Andrew Neitlich, Founder and Director, Center for Executive Coaching
The healthcare industry faces daunting challenges, and the forces driving change keep coming. These challenges come from all directions: reimbursement and payer mix, government intervention, advances in medical technology, changes in information systems, an aging patient population, industry consolidation, complex physician relationships, and ongoing challenges recruiting top talent.
There is no magic bullet that will help healthcare leaders address all of these forces. Sometimes it feels like the most important skill is learning to cope.
However, we have discovered that when healthcare leaders and their teams develop a simple skill – the ability to coach their people – they have a powerful way to improve results and accelerate change. Coaching skills are not the one and only answer of course, but they are a piece of the puzzle that is simple to learn and has huge impact.
We define coaching as a dialogue, usually involving powerful questions that enable insights to improve performance. A good coach helps others to identify new ways to address challenges and get better results. Unlike directive conversations, coaching allows people to identify options that work their unique styles. It also helps them to solve problems independently while developing new capabilities. Effective leaders and managers use coaching when appropriate as a key approach to improve performance and develop people.
Many healthcare systems recognize the value of coaching. At the Center for Executive Coaching, the fastest-growing segment of our membership is with healthcare leaders – including C-level executives, Human Resources leaders, and physician leaders.
Following are five reasons why learning to coach has an impact:
One: Help people to handle overwhelm and multiple priorities.
To put it bluntly, healthcare executives, managers, and front-line employees are swamped. With all of the strategic initiatives to execute and daily fires to fight, there is rarely enough time to do everything required.
This can lead to stress, feelings of overwhelm, and diminished productivity.
Coaching helps. Executives and managers can coach their direct reports to stay focused on the most important priorities, set boundaries, and keep their teams aligned and working on the things that matter most.
Coaching also helps to uncover root causes and solutions to issues that drain time and productivity. For instance, the CEO of a major health system asked for coaching from her team about why she felt she had to work 24/7. The team challenged her to map on an organization chart all of the initiatives she was leading. After this exercise, the CEO realized that she was doing the work of multiple executives. She concluded that she needed to delegate more effectively while also developing or hiring additional resources.
Two: Develop talent.
Coaching is one of the most effective tools available to develop talent. Many healthcare organizations don’t have enough leaders who can help the organization grow and/or execute key initiatives. In addition, many organizations suffer from huge variability in the ability of their managers to engage their teams and get consistent results.
By learning to coach, healthcare leaders can build organizational capacity and consistent results across units. In contrast to the traditional command-and-control approach to management, coaching is about developing others, not telling them what to do and how to do it. Coaching enables people to think on their own and work proactively to solve their own problems. Over time, they become more self-reliant. They develop their own initiative and leadership skills to tackle difficult problems.
More specifically, coaching helps executives, managers, and their teams solve problems more effectively. It is often hard to get things done in health systems. Sometimes it seems that no one wants to say “yes” to an idea, while any single person can say “no” and essentially block the idea from moving forward at all.
In contrast, organizations that have coaching as a core competency support employees to keep coming up with ideas, get stakeholder buy in, know when to ask for support from above to keep the momentum going, and then implement for results. Most recently, we see a number of six-sigma coaches being trained in organizations to help uncover and expedite solutions to improve productivity, quality of care, and patient satisfaction.
When coaching becomes a competency that executives and managers have for developing talent, everyone wins. The employee wins because he or she develops new skills and abilities. The leader-coach wins because he or she spends less time solving problems that others can solve – thereby freeing up their time to address more strategic issues. Finally, the organization benefits because they develop a stronger backbone of middle managers and a pipeline of leaders ready to move up when required.
Special case of developing talent: physician leaders.
A special case of developing talent involves physician leaders. In many healthcare systems, physicians are stepping out of practice and into administration. Unfortunately, few have been trained in leadership or management. Many have major blind spots that hinder their performance, frustrate colleagues, and hurt productivity.
Coaching is a powerful way to help physician leaders become aware of their styles, how they interact with others, and make choices to improve their ability to execute and work with others in productive ways.
While it often makes sense for health systems to hire external coaches for physician leaders, that is sometimes not enough. Executives can use coaching as a tool to help physician leaders think in new ways about the best way to handle different situations and continue to develop professionally.
Three: Improve employee engagement.
It is said that employees don’t leave bad organizations, they leave bad managers. For this reason, improving employee engagement is not just a matter of responding to annual employee surveys. It requires managers who know how to engage their teams, authentically and personally.
