Dr. John (not her real name) put her head on the desk as the coaching session began, unable to raise it for over 4 minutes. Exhausted, she needed a quiet time out. Responsible for hundreds of medical students who don white coats and recite the Hippocratic oath, her leadership role and that of her colleagues – to transfer best medical practices and train the next generation of physicians – is becoming significantly more complex. Unaware of the many factors that will govern how they care for patients, the new doctors she is responsible for will soon complete their education with a promise their work will have meaning.
Medicine has been plagued by increasing administrative rules and regulations, politics, burnout, and disillusionment. Meaning can be lost in the chaos. The heightened anxieties, including those magnified during a protracted pandemic translate to disproportionate challenges in the field of academic medicine. When Dr. John lifts her head, she says simply and quietly, “I don’t know if I can do this anymore.”
Coaching in academic medicine is relatively new. Like many academic medical centers, the University of North Carolina at Chapel Hill (UNC) School of Medicine (SOM) has long been at the forefront of medical practice as one of the nation’s top public medical schools. It is a place where the best and brightest come to practice and teach. The Faculty Affairs and Leadership Development (FALD) team began to build a culture of coaching in 2019 with a goal to “enable radical organizational transformation by building conversational coaching skills as a daily way of working.” The underlying intention was to build a high-performing environment that supports leaders to be “accountable for delivering results, while fostering a climate of full engagement, personal development and mutual support.”
UNC hired an Executive Leadership Coach to oversee these efforts and provide coaching services for over 50 leaders within the SOM and UNC Health. Many of the leaders chose to continue past the initial engagements, which required additional people to fulfill the role of coaches. Nine additional faculty members were trained to deliver coaching and six of those have been coaching other faculty since 2020. The pandemic drastically interrupted the initial goals, but the demand for coaching became greater. We built a case to invest again in this needed service.
Coaching has many demonstrable benefits including decreases in burnout, increases in wellbeing, and a positive ROI in terms of decreased turnover and increased retention. In a hospital setting, this is a critical factor to the bottom line. One key professional position turnover can cost a system in excess of $1 million. The benefits of coaching in healthcare and research on its impact are still in an early stage of development.
Several healthcare systems have had champions of coaching leave for retirement or other personal reasons and even award-winning initiatives can quickly lose steam – cited as just another expense in larger systems that show small margins. So, coaching in healthcare, particularly hospital systems has been a heavier lift than for many industries like technology and pharmaceuticals. During the recent pandemic, an intense need for personal development and connectivity made coaching more than a desired offering; it became a critical need.
UNC determined to find a solution to make coaching a sustainable and transformational equation – a best practice in medicine. The ambition was to implement a large-scale coaching initiative to address the challenges. To realize the vision of cascading coaching skills development to accelerate the cultural shift, UNC partnered with Pyramid Resource Group’s Healthcare Coaching Institute. In order to address the needs of over 2,500 faculty and staff, it would require a significant investment of time and resources, and a way to secure administrative support for the initiatives. Pyramid made an early request of UNC SOM to assign coaches for not only the faculty, but for the stellar healthcare leaders who attend the Healthcare Coaching Institute course for Level 2 certification.
Where do we begin to exact the needed changes for coaching in healthcare? Here’s a map for consideration and expansion. The journey map shown below is a dynamic blueprint for how we established a destination for building this desired internal capability.
One major goal of the program was to increase the availability of credentialed faculty and staff that could provide coaching services for our community. Additionally, we wanted to provide basic coaching skills to many in leadership positions (including Department Chairs, hospital leadership, and administrative leaders). Our ultimate goal is to provide access to a coach to anyone who requests one.
Through the partnership with the Pyramid Resource group, we created the map above and established two programs as points of entry.
- Identification of a cohort of faculty and staff who will undertake the full International Coaching Federation (ICF) PCC training pathway. Ideally, we will train 1% of our employee base or 25 coaches in a “jobs-plus” role to serve different needs throughout the organization.
- Train 120 faculty leaders and license the “Leader as Coach” program, a 14-hour course and primer for sustainability so every leader will learn and practice coaching skills. This course equips participants with skills such as active listening and reflective inquiry. Currently, 40 faculty and staff have completed the program and we have another 40 scheduled for the fall cohorts.
The feedback from the first 41 participants gave us quotes that resonated with others (shown below), and our enrollment for the next 40 participants is complete. We will reach our goal of training all 120 faculty leaders within 18 months of the program launch.
“This was my first exposure to coaching, and was literally transformative for me.”
“I expected to learn a few ‘quick tips’ to help in my leadership roles. I had no idea I’d be learning a completely different mindset and approach to motivating and guiding people in many different settings.”
“During the recent pandemic, an intense need for personal development and connectivity made coaching more than a desired offering; it became a critical need.”
“Being forced to practice coaching and being coached – lots of discomfort in this. But also tremendous growth, even from a 20-minute session.”
“I really appreciate the investment in us as leaders at UNC and am grateful for the opportunity to grow into my professional identity through this training.”
Our enrollment for the next 40 participants is complete. We will reach our goal of training all 120 faculty leaders within 18 months of the program launch.
All of this work ties back to the FALD strategic priority of enhancing leadership development programming across the faculty lifecycle. Not only will the faculty being coached benefit from the coaching services, the faculty leaders being trained in coaching and participating in coaching relationships will also find new meaning in their roles and contributions to others. This level of connectivity has given us all a reason to hope that the changes we feel are needed, are available and possible.
Scaling coaching to groups Is a key step along the coaching journey. The commitment from those who lead the School of Medicine and the UNC healthcare leadership initiatives are noteworthy. Key leaders from the School of Medicine and the Healthcare System have taken the courses, including the Leader as Coach training. They seek out information and research for impact, and are designing pathways to become leading edge as a new team who advance coaching in healthcare.
We believe in the future of coaching to elevate all leadership programs and approaches to exact the change we all desire, and as Mitsch declares after 30 years of leading in the coaching field, “We change healthcare through coaching – one leader, one team, one organization – one conversation at a time.”
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