nunacoaching

[nunacoaching]

Thoughts on honesty in coaching

I'm watching "Gordon Ramsays Hell On Wheels", where the basic premise is take a TERRIBLE restaurant and turn it around in 24 hours. While Gordon can be abrasive as fuck, he also gets ultra real with everyone on the team, especially the leader. They take an honest look at the situation through video surveillance, reading Yelp reviews, and doing a lot of first hand observation and discussion around what they observe.

What Gordon creates with that brutal honesty is space for everyone to clearly view the problems they actually face. In the episode I'm watching, it's that the chef has given up and the owner hasn't been coping well with the death of his brother and former co-owner for several years. Those are some basic level root causes right there. But he actually coaches around that. He resparks the chefs original passion for cooking.

With the owner it's a little more complicated. This restaurant, which is a family business, is leterally ripping his family apart. This isn't only a business problem, this guys daughter is in years on video saying how all their arguments as a family come back to the restaurant. This family is quite literally showing up the the source of all their misery day after day after day. He doesn't quite get there with Vinny the owner. To me it seemed clear that Vinny needed to deal with his guilt and resentment and fear before he could be of any assistance to the family business. Vinny, ended up making a commitment to be more professional, but I don't trust that to be a long term solution. Gordon didn't even try to empathize with Vinny, so he put a band aid on Vinny's issues. It was all still Vinny's fault, when in Vinny's world it's always been his fault for everything. I don't think a momentary resolve to up his professionalism isn't likely going to sustain.

Gordon continues to play hardball by commiting Vinny's father to stop funding the restaurant in 3 months. This is another example of the importance of honesty with what it's going to take. Vinny needed to have a moment of clarity and move forward, or this whole operation is do damaging that it needs to just go away.

As a coach, honesty and empathy with your clients are pillars of achieving success. That, having your outrage match the gravity of the situation.

[nunacoaching]

Welcome, Intros, and Objectives

What’s up world! My name is Jamie Wood and I just accepted my first professional coaching/consulting job with Sutter Health as a Senior Lean Consultant. I’ve had lots of “coaching moments” in my short but intense career, but this is my first job where I’ll get to focus full time on being a coach. I’m excited to test out some theories about coaching that I’ve been developing here and there over time. This is going to be the space where I check in and observe what I’ve done and what I’ve learned.

So, who am I? Again, my name is Jamie Wood, I’m 30 years old, and I have been a Healthcare Administrator since 2014, when I graduated with my MHA from the University of Minnesota. That May I started my first “real job” as an administrative fellow at Seattle Children’s Hospital. This was my first introduction to Lean principles, referred to as “CPI” (for continuous performance improvement) in the local vernacular. These principles permeated the sense of “what it’s like to work here” from front-line teammates to senior leadership. To me, Lean is an effective framework from which to base a professional coaching ethos. Lean is all about defining and increasing our interactions with true value. If each moment of a life is laid end to end, and each moment gets defined as “value added” or “waste”, Lean is a set of principles working toward increasing the percentage of those value added moments across a lifetime. It’s a powerful perspective.

My first real experience with coaching was, perhaps surprisingly, as a missionary for the mormon church. While today I don’t espouse hardly any of what you would call typical “mormon” beliefs, I did when I was 19-21 and as a result was able to really dig into coaching almost full time on my mission. As I was quickly shuffled up the ranks of missionary leadership, I spent the last 6 months of my mission as an “assistant to the president”, which is primarily a management, strategic planning and coaching position. In that role I was able to develop seminars, training workshops, and perform lots of 1-on-1 coaching to other leaders, managers, and front-line companionship's. I also greatly benefited from an incredible mentor, that Mission President that I was an assistant to, who had been a professional coach after a long and successful career as CFO of a major national bank. Back then I didn’t know that these skills he was teaching me and that I was practicing could be bucketed into “coaching”, but as I’ve gained exposure to coaching throughout my short career, I realize that my natural skill set and what I enjoy overlays quite well with professional coaching.

