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Performance Outcomes Sustainability-Coaching©: How to Solidify Transformational Change in Healthcare
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Editor’s Note:
Coaching is an integral part of helping your customer have the best workplace experience and is the tool that will push cultural change and make it sustainable. In this piece, our guest authors take the customer experience training, demonstrating how management can make a deeper commitment to internal customers. Their perspective discusses the value of one particular tool.
By Katharine B. White & William T. White
CHG Guest Authors
Most transformational efforts in healthcare fail early in the change cycle, primarily due to three common factors:
- Project management planning deficits1
- Poorly executed change-management strategies/tactics2
- Half-hearted senior management sponsorship/follow-through3
What is perhaps healthcare’s greatest challenge however, is that even highly successful benchmark transformational change efforts (e.g., the Johns Hopkins ICU Collaborative) that achieve groundbreaking initial results, are strongly challenged to continuously sustain and improve performance outcomes excellence.4
Looking at traditional models.
Healthcare’s traditional approach to initiating culture change and “holding the gains” involves implementing large-scale “leadership and human resources” competency development/management models. Widely researched and prescriptively taught, the proponents of these models seem to leave little room for debate regarding logical adequacy and empiric validity; the prevailing mantra is “organizations should just go do them.”
Executives, directors and managers are deployed to leadership training by “plane, train and automobile” (teleclass, classroom, Webinar, e-learning, for example) to get smarter and to become more effective managers of others, so as to achieve more consistent outcomes. Competing schools of thought have emerged in healthcare over the past several years that dismiss competency management approaches in favor of standardized management models that almost exclusively focus on outcomes.
Getting realistic in 2008.
A “Healthcare Reality Check” reminds us that as we approach 2008, hospitals continue to be plagued by some or all of the following: preventable medical errors, safety incidents, variable clinical outcomes, patient satisfaction shortcomings and care -provider disengagement.
Despite highly intelligent and extremely dedicated leaders and care providers, “healthcare” just can’t seem to get it right.
A “Human Resources Reality Check” sheds additional light on the problem: A recent Leadership IQ Study (20,000 participants) found that while 93 percent of healthcare managers thought they communicated and supervised employees’ expectations extremely well, only 11 percent of their direct reports agreed.5
Such a performance management gap in what is perhaps the most transactional and emotional life and death work setting of all, is both stunning and unacceptable. A proposed “can’t miss” solution to this seemingly unresolvable dilemma is Performance Outcomes Sustainability-Coaching©
A look at POS-Coaching.
Performance Outcomes Sustainability-Coaching (POS-Coaching)© is a performance management innovation uniquely designed to sustain healthcare performance outcomes. This is a specific coaching methodology of Healthcare Values: Patients First ® (HCV: PF), a cultural transformation enhancement innovation which integrates a hospital’s Quality Management, HR and Operations Infrastructures.
HCV: PF® guides hospitals to focus 50 percent of total performance management efforts on the behavioral competencies of Communication, Collaboration, Patient-First and Continuous Improvement (deficits of which are responsible for nearly all preventable errors, clinical variation and patient dissatisfaction) and 50percent on technical care/service outcomes.
In concert with this approach, POS-Coaching is a bimonthly, structured coaching experience that equitably supervises priority behavioral competencies and technical care outcomes. A template of competency and technical outcomes measures (can’t manage what isn’t measured) guides the coaching dialogue, which ultimately focuses on continuously identifying opportunities to improve patient care/services.
Teaching skills and conducting bi-monthly sessions.
Manager-coaches are taught high-level leadership and coaching skills utilizing nontraditional methods, and employees are engaged in the process of final-drafting the behavioral competency measures (customized to care setting) around which they are coached.
This unique performance management approach reduces change management resistance, fosters relationship and team building, enhances micro- and macro-level communication and, perhaps most importantly, improves and sustains patient care and service outcomes.
The roll-up of bi-monthly sessions constitutes the employee’s annual performance evaluation that can leverage pay for performance. Early on, a hospital’s core values are mapped to Communication, Collaboration and Patient-First behavior measures that facilitate cultural transformation evolution.
A key process element.
While multiple structural and process components of “HCV: PF” work together to transform an aligned hospital to “next generation cultural integration,” it must be recognized that POS-Coaching is the key process element that helps achieve that most elusive, sought-after prize: performance outcomes sustainability.
Only when performance outcomes excellence can be sustained over time, can a hospital legitimately stake a claim for tried and true cultural transformation renaissance. And only when performance excellence is equally measured and coached according to both behavioral competency and technical care/service outcomes, is healthcare renaissance possible.
For more information about POS-Coaching, click here.
Footnotes
1 Maxfield, David, “A Healthcare Managers Guide to Predicting and Preventing Project Failure,” www.healthleadersmedia.com- November 2007
2 White, Katharine, “Light on Healthcare: The Achilles Heel of Holding Accountability in Healthcare,” http://www.lighthousepsi.com/newsletters/news-2006-nov.htm
3 White, Bill, “Managerial Courage: Does Your Organization Qualify?”,
http://www.lighthousepsi.com/newsletters/news-2007-march-april.htm
4 Provonost, Peter: Keynote Speech, Rhode Island ICU Collaborative Outcomes Congress 9/27/07 (Peter Provonost, MD, PhD: John Hopkins Hospital ICU Collaborative)
5 Murphy, Mark: “What Great Managers Do Differently,” www.leadershipiq.com.
Katharine B. White, MSN, RN, CPHQ, CC, ACC, is president of Lighthouse Performance Strategies, Inc. and a Strategic Affiliate of Corporate Health Group. She may be contacted at www.lighthousePSI.com
William T. White is CEO of Healthcare Renaissance Consulting, a wholly owned subsidiary of Lighthouse Performance Strategies, Inc. Contact him at www.healthcarerenaissance.net
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