True engagement happens one employee at a time. Effective managers engage employees by connecting with each employee one by one, choosing the right leadership strategy for each employee, giving regular feedback, acknowledging employees for their contributions, and helping employees develop professionally.
Unfortunately, few managers in healthcare have formal training in how to engage and mobilize employees. Many come from clinical backgrounds and haven’t learned management skills. Others learned from poor role models and have no one else to emulate.
Executives with coaching skills help new and even seasoned managers improve their ability to better engage and mobilize their teams. For instance, one of the most powerful coaching methodologies that we teach at the Center for Executive Coaching is a comprehensive approach to coach managers so that they become better at building effective, motivated teams of talented people.
At the same time, managers who know how and when to coach are more likely to build an engaged team. Coaching requires listening, involving, and valuing the other person’s talents. Coaches also take time to understand the aspirations, motivations, and unique talents and style of their employees and team members. These are attributes that tend to build engagement and loyalty.
These practices lead to improved employee loyalty and reputation as an employer of choice.
Four: Build teams that are moving in the same direction.
Many teams in healthcare systems are not as aligned as they could be. Team members often have different agendas and different levels of commitment.
Executives and managers with coaching skills can coach team members – individually and as a group – to have open, honest conversations about what is required for team success.
For example, in one team coaching exercise, team members are coached to give honest feedback and advice to each other about how the team as a whole can get better, and how individual members of the team can make more positive contributions. Team members also learn to receive and respond to the advice productively, and collaborate to move forward in new and more effective ways.
Five: Create a culture that is willing and ready to execute change.
Finally, coaching skills enable large-scale culture change. When executives want the organization to change, they need to go first and model the changes they want to see. This requires them to collaborate and coach each other about key habits and behaviors they want to see in each other.
From there, culture change flows down through the organization, the same way that chocolate flows down a chocolate fountain, from one layer to the next. Executives and managers who know how to coach can use their coaching skills to help the next level think about the changes that need to happen, and come up with their own insights about how to adopt and model the change. They can also coach managers on the right messages to send to be sure that everyone is consistent and on the same page.
Case Study: $1 billion health systems accelerates change using coaching skills as a platform
Recently we worked with the CEO and leadership team of a $1 billion health system. The system was facing huge pressure to change – from the need to increase revenues, double profit margins, and make improvements to both quality and service. The team was struggling in part because the organization was not moving at the pace required.
A retreat focused on coaching skills introduced processes to coach employees in a variety of situations: leading change, building high-performance teams, engaging and mobilizing their employees, handling overwhelm and multiple priorities, and creating a high-performance culture.
During this process, the leaders had a number of insights about what was working and gaps that they needed to fill. For instance:
- They acknowledged that some of their direct reports were obstructing change and needed to be removed, redeployed, or have their roles shrink.
- They identified areas to coach direct reports about ways to be more proactive in moving the change agenda forward.
- They agreed to coach their direct reports to get better at sending consistent and authentic messages about the change required.
- They learned that the organization as a whole was spending too much time on issues not directly related to the change process, and that everyone needed to do a better job focusing, delegating, and setting boundaries. The leadership team recognized the need to coach their direct reports to get focused, set the right priorities, and take things off their plates in order to spend enough time on the change process.
- The team coached each other on behaviors they wanted to see from each other in order for the team as a whole to model the change they wanted to see throughout the organization. For instance, one executive learned that she needed to care less about being liked and avoiding conflict, and stand up for herself and for the highest possible standards. Another learned that he has to delegate more effectively, even if that means taking time to develop his people.
A next step from this retreat was to repeat the process with the next layer of management. That way, the commitment and readiness for change flowed through the organization, one layer at a time.
Coaching is not a panacea. We are not suggestion that learning coaching skills is going to solve all of the daunting challenges that healthcare organizations face.
However, in terms of return on investment, creating a culture of success through coaching is one of the most powerful strategies that healthcare organizations and leaders have at their disposal. Coaching is am effective tool to help people get focused, develop talent and new leaders, align teams, and accelerate change.
Andrew Neitlich is the Founder and Director of the Center for Executive Coaching, which trains executive and leadership coaches worldwide. He is the author of The Way to Coach Executives and Elegant Leadership: Simple Strategies, Remarkable Results. As a coach and consultant, Andrew has helped a number of leading healthcare systems with change leadership and performance improvement initiatives. He received his MBA from Harvard Business School.