So, what are the objectives of this feed? The primary objective is to generate value. This is where I will come to record observations about the coaching methods/approaches that are most effective in reducing waste and creating additional value. It’s a place to expose thoughts around defining and implementing an effective coaching ethos that reliably generates value. Periodically it should be a place to display the value that’s generated, and connecting that value to learnings about the developing coaching approach.

Here are some core theories I would like to test:

- Nothing matters but TRULY front-line driven improvement. Any time a manager, CEO, whoever steps on unit and says “Hey everybody, we’ve got a new process we want to try...” That new process or idea is DOA. You cannot drag and drop a project from one department to another. The only thing we need to try and “drag and drop” is the mojo that gets front-line teammates jazzed-the-fuck-up about making improvements. And there’s no way to create that mojo other than creating it themselves. I mean this in a flat out universal sense. If your nurses on your unit didn’t physically identify the barriers to value, learn all they can about why it happens, come up with THEIR OWN IDEAS on how to improve and test those ideas themselves, you will NEVER make improvement on the problem you’re working through.  It’s a fundamental question about whether or not you can actually coerce someone into doing something that they didn’t want to do in the first place. My guess is no, not for an extended period of time.

- Communicating with complete and tactful honesty will accelerate adoption of important countermeasures. What I mean is if through observation I come to understand some fundamental truths that reveal a relatively harsh reality, I should still communicate what I’ve learned. An example is if I were to learn that front-line teammates are honestly willing to just “wait out” current regimes. How on earth could any initiative “handed down” ever sustain in that climate? It couldn’t, so articulating that reality to leadership is incredibly important. It’s a harsh reality, but it’s best to actually acknowledge it if you want to change it. Same goes for articulating root causes through A3 thinking. If we can demonstrate that we’ve used good thought process, we can stand by our root causes and clearly articulate the value we expect to create from our proposed countermeasures. Communicating that value honestly and tactfully forces leadership to acknowledge the creativity, commitment, and genuine patient centered-ness of front-line teammates, eventually allowing them to more consistently defer to their expertise.

- A hyper practical approach will accelerate development in those I coach. An example would be to ask a front line teammate to think of the tiniest and easiest improvement they could possibly imagine. I’m talking something that could be rapidly improved with 1 observation and have a countermeasure implemented by the end of the day, with a projection on the amount of waste you’ve reduced or value you’ve added. An example: An RN wonders why we have to go to pharmacy every time we need lidocaine for a biopsy. Observe 1 instance of an RN retrieving lidocaine from the pharmacy with a process time of 5 and a half minutes. The observation is confirmed as typical by the RN, if not, do one more observation to get a “typical” instance. Ask the RN what she thinks they could do to eliminate that waste. RN says “what if we put it in the pixys?” time how long you think it would take to retrieve from the pixys, subtract, multiply by the number of biopsies we do in a week/month/year and BAM, you just finished your first rapid improvement workshop in about 10 minutes. Let’s say you find out you do 800 biopsies a year, and it takes 30 seconds to get lidocaine from the pixys. 800 * 5 minutes saved = 4,000 minutes of waste reduced (nearly 67 hours, or about $6,000 if put in terms of salary) over the course of a year, and it took you 10 minutes from start to finish. I want to hunt for and collect as many of these “HYPER JDI’s” as I can and document them, and celebrate the living fuck out of them, and then move onto a slightly bigger improvement. All the way focusing on essentially one thing at a time until they can take on two at a time.

- Senior Leadership visibility to patients and teammates is critical to maintaining and improving culture. I would like to see Senior Leadership regularly rotate something like a 24 hour responsibility, where on those 24 hours every patient in the hospital has a direct line to you and you are in charge of organizing and responding to all those requests. It’s my idea so it will never fly on its own, but I’d like to figure out how to influence the senior leadership team to understand the importance of visibility and tangibly demonstrating putting what the patient defines as value first.

That’s about enough for now to get the flavor. My first day is 8/6/2018. So we’ll see how it goes! Until then I’m going to catalog my efforts with my own department. Let’s see what value we can create in a few months!