Partners for Patient Coaching for Improvement Series Participant Workbook

Session One: A Coaching Mentality

Leadership vs. Management-Self Assessment Your Leadership / Coaching Activities 3 Your Management Activities Note: This is for your personal use and not intended for you to submit to WHA

Assessing your Feedback Take a few minutes to answer the following: 4 ConceptYes 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. Note: This is for your personal use and not intended for you to submit to WHA

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 Note: This is for your personal use and not intended for you to submit to WHA

Session One: Goal Setting Two strengths that I have in regards to coaching and leadership include: Two opportunities that have to improve on my coaching and leadership include: Two coaching and leadership goals I want to complete this month include: I will know when I have achieved these goals when: Note: This is for your personal use and not intended for you to submit to WHA

Session Two: Engaging Hearts and Minds

Identifying the Why and What Use the table below to help articulate your improvement message… WhyWhat Why is this important to the patients?What are you asking to be accomplished? How does it help improve care and safety?What are they key steps to accomplishing the request? Why is this important to the employee?How will you know when the request is completed? How does it positively effect the work they do? Why is this important to the unit / hospital? How does it positively effect the unit / hospital?

Develop your Story Framework Beyond “trust me!” … 1. Decide what qualities make you trustworthy. 2. With your chosen quality, tell a 3 minute story that delivers evidence of that quality, e.g.: –Person/event in your life that taught you the importance of that quality –A time that you failed your own standard and vowed to never let it happen again –A specific event that exemplifies this quality in you 3. Find a trusted colleague to listen to your story and give you feedback. 4. Use it, more than once.

Session Two: Goal Setting Two opportunities that have to improve on my coaching and leadership include: Two coaching and leadership goals I want to complete this month include: I will know when I have achieved these goals when: Note: This is for your personal use and not intended for you to submit to WHA

Session Three: Facilitating Effective Coaching Interactions

Rules of Scenario Based Role Playing #1 Rule of Scenario Based Role Playing: Role play to the 80% not the 20% Role plays are intended to help people practice what usually happens They are not intended to demonstrate the extremes of human behavior If you are the recipient of the coaching feedback, be nice so your peer can learn #2 Rule of Scenario Based Role Playing: You play like you practice If you are the person practicing, take the practice to heart. Get into the role and act exactly as you would if you were actually providing feedback. By making the role play as real as possible, you are building mental and muscle memory, so when the “game” starts, you are ready.

A Universal Framework for Effective Coaching Interactions Universal Coaching Framework Defined: The below coaching framework has been widely recommended and trained by several world-class leadership training institutions. The two main keys to this framework are: It requires both the staff member and the coach to first positively process before providing constructive feedback It encourages goal setting and follow-up This framework can be used for a wide array of scenarios. Step 1 : Frame the conversation (Why are we here?): __________________________________________________________________________________________________ Step 2 : Ask them to positively self-reflect on at least 2 topics: __________________________________________________________________________________________________ Step 3: Ask them to constructively self-reflect: __________________________________________________________________________________________________ Step 4: Summarize your understanding of their statement (So it sounds like…): __________________________________________________________________________________________________ Step 5: Provide your positive observations: __________________________________________________________________________________________________ Step 6: Provide your constructive observations: __________________________________________________________________________________________________ Step 7: Help them set no more than 2 goals for improvement and document goals: __________________________________________________________________________________________________ Step 8: Schedule a time to meet to assess progress on goals: __________________________________________________________________________________________________ Step 9: At next meeting repeat process.

Universal Coaching Framework Scenarios Scenario One: Nancy is a valued night shift nurse. She has been at WHA Memorial for 9 years and is respected by her peers. WHA Memorial has recently started hourly rounding. Nancy has been struggling with consistently completing hourly rounding. Tom, Nancy’s manager and leader of the hourly rounding initiative, sit down to discuss her obstacles. Scenario Two: Joanne is the team lead for WHA General’s Readmissions Improvement Team. The improvement project started out with a lot of energy and enthusiasm and made initial progress. As of late it seems as if the project has fallen off of Joanne’s radar and progress is stalled. Stephanie is the director who oversees improvement projects. Joanne and Stephanie sit down to discuss.

Asking for Leadership / Physician Engagement Keys:  Start with reiterating your shared purpose  Be clear about what you need, and what you are willing to commit to doing. ______________________________________________ “I want to talk about our goal of _______. I am fully committed to achieving that goal”. “What I really need is _______, because it will____”. “I want you to know that you can count on me to_____”. “ Does this make sense to you, or do you have other ideas?”

