Individualize the coaching; no one size fits all

26. The High Performers: Characteristics

27. The Naysayers / Negative Nellys: Characteristics

28. Those Along for the Ride: Characteristics

29. Delegation Keys • You cannot single handedly drive improvement • Sometimes is it challenging to hand off elements of your pet project • Delegate for the right reasons

30. Delegation Strategies • Delegation for Development • Use delegation to challenge your high achievers • Make sure the hand off is a win-win for you and the individual • Put them in a position to succeed • Make the project a learning opportunity

31. Delegation Strategies • Delegation for Engagement • Use micro-delegation to engage the riders and fence-sitters • Use delegation when you have a hunch that someone has high potential that has not been tapped yet • Use delegation if someone has a particular strength • Early on keep the task easy and gradually grow responsibility if performance is positive • Be prepared to scale back if needed

32. Delegation vs. Dumping • Delegate with purpose • There are always tasks that are not pleasant • If you delegate a project, make sure you are going to follow-up in a timely manor • When delegating, communicate your purpose so that the receiver does not feel “dumped” on

33. Developing Feedback Loops • Feedback Types • Formal Feedback • Informal Feedback

34. 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

35. 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…

36. 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

37. 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

38. Poll Questions #2 Which of the following best describes your current state as a improvement coach / leader. • I am good at the management functions but would like to improve as a improvement coach • My management and coaching skills are strong, but I need to delegate more • I am new to leadership and want to work on all aspects • I am the Dalai Lama of Management and Leadership and need not improve

39. Influence Leadership • When those that you are coaching for improvement don’t directly report to you

40. Influence Leadership Considerations • It is important to foster a relationship with the managers of the teams you are helping, as well as the staff you are working with • Sometimes your manager can be a great help with this • Work with the manager to clearly define the role of the improvement coach and manager in the project • Be mindful of maintaining trust between all parties • Inform the managers of your “informal feedback” strategies • Work within the system of the operations and if you cannot, work with the managers to find a solution

41. Poll Questions #2: Results Which of the following best describes your current state as a improvement coach / leader. • I am good at the management functions but would like to improve as a improvement coach • My management and coaching skills are strong, but I need to delegate more • I am new to leadership and want to work on all aspects • I am the Dahlia Lama of Management and Leadership and need not improve

42. Coaching for Improvement Series: • Oct 11: Developing a coaching mentality • Nov 9: Finding time to coach • Dec 13: Effective coaching interactions Next month action items: Complete webinar #1 workbook, which includes goal setting. “If you write it, it will come.”

43. Closing Comments • “Be a light, not a judge. Be a model, not a critic” • Steven Covey: 7 Habits of Highly Effective People Questions?