At the intersection of two large and diverse professions lies an opportunity for relief from the pain and struggles that adversely impact many lives. Healthcare and coaching meet in both research and practice: asking questions and in finding pathways to solutions at the intersection of humans and healthcare. The goal of this article is to provide a foundation of understanding with regard to the value of coaching in health care settings: helping to foster fulfilling, less stressful, more balanced personal, professional and spiritual selves. The plethora of topics that coaching includes — knowledge sharing about leadership, mindfulness, self-awareness, interpersonal communication, connection, teaming, empathy, preventing burnout and increasing engagement, etc. — will be addressed in upcoming blogs.

The Healthcare System

The concept of “the healthcare system” is itself both broad and diverse. For many of those who work in this huge industry, estimated at over 16 million people in 2018 (Commins, 2019), the term may conjure up different images. Most obvious are those organizations where care is delivered directly to patients such as in hospitals and hospital systems, medical practices, home healthcare agencies, and outpatient clinics. For others, the term healthcare system encompasses a broader scope, where health- and well-being-related products and services are delivered through complex manufacturing, distribution, and innovation networks. The ultimate recipient in this case may never be seen by those that work within the organizations, such as academic research centers, pharmaceutical companies, biomedical device manufacturers, billing and insurance companies, and IT developers. From an even broader perspective, all of the product and service developers and distributors that support individuals and organizations in their healthcare work are also part of the healthcare system, such as food service providers, consultants, and even fuel suppliers who serve healthcare organizations. As one hospital system executive described it, “there are two kinds of people here — those that deliver care to patients and the rest of us who support them.”

It is a big industry; 2019 revenues were estimated at $2,487.7 billion. Hospitals, a sub-industry, accounted for 47.6% of this revenue (Statistica, 2020). If you work in healthcare, you know that roles can vary widely. Even if you do not work in healthcare directly, you may be touched by the system in many ways as: patient, consumer, family member, student, educator, and more. The outcome of each of these touches is dependent upon many individuals who work behind the scenes. It is hard to imagine anyone not being impacted by the healthcare system in some way. As one might expect, healthcare organizations and individuals within them face enormous challenges. One way to help address these challenges is through coaching.

Challenges in Healthcare Systems and System Extensions

In today’s challenging healthcare environment, healthcare professionals and leaders are being required to adapt and respond quickly to address organizational needs (Figueroa et al., 2019). As mentioned by Figueroa et al., at the macro level, efficiency, change, and human resource management have been identified as valuable within healthcare systems. Healthcare workers face a variety of challenges which include, but are not limited to: lack of promotion, salary caps, work overload, lack of staffing, lack of training and mentoring as professionals, and constraint time with patients (Becker’s Hospital Review, 2011). However, they are still required to deliver high-quality patient care despite these obstacles. There are many effective methods that can assist with these challenges such as team engagement, communication, collaboration, and professional development.

In the current SARS-COV-2 (COVID-19) pandemic, another layer of change and risk has been added to the already overwhelmed working system. Healthcare professionals are risking their own health to serve those that are infected with COVID-19. The Pan American Health Organization (2020) reported in September that an average of 570,000 health workers across the region had fallen ill and more than 2,500 had died as a result of contracting the virus. Healthcare workers have needed special personal protective equipment (PPE) to protect them from infection. Initially, it was particularly challenging for healthcare workers to receive adequate equipment. Infected healthcare workers have left units understaffed, increasing workloads of others. Moreover, healthcare workers have been uplifted to leadership roles by default to help navigate the fast-changing situation. These new leaders may not have the experience to sustain team engagement and effectiveness.  

COVID-19 has resulted in hospitals and health systems succumbing to increased financial pressure. As the coronavirus continues to overwhelm, financial challenges such as hospital costs, canceled or limited services, additional expenses for PPE, and external staff contracting have all contributed to the financial stress. Therefore, there has been a sharp decline in revenues met with increasing costs. The American Hospital Association (2020) assessed the financial impact on hospitals to include losses of $50.7 billion per month between March 1, 2020 and June 30, 2020. Hospitals and health systems will continue to need additional relief funds to continue treating patients and saving lives. On the personal level, healthcare workers need increased support for their families as they continue to battle through long shifts and extended work hours. Services such as childcare, transportation, and nearby housing have become critical needs during this crisis.

