1. Partners for Patients Coaching for Improvement Webinar II Facilitating Effective Coaching Interactions Thomas Kaster WHA Quality Coordinator Stephanie Sobczak WHA Quality Manager 1

2. Overall Objective The objectives of this series: 1.Help you self identify your personal coaching style and opportunities for growth 2.Help you analyze your personal work environment to identify opportunities for effective improvement coaching 3.Provide you with the best known skills, resources and practice for leading effective improvement coaching interactions 2

3. Poll Question #1: Goal Setting Considering the below actionable item from the last Coaching for Improvement Webinar session, how would you describe your progress? Two coaching and leadership goals I want to complete this month include: a)I set two SMART Goals and was able to make significant progress on those goals b)I set at least one SMART goal and started to make progress c)I set at least one goal but have not made progress yet d)I was not able to set any goals.

4. Today’s Objectives / Structure The origins of coaching through asking questions An essential framework for effective coaching interactions Learn strategies for: – All performance level employees – Meeting disrupters – Getting engagement – Laggards Set future coaching goals 4

5. Poll Question #1: Results Considering the below actionable item from the last Coaching for Improvement Webinar session, how would you describe your progress? Two coaching and leadership goals I want to complete this month include: a)I set two SMART Goals and was able to make significant progress on those goals b)I set at least one SMART goal and started to make progress c)I set at least one goal but have not made progress yet d)I was not able to set any goals.

6. Poll Question #2: Finding time to coach Considering last months session, I was able to start or accomplish the following strategies for finding more time to coach? (Click all that apply)  Reducing time in meetings  Reduce unnecessary or duplicative work  Better manage e-mail  Delegate more effectively  Have more independent work teams  More quickly address teams that are failing  Have yet to start any

7. The System of Improvement Coaching 7 A Coaching Mentality (positive coaching ) Effective Coaching Interactions Finding Time to Coach Engaged Staff

8. Poll Question #2: Finding time to coach: results Considering last months session, I was able to start or accomplish the following strategies for finding more time to coach? (Click all that apply)  Reducing time in meetings  Reduce unnecessary or duplicative work  Better manage e-mail  Delegate more effectively  Have more independent work teams  More quickly address teams that are failing  Have yet to start any

9. The Socratic Method: Asking questions that lead to improvement “Although leadership is about moving people, the truth is nobody moves unless they move themselves. The Socratic method is a way to help people see when they need to move and where they need to move to.” The Socratic Method Leveraging Questions to Increase Performance M A J. N O R M A N H. P A T N O D E, U S A F 9

10. Stephen Covey: 7 Habits of Highly Effective People Use empathic listening to be genuinely influenced by a person, which compels them to reciprocate the listening and take an open mind to being influenced by you. This creates an atmosphere of caring, and positive problem solving. 10 Habit #5: First seek to understand and then to be understood.

11. Setting the Stage for a Coaching Interaction: Considerations 11 SuggestedAvoid Process Relationship First and then TaskJumping right into the constructive coaching conversation Enter each conversation assuming that the person wants to do things right Assuming that the person purposely is doing the wrong thing or does not care Make the meeting place a consistently safe place Only calling people in to your office or a meeting room when something bad happens Understand the psychology behind meeting set up. Having people sit in the corner of a room while giving them feedback Talk about perceptions and observationsUsing trigger words like always, never and starting sentences with “You.”

12. Setting the Stage for a Coaching Interaction: Considerations 12 SuggestedAvoid First seek to understand and then to be understood Downloading what they did wrong and how they need to fix it Getting them talking about positives in themselves Allow them to only focus on their negative aspects Provide timely feedbackWaiting until several improvement needs are identified and then addressing them all in one sitting Be comfortable when there is silence. Silence is golden Not allowing the individual the time to think through the situation Know when things have escalated and you need to regroup and reschedule Digging in your heals determined to win the argument

13. Avoid the Garbage Sandwich Avoid this classic technique: Top Bread: This is what you are doing well Middle: This is what you are doing wrong Bottom Bread: This is what else you are doing well 13

14. Why Avoid Using the Garbage Sandwich? It becomes predictable Staff starts to brace themselves whenever they receive a compliment It limits the recipient’s ability to self reflect and analyze There are better ways 14

15. A Framework for Effective Coaching Interactions (See workbook) Step 1: Frame the conversation-Why are we here Step 2: Ask them to positively self-reflect on at least 2 topics – Keep them positive Step 3: Ask them to constructively self-reflect Step 4: Summarize your understanding of their statement Step 5: Provide your positive observations 15

16. A Framework for Effective Coaching Interactions (See workbook) Cont… Step 6: Provide your constructive observations – Most times will align with their 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 16

