CoachingPart I

Coaching in the OR

Dabo SwinneySteve Spurrier

Learning How to Drive

• A PowerPoint presentation

• A drivers manual

• The car keys and the freeway…

Knight, Jim. Instructional Coaching. California: Corwin Press, 2007. Print

Another Way• A PowerPoint

• A drivers manual

• An introduction to the car

• A lot of practice driving with a “coach”

• Freedom

Knight, Jim. Instructional Coaching. California: Corwin Press, 2007. Print

• Listening and watching

• Asking questions about what you see or hear

• Trying to improve people’s performance

• Getting people to understand how to help themselves

What is Coaching?A Quick Review

• Telling

• Criticizing

• Instructing/Teaching

What Coaching Isn’t

Show Me/Teach Me

Watch Me

Give Me Feedback

COACHING

When You Give Feedback

• Keep it simple

• Keep it focused

• Be respectful

• Be kind

Rules To Guide You

Think about:

• What you saw

• Will coaching be effective for this team:• Is the culture ready for coaching in the OR?

• Should I coach in a one-on-one setting?

• Am I right the person to coach?

• What is going on in the OR • Is it a good time to coach?

How Feedback is Usually Given

• Criticizing

• Telling

• Yelling

• One-sided

• People are incompetent

Coach By Asking People Questions

• You are coaching adults

• You want them to figure things out on their own – through REFLECTION

• You want them to come to their own solutions if possible

• You are guiding them – not telling them… you want the “light bulb” to go off

Your Observatio

n:

I saw . . . .

Your Opinion:

I think it is important

to. . . .

Your Question: I wonder. .

.

Part 1: Your Observation

• Tell them what you saw:

• Be specific and clear

• Stick to the “facts” as you saw them

Examples of the Words

• “I saw”

• “I observed”

• “I watched”

• “The team did”

• “The team didn’t”

• “I noticed”

Part 2: Your Opinion

• Why you think what you saw is important

• This is your chance to explain why you pointed out what you did

Examples of Opinions

• “I think . . . ”

• “I believe . . .”

• “It is really important to . . .”

• “I am pleased because. . .”

• “I am concerned . . .”

Part 3: Your Question

• It will help the team reflect on what happened and if done properly help them to understand why

• You should try to be genuinely curious about what happened

Examples of Questions

• “Can you help me understand?”

• “I am curious, what do you think happened?”

• “How did that make you feel?”

• “Where do you think your team was coming from?”

• “What is your point of view?”

• “How did you experience that?”

• “I wonder what you think happened”

The Three Parts Put Together

1. “I noticed that the team did not debrief at the end of the case.”

2. “I think that the debriefing is really important.”

3. “Can you help me understand why that happened?”

Things to Be Careful About In Your Questioning

Avoid Generalizations

• “I noticed that communication wasn’t very good. I think that having good communication is important. Can you help me understand what happened?”

• Instead, give specific examples.

Avoid Assuming You Understand People’s

Actions• "I noticed that you skipped the

introductions because you were in a hurry.”

Avoid Making the Team Guess What You Are Thinking

• “Can you tell me what you did wrong?” [when you already know exactly what you are after]

Avoid Questions That Already Contain the

Answer• “Don’t you think it would have been better if you would have done…”

• It’s better to let them figure it out rather than have you tell them so ask: Is there a better way that you could have done that?

Avoid Disguising a Statement as a

Question• “You didn’t really want to do that,

did you?”

Avoid Singling Out Individuals When You Are Coaching The

Team• “Dr. Brown I noticed that you didn’t participate in the briefing section. I think the briefing section is important. Can you tell me why?

CoachingPart II

Lets Head Into The OR

How would you have coached the team to

remember the Heparin?• Write it on a sticky note

• Use memory

• Write it on the white board

• Paging the surgeon right away

• It wasn’t appropriate to coach the team about the heparin at this point in the case

As the coach, what would your reaction be to the surgeon

saying, “Speak now or forever hold your peace?”

• It was okay for the surgeon to say that. I shouldn‘t say anything.

• It is not okay for the surgeon to say that and I should talk to the surgeon about this now.

• It is not okay for the surgeon to say that and I will talk to him alone following this case.

Later Today We Will Spend Time

Talking About Some of the

Tricks to Having One-on-One

Conversations

• How do you think the coach did? Give him a grade:

• A = Excellent

• B = Above average, but it could have been improved

• C = Average

• D = Below Average

• F = Poor

How Would You Coach The Coach?

Coaching the “Difficult” Team

• Our coaching skills can be challenged sometimes by situations and personalities

• Often, the best strategy is to move from coaching in the OR to coaching one on one outside the OR

We think it is much easier to

coach using a tool to guide your observations

Observation Tools In Today’s Training

• We will be using observation tools all day long

• We have observation tools available for you to use to coach in the OR

Using observation tools

can keep you focused• Can Keep you focused on what you

want to look for

• Can keep you organized

• Can help you watch each team in a standardized way

• Give you something to coach off of

The Results of Good Coaching

Are:• Everybody on the team is on the

same page

• Better morale

• Better functioning team

• Better patient care

TeamSTEPPS®: Strategies and Tools to Enhance Performance and Patient Safety. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/teamstepps/