A Research Paper By Renae Waneka, Leadership and Business Coach, UNITED STATES
Culture of Coaching in Health Care Organizations
Healthcare workers were stretched thin and burned out prior to the COVID-19 pandemic. With the onset of the pandemic, burnout and resignations among healthcare workers soared, while data indicate that the shortage of healthcare workers that has plagued the industry will continue until 2030. Organizations are grappling with how to best solve these problems. Creating a culture of coaching within an organization may be one way to address these issues in health care. Healthcare leaders who are interested in enhancing employee performance, retention, and well-being may benefit from applying some of the recommendations that follow.
Healthcare Worker Well-Being
Prior to the COVID-19 pandemic, healthcare workers were pulled between increasing administrative responsibilities and more limited resources to provide care for their patients. Shortages of primary care clinicians and registered nurses have further impacted the ability of the health care system to care for patients and taxed both the system and its workforce, and these workforce shortages are expected to continue until 2030(Spetz, 2017); (Spetz, 2022).
When the pandemic hit, clinician well-being reached an all-time low, with high rates of burnout and clinicians leaving the field in unprecedented numbers. The American Medical Association found that “job turnover in the primary care physician workforce leads to an additional $979 million in annual excess health care costs across the U.S. population, with $260 million (27%) attributable to burnout” (American Medical Association, 2022). In 2022, Dr. Vivek Murthy, the U.S. Surgeon General, identified burnout among healthcare workers as a top priority and proposed actions organizations can take to help solve these problems(U.S. Health and Human Services, 2022). One of the recommendations is to “transform workplace culture to empower health workers and be responsive to their voices and needs”(U.S. Health and Human Services, 2022). Gallup found that – regardless of industry – great managers who care about the well-being of their employees had less turnover and that employees who did not experience burnout are highly engaged at work, have high levels of well-being, and work in a strengths-based culture(Clifton, Gallup Finds a Silver Bullet: Coach Me Once Per Week, 2021).
Coaching Within Healthcare Organizations
Coaching for clinicians has been shown to reduce burnout, improve well-being, and lessen the likelihood that clinicians will reduce their clinical time, all of which have positive impacts on the performance of healthcare organizations and the health of patients (Dyrbye, 2019)(Fainstad, 2022). One study shows that physicians who received one-on-one professional coaching had a significant reduction in emotional exhaustion and symptoms of burnout(Dyrbye, 2019), while another study found that physicians in their residency training who were randomly assigned to six months of group coaching also had a significant reduction in emotional exhaustion compared with a control group(Fainstad, 2022). Most published research on professional coaching in health care focuses on physicians. However, research in industries beyond health care indicates that coaching skills throughout the hierarchy of an organization, especially during organizational change, can boost employee well-being(Huflejt-Lukasik, 2022).
One-on-one and group coaching is often reserved for key organizational leaders. Providing coaching to these individuals first is supported by research from Gallup that shows that the quality and skills of leaders and managers account for 70% of the variation between great and horrible workplace engagement(Clifton, Gallup, 2019). Investing in coaching for leaders and managers improves the effectiveness of these individuals by empowering them to leverage their strengths to lead and manage organizational change, which has a large impact on staff well-being at all levels of the organization. When staff feel acknowledged and empowered to have agency over their work lives, they want to invest time into the organization, which leads to increased satisfaction and well-being at work.
Peer coaching is another method that provides coaching skills and support to individuals. It includes two or more peers who connect formally or informally to talk about work issues. A literature review found five core components consistent across peer coaching engagements: (1) a voluntary, collaborative relationship; (2) self-evaluation; (3) coach feedback; (4) setting goals or preferred outcomes; and (5) leveraging participant strengths and amplifying their capacity (Schwellnus, 2013). Peer coaching can be an ongoing professional development opportunity for staff and is often more affordable and effective at transferring knowledge and skills than training, as shown in a study of allied health professionals using peer coaching with one another (Ladyshewsky, 2010).