Coaching

Coaching is also a broad and diverse industry and can be defined in many ways. If you are imagining a sports coach, you are in only one of many ballparks. One of the more targeted definitions of coaching, as we use the term, has been provided by the International Coach Federation (ICF). “The ICF defines coaching as partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential” (ICF, n.d.).  It covers a lot of ground from developing self-awareness of one’s own perspectives and limiting beliefs that impact work or personal effectiveness to becoming more mindful and appreciative.  Coaching can be focused on the individual, such as in leadership, career, health/wellness or emotional intelligence coaching. Coaching can also be offered to groups of individuals with a common goal, such as entrepreneurs focused on their business development, or on teams within an organization all working to improve interdepartmental communication. The agenda for coaching sessions is typically established by the coachee, along with the input from their supervisor. Importantly, coaching is confidential between the coachee and the coach, with terms that are spelled out clearly by the coach. Coaching is designed as a safe space for coachees to explore their own views and challenges with the assistance of a non-judgmental professional trained to practice with evidence-based coaching methodologies. Coaching is not therapy, advice-giving, or mentoring. It is a collaborative, partnering process where coach and coachee come together to explore, share, and focus on the professional growth of the coachee.

Coaching in Healthcare Systems

Healthcare coaching is a vessel designed to support healthcare leaders, practitioners, workers, administrators, and ancillary staff members  as they navigate the uncertainty of their challenging environments.

Few industries are as primed to benefit from coaching – in both the short and long term – as healthcare. For too long, coaches have mostly been relegated to the upper echelons of the sector: senior administrators and executives retained executive coaches to improve leadership skills and meet career goals, while physicians, nurses, and other providers were, occasionally, assigned coaches as part of “remediation” plans. Although there is no disputing that coaches are excellent in assisting any client willing to identify goals and achieve momentum, we believe a case can be made for broader use of coaches throughout healthcare.

Even prior to 2020, healthcare professionals were suffering. The rapid increase in burnout, moral injury, compassion fatigue, disengagement, dissatisfaction, and attrition across the profession made weekly headlines, and healthcare centers scrambled to find ways to mitigate the multivariate sources of pain. Now, as pandemic fatigue sets in, these injuries have deepened, and many practitioners are struggling to restore a sense of balance. As hospital systems continue to push the idea of “self-care” as a panacea, practitioners fight the rising tide of their own exhaustion and demoralization.

Coaching - be it personal, professional, or in a group setting – is particularly well-suited to assist health practitioners through these times. Coaching is in some ways more approachable than traditional therapy as it carries minimal professional stigma or licensure risk (real or perceived). Furthermore, many healthcare professionals prefer a progressive, goal-oriented approach to difficulties they are experiencing. A series of coaching sessions can be offered as an onboarding perk to assist new hires with assimilation, especially in these times of extreme stress when typical mentoring relationships might be overtaxed or nonexistent. Coaches serve as thought-partners, support the development of mindfulness and other wellness practices, reinforce the need for genuine self-care, bolster communication skills including the value of deep listening, and can assist in deconstructing and managing workplace conflicts.

When coaching is most effective, desired outcomes are set by the coachee but often evolve over time as familiarity and trust are built. Establishing personal and professional well-being, setting and achieving goals, attaining peak performance, finding clarity of purpose and self-fulfillment are lofty goals for any profession, but In the midst of a pandemic, the healthcare industry is particularly in need of the relief and restoration that great coaching – and great coaches – can bring.

Contributing Fellows of the Institute of Coaching (IOC), McLean Hospital, Affiliate of Harvard Medical School:
X. Carmen Qadir, PhD, MBA, BCC
Keyaunoosh Kassauei, MD
Bernadette Norz, PhD, MBA, ACC
Kemia M. Sarraf, MD, MPH, RCC TIPCtm

References

American Hospital Association. (2020, May). Hospitals and health systems face unprecedented financial pressures due to COVID-19. https://www.aha.org/guidesreports/2020-05-05-hospitals-and-health-systems-face-unprecedented-financial-pressures-due

Becker’s Hospital Review. (2011, April 5). The top 10 challenges facing healthcare workers. https://www.beckershospitalreview.com/hospital-management-administration/the-top-10-challenges-facing-healthcare-workers.html

Commins, J. (2019, January 4). Healthcare job growth outpaced nearly every other sector in 2018, Health Leaders. https://www.healthleadersmedia.com/strategy/healthcare-job-growth-outpaced-nearly-every-other-sector-2018

Figueroa, C. A., Harrison, R., Chauhan, A., & Meyer, L. (2019). Priorities and challenges for health leadership and workforce management globally: a rapid review. BMC Health Services Research, 19(1), 239.

ICF (n.d.). Core competencies. https://coachfederation.org/core-competencies

Pan American Health Organization. (2020, September 2). COVID-19 has infected some 570,000 health workers and killed 2,500 in the Americas, PAHO Director says.  https://www.paho.org/en/news/2-9-2020-covid-19-has-infected-some-570000-health-workers-and-killed-2500-americas-paho

Statistica (2020). Health Care NAICS 621-623. https://www.statista.com/study/15826/industry-report--health-care/

UCLA Health (2020, July 7). 7 steps to reduce pandemic fatigue. https://connect.uclahealth.org/2020/07/07/7-steps-to-reduce-pandemic-fatigue/