Asking for Leadership / Physician Engagement -- Scenarios Scenario One: Jana is a nurse manager that is in charge of implementing an early elective delivery hard stop policy in her hospital. She needs Doctor Evans to act as a physician champion of the project and help communicate and enforce the policy with all other doctors that deliver in her hospital. Scenario Two: Travis is a quality improvement manager who is launching a new bid side reporting initiative at his critical access hospital. They have tried implementing bedside reporting in the past but it has never stuck. He wants to ask the CEO Mark Cleveland to champion the project.

Engaging the High Potential Fence Sitter Strategy Engaging the High Potential Fence Sitter Strategy defined: This strategy can be used to help nudge a reluctant, high potential associate into action. It keys on helping the individual understand the opportunity while providing them confidence that they can provide value to the project. Step 1: Remind them of the opportunity, briefly describe and ask them if they had any questions on the details: __________________________________________________________________________________________________ Step 2: Ask them how they feel their knowledge skills and abilities could contribute: __________________________________________________________________________________________________ Step 3: Reiterate to them how you feel they can contribute: __________________________________________________________________________________________________ Step 4: Ask them if they have any obstacles that would keep them from participating in the project: __________________________________________________________________________________________________ Step 5: Help them work through the obstacles: __________________________________________________________________________________________________ Step 6: Tell them how to show interest / sign up for the project: __________________________________________________________________________________________________ Step 7: Ask for their commitment to follow-up: __________________________________________________________________________________________________ Use the above format to help address the scenarios on the next page.

Engaging the High Potential Fence Sitter Scenarios Scenario One: Stephanie is a very solid contributing nurse to the ICU unit. Her unit manager Tom is starting a CLABSI project to help reduce the risk of Central Line infections. In the staff meeting Tom asked for volunteers for the team and was hoping Stephanie would raise her hand. She didn’t. They are sitting down for Stephanie’s monthly one-on-one discussion… Scenario Two: The Med-Surge manager and their quality consultant want to trial several new materials designed to reduce the prevalence of hospital acquired pressure ulcers. Their vender is recommending a few new heel pressure reducing boots, as well as a new set of organic lotions. The Med-Surge manager knows that one nurse really focuses on patient repositioning every hour and other pressure ulcer prevention initiatives. She was surprised in a nurse staff meeting, that the nurse in mind did not volunteer, when the group was asked.

The Meeting Disrupter Strategy The Meeting Disrupter Strategy Defined: This strategy works very well to help individuals who are disruptive in meetings self evaluate and learn potential strategies that will help them improve their in-meeting communication. The key to this strategy focuses on framing the conversation in terms of perception and observations, so the receiver does not feel hurt and become argumentative. __________________________________________________________________________________________________ Step 1: Insure that they feel comfortable, safe and that you understand them: __________________________________________________________________________________________________ Step 2: Identify what you observed in the meeting and ask them to explain why they felt that way: __________________________________________________________________________________________________ Step 3: Reiterate or paraphrase their explanation, letting them know that you understand their concerns: __________________________________________________________________________________________________ Step 4: Explain to them how they may / can / are perceived by their peers and leaders when they communicate that way: __________________________________________________________________________________________________ Step 5: Work together to come up with an alternate solutions to expressing feelings on topics in meetings when they disagree:

The Meeting Disrupter Scenario Use the Meeting Disrupter Strategy to help address the below scenario. Tom is a nurse on the med serge unit. In a department meeting when discussing the new EMR daily falls and pressure ulcer risk check lists, Tom was very vocal about: “All I do is spend my time on that computer. Can’t we just throw them all away and use paper again? I want to be a nurse not a software engineer.” After Tom’s comment the meeting got derailed and people lost focus. Tom and Stephanie are sitting down to discuss his behavior.

Paraphrasing Framework Paraphrasing Framework Defined: Paraphrasing is a very effective was to prove to the other party that you are actively listening. It also gives the person speaking the opportunity to correct you on your interpretation of their content. The keys to effective paraphrase include: ___________________________________________________________________________________ Start your statement with: “So it sounds like…”: ____________________________________________________________________________________ Restate what they said in your own words: ____________________________________________________________________________________ Ask if what you said is correct: ____________________________________________________________________________________

Paraphrasing Framework Scenarios Use the Paraphrasing Template to help address the below scenarios. Scenario One: Beth is a third shift manager. She is feeling pressured to complete hourly rounding on her shift. She is frustrated because she is trying very hard, but has less CNA and administrative support on her shift. Scenario Two: Robert is working very hard to get the team engaged in their new falls initiative. The initiative started out strong but is now an afterthought. Robert is frustrated because he does not feel like the management staff is providing enough time and focus on the initiative.