17. When to use framework When meeting with a high achieving employee or staff member When meeting with a moderate achieving employee When meeting with a struggling employee It works great for almost all coaching interactions 17

18. Using the Framework Scenario #1 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. 18

19. Using the Framework Scenario #2 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. 19

20. Engaging the High Potential Fence Sitter Someone who: – You sense or know has much to offer but is not stepping up – You sense may be too shy or reserved to self promote – You know would be great for a project but does not volunteer 20

21. Engaging the High Potential Fence Sitter Strategy Cont… 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 21

22. Engaging the High Potential Fence Sitter Strategy 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 22

23. Engaging the High Potential Fence Sitter Scenario Scenario: 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 a 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 23

24. The Meeting Disrupter Someone who: – Generally has good intentions – There are always elements of truth to their comments – Struggles with communicating positively in various situations – Can be disruptive to meetings – Someone you do not want to loose – Can easily be interpreted as negative 24

25. The Meeting Disrupter Guidance They may not realize how they are perceived They may have very passionate stances on topics They may not have even taught how to communicate more effectively To insure you do not belittle, embarrass or insult, talk in terms of how they are perceived or observed 25

26. The Meeting Disrupter Strategy Step 1: Insure that they feel comfortable and 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 26

27. The Meeting Disrupter Strategy 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 27

28. The Meeting Disrupter 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. 28

29. The Very Late Adopters (almost laggards) Someone who: – Despite multiple communications and trainings, is still not consistently performing the new process – Has the ability to complete the process correctly – You sense there are other underlying reasons why they are not performing the requested process 29

30. The Very Late Adopters (almost laggards) Strategy The Five Whys Ask Why Five Times – You may get superficial answers in the first one or two attempts, but by the time you get to 4 and 5 you will most likely find a root cause. 30

31. The Very Late Adopters (almost laggards) Scenario The Five Whys “Joanne is a night shift nurse and somewhat of a leader in her peer group. The first and second shifts are performing well on hourly rounding. For some reason the third shift is not. Tom, Joanne’s supervisor sit down to talk about the situation.” 31

32. The Very Late Adopters (almost laggards) Example 5 Why’s approach example – I know that you have concerns with our new hourly rounding initiative. By helping me understand your concerns we may be able to help the entire unit. Why 1: “If I could instantly eliminate the obstacles that are keeping you from embracing this change what would they be?” – Answer: “We are just too busy and it is impossible.” Why 2: “When you say you are too busy, what do you mean? – Answer: “We just have too much to do” Why 3: “What are some tasks that you feel take up your time that keep you from completing hourly rounding.” – Answer: “For instance it seems like during the night shift we never have the supplies we need. I spend a lot of time looking for clean linens and supplies.” 32

33. Approaching a colleague who is resistant to participate (direct approach) 5 Why’s approach example continued… – Why 4: “Why do you thing you do not have enough supplies.” Answer: “Well the CNA staff always restocks supplies in the morning and by the end of the day, supplies are usually low.” – Why 5: “So what do you think we could do to insure your supplies are there for your when you need them?” Answer: “Maybe if supplies are checked prior to the staff change that could help.” – Paraphrase: “So if we developed a system that helped insure that you have the supplies you need, do you think that will help you complete hourly rounding. Answer: “It would certainly help.” – Keep digging: “Are there any other obstacles that might be keeping you from completing hourly rounding?” Repeat 33

34. Essential Skill: Active Listening and Paraphrasing “Actively” listening and processing the information being presented Understand an individuals barriers to participating Goal: The ability to repeat the sender’s message-“read back” – Paraphrasing is the most effective way to actively listen 34

35. Essential Skill: Paraphrasing Paraphrasing Framework 1.“Start your statement with “So it sounds like…” 2.Restate what they said in your own words: “So it sounds like you feel that if your supplies were made more available to you during the night shift, you would have more time for hourly rounding.” 3.Ask if what you said is correct: 1.“Is that correct?” Complete example: “So it sounds like you feel that if your supplies were made more available to you in the night shift, you would have more time for hourly rounding. Is that correct?” 35

36. How Can you Learn? According to Stephen Covey, the best way to master a skill is to teach it. Learn Do Teach Master 36

37. Resources for You Workbook – Framework for techniques – Role plays #1 Role Play Rule: 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 Be nice so we can learn 37

38. Coaching for Improvement Summary 38 A Coaching Mentality (positive coaching ) Effective Coaching Interactions Finding Time to Coach Engaged Staff

39. Closing 39 Great Job in 2012! Just like you make other goals, make coaching and leadership goals and well Look for a survey regarding the Coaching for Improvement Series, in late December. Have happy and safe holidays!