While starting coaching with organizational leaders provides guiding principles and behaviors that benefit an organization, finding cost-effective ways to provide access to coaching skills and conversations to a greater number of individuals within the organization allows the organization to empower its people to create the positive change they want in the workplace. According to Cooks-Campbell, coaching within organizations empowers individuals, increases employee engagement, improves individual performance, provides a deeper level of learning, and enhances employee commitment to the organization(Cooks-Campbell, BetterUp, 2021). Teaching skills such as active listening, asking questions, and giving and receiving feedback provide a coaching framework that can be used by everyone in the organization when tackling challenges. When conversations include some of these elements, it models coaching across the organization.
Considering the costs associated with job turnover and the high rates of burnout among healthcare workers, providing coaching and training around coaching skills are mechanisms that may help address these issues.
Infusing a Culture of Coaching in Healthcare Organizations
Coaching is one mechanism that organizations can use to create a workplace culture that empowers individuals to build a culture that works for them. Infusing a culture of coaching within an organization can provide the value of coaching to a greater number of individuals across the organization. This increases access to coaching and can enhance employee performance and well-being while addressing organizational challenges such as burnout and clinicians leaving the workforce.
While formal one-on-one and group coaching can cost upwards of $600 per hour(Whitmire, 2019), creating a culture of coaching within an organization that includes one-on-one and group coaching, workshops to teach coaching skills to a greater number of individual employees, and peer coaching circles is a more cost-effective way to incorporate coaching at all levels of an organization and empowers individuals to work together to solve organizational challenges.
Here are some guidelines to consider when creating a culture of coaching within an organization:
Foster a coaching mindset: Encourage a coaching mindset by emphasizing the importance of active listening, asking questions, and providing feedback. Coaching explores behaviors and uncovers the root causes to help individuals make lasting changes that benefit themselves and their organizations. With a coaching mindset, leaders and managers outperform their peers and are better able to leverage opportunities, make tough decisions, and engage their employees (Tan, 2022). Encourage employees to seek out coaching opportunities and to view coaching as a valuable tool for personal and professional growth. This can include using coaching conversations to set goals, provide feedback, and evaluate performance. When leaders and managers model a coaching mindset, it encourages others to follow and engages employees in problem-solving.
Encourage coaching at all levels: Provide one-on-one coaching for key leaders and managers. Coaching for these leaders gives them exposure to coaching skills and helps them reach their personal best, adjust to environmental demands, and expand their personal impact. Since these leaders often set the culture and associated behaviors for the organization, investing in their leadership is a way to model key practices across the organization. Using coaching skills with direct reports and peers will model this behavior and encourage employee engagement in solving work challenges.
Encourage all employees to engage in coaching conversations, regardless of their role or level within the organization. Bedside staff, managers, and executive leaders can engage in coaching conversations with their peers to troubleshoot work challenges together. Peer coaching enhances collaboration, connection, performance, and well-being for those who participate, which also provides organizational benefits in terms of performance and outcomes(Cooks-Campbell, 2022). Organizing peer coaching circles in which staff at similar levels within the organization meet to troubleshoot work challenges together provides structure to problem-solving and encourages staff to take responsibility for creating a workplace culture that resonates with them.
Provide training and resources: Provide training and resources to help employees develop coaching skills. This provides practical skills that can be provided at any level of an organization and helps instill common principles and practices into the organizational culture. This can include workshops, online courses, and access to coaching resources such as books, articles, and videos. Coaching skills improve the ways employees interact with each other, patients, and other stakeholders and have been shown to address 80% of routine obstacles at work(Center for Creative Leadership, n.d.).Training and resources that focus on active listening, asking questions, and giving and receiving feedback all support a culture of coaching.
Set clear expectations for coaching: Clearly communicate the expectations for coaching within the organization. This can include expectations around frequency, duration, and format of coaching conversations. Having a defined process is often beneficial as individuals embark on a new path of coaching together. Outlining something concrete for people to follow and providing a defined timeframe to test the process and provide feedback sets the plan up for success. As with any project, sharing why your organization is pursuing a culture of coaching and how people will work together to make it happen is useful in bringing people along.
Recognize and reward coaching efforts: Recognize and reward employees who engage in coaching efforts. This can include providing public recognition, bonuses, additional professional development opportunities, or other incentives. Recognition increases engagement and shows that you value employee contributions (Prossack, 2021), while also reinforcing the behaviors you want to see within the organization.
