Contributors: Jennifer Tomasik and Richard Levin
To learn more about Jennifer and Richard, click here.
Physician and nursing leaders at a world-renowned academic health center compete for resources to pursue individual quality and safety priorities, rather than work together on shared priorities to improve care.
The top team of a healthcare start-up found that it can optimize the services and technology silos of its business, but leaders are challenged to integrate products and services to create extraordinary value for customers.
The CIO of a multi-state health system understands the importance of collaboration to implement an electronic health record, but the work of engaging across administrative, technical, and clinical functions never happens. You can guess the result.
Today’s healthcare environment is fraught with diminishing resources and a healthy dose of uncertainty about the future. The need for different disciplines to work beyond their respective professional and organizational silos is critical to creating value and ensuring great care. As evidenced in the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health (2011), “As the delivery of care becomes more complex across a wide range of settings, and the need to coordinate care among multiple providers becomes ever more important, developing well-functioning teams becomes a crucial objective throughout the healthcare system.” 1 We believe this is true for clinical and administrative leaders alike, who can feel culturally separate in longstanding, almost tribal, professional silos. Silos foster the continuation of tenacious traditions that fail to acknowledge the patient as a holistic being, like separating dentistry from the rest of medicine or viewing departments or specialties as if they are disconnected from the larger organizations of which they are part. Teamwork and collaboration across disciplines is often expected, but rarely taught or explicitly promoted.
We see the potential in altering this trend by leveraging and evolving a traditional support for healthcare leaders—executive coaching. We have experienced tremendous success reinventing coaching as a bridge between leadership development and the growth of the organizations the leaders spearhead. We call this Coaching 2.0.
Defining Coaching 2.0
Coaching typically focuses on strengthening an organization’s leader, or guiding high potential executives who are not yet ready for prime time. When executive coaching was founded in the mid-1980s, its objective was to advise and teach senior executives, especially CEOs, to become more motivating and inspiring leaders. In this way, traditional coaching has been oriented around individuals—improve or “fix” the leader, and you will improve the organization’s performance.
The complexity of 21st century organizations demands a different approach. In today’s organizations—and in healthcare in particular—collaboration is key. Work is more frequently accomplished through influence, rather than authority. People come to work because of what they can contribute to a bigger mission. Coaching individuals is necessary, but not sufficient. It needs to be grounded in the set of interactions among the individual, the mission, and the organizational system as a whole. In Coaching 2.0, the leader is central, but the focus expands to the actions of the broader team and the structure and resources needed to tackle the organization’s most critical priorities. In other words, what does the business need to succeed, and how do we re-orient the leader, the team, and the ways in which they work together to make success possible?
Coaching 2.0 in Action
Consider the physician at a teaching hospital who was tapped by a Fortune 500 pharmaceutical company to be its Senior Vice President. Excited and energized to take on his first professional leadership role, the SVP found himself leading a 200-person department. With no leadership or management training, the SVP decided it would be good practice to meet individually with all 200 of his “direct reports.” After meeting with 50 employees, the SVP, exasperated and exhausted, sought the services of an executive coach. When the coach suggested the SVP narrow his direct reports to five, the SVP slapped himself on the forehead and said, “I never realized I could do that!”
There are many dimensions to this story. One: coaching does not happen in a vacuum; leaders work within organizations. Two: the organization failed to sufficiently onboard its new SVP. And three: the SVP’s department remained virtually at a standstill until its leader learned how to lead. This slowdown created undue stress on the larger system, which risked imploding. This was an opportunity not only to continue to provide coaching to the leader, but to work with his new team to create a strategic roadmap and determine how to organize for successful implementation. In a relatively short time, the department shifted from feeling stagnant to aligned and focused on a shared strategy.
“Stress on the system” is one of the primary reasons leaders seek the services of a coach or a management consultant. Stress is an output of systems dominated by silos, as silos block the flow of information and resources toward shared aims. Stress is increasingly pervasive in healthcare, with ripple effects that threaten safety, quality, and productivity. Leaders under stress often “unload” on their followers, showing anger or “bad behavior.” The stress then rolls downstream—for example, with doctors yelling at nurses, nurses shouting at administrators, administrators antagonizing patients or vendors, and so on—until the system begins to falter. In many health systems, stress, more than the need to achieve patient-centered care, is the key factor driving work forward. In response to outbursts and missed metrics, human resources departments often seek coaches for remedial rather than developmental interventions, and administrators frequently hire management consultants to repair the system.
Coaching 2.0 ties all of these components together, using cross-trained management consultants and executive coaches who work together to address the human, organizational, and business dimensions of an organization. With Coaching 2.0, interlocking pieces of the healthcare ecosystem more seamlessly connect, with the potential to create a lower-stress, more cost-effective, and more efficient healthcare business.