Lead by example: Leaders within the organization should model coaching behaviors by engaging in coaching conversations, seeking out coaching opportunities, and providing coaching to their team members. Since culture and expectations are modeled by key leaders and influencers in the organization, staff interested in advancing in the organization will model behaviors seen in their superiors (Groysberg, 2018). As a leader, what is one behavior that you can showcase to build or reinforce a culture of coaching?
By following these guidelines, organizations can create a culture of coaching that supports employee development, enhances performance and well-being, and fosters a positive work environment.
Healthcare Workforce
Healthcare workers have reported unprecedented levels of burnout and are resigning from the workforce at greater rates than they were prior to the COVID-19 pandemic. With healthcare workforce shortages anticipated to continue, organizations are looking for solutions. Providing coaching skills and creating a coaching culture within a healthcare organization can address some of the causes of burnout, enhance employee well-being, retain employees, and set individuals and the organization up for success. The following one-page guide to the information shared here provides an easy way to get started today.
Guidelines for a Culture of Coaching in Healthcare Organizations
Provide the following coaching opportunities:
- One-on-one or group coaching to leaders and managers.
- Workshops to teach coaching skills to a greater number of individual employees. Include skills such as active listening, asking questions, and giving and receiving feedback.
- Peer coaching circles at different levels within your organization so that everyone has an opportunity to use their coaching skills.
Instill the following into your organizational culture:
- Foster a coaching mindset by emphasizing the importance of active listening, asking questions, and giving and receiving feedback. Use these skills in your communications with individuals across the organization.
- Encourage coaching at all levels whether this is through one-on-one or group coaching, coaching with direct reports, or peer coaching. Anyone – at any level in the organization – has an opportunity to learn and use coaching skills.
- Provide training and resources so that everyone in the organization has a common set of coaching tools that they can use. Consider providing a workshop on active listening, asking questions, or giving and receiving feedback. Tip sheets or other resources that provide a clear and concise way for anyone to incorporate coaching into their daily work lives is another option to consider.
- Set clear expectations for coaching so that everyone knows why the organization is fostering a culture of coaching and the frequency, duration, and format of coaching that is expected of them.
- Recognize and reward coaching efforts so that they reinforce the behavior that you expect to see. Offer public recognition, gift cards, or other incentives. Consider encouraging all staff to share and recognize others for their coaching efforts.
- Lead by example so that others in the organization see leadership using coaching behaviors in ways that benefit their teams and the organization.
References
(2022, Feb 28). Retrieved from AMA-ASSN.ORG.
American Medical Association. (2022, Feb 28). Retrieved from ama-assn.org.
Center for Creative Leadership. (n.d.)
Clifton, J. (2019, May 7). Gallup.
Clifton, J. (2021, May 27). Gallup Finds a Silver Bullet: Coach Me Once Per Week. Retrieved from Gallup
Cooks-Campbell, A. (2021, November 12). BetterUp.
Cooks-Campbell, A. (2022, March 17).
Dyrbye, L. (2019). Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians A Pilot Randomized Clinical Trial. JAMA, 1406-1414.
Fainstad, T. (2022). Effect of a Novel Online Group-Coaching Program to Reduce Burnout in Female Resident Physicians A Randomized Clinical Trial. JAMA.
Groysberg, B. (2018).
Huflejt-Lukasik, M. (2022). Coaching as a Buffer for Organisational Change. Frontiers in Psychology, 13.
Ladyshewsky, R. (2010). Building competency in the novice allied health professional through peer coaching. Journal of Allied Health, 77-82.
Schwellnus, H. (2013). Peer-coaching with health care professionals: What is the current status of the literature and what are the key components necessary in peer-coaching? A scoping review. Medical Teacher, 38-46.
Spetz, J. (2017, August 15). healthforcecenter.ucsf.edu.
Spetz, J. (2022, September).
Tan, A. (2022, July 13).
U.S. Health and Human Services. (2022). Retrieved from hhs.gov
Whitmire, A. (2019, June 22). Institute of Coaching.