Coaching Part I

Coaching in the OR Dabo Swinney Steve Spurrier

Learning How to Drive A PowerPoint presentationA PowerPoint presentation A drivers manualA drivers manual The car keys and the freeway…The car keys and the freeway… Knight, Jim. Instructional Coaching. California: Corwin Press, Print

Another Way A PowerPointA PowerPoint A drivers manualA drivers manual An introduction to the carAn introduction to the car A lot of practice driving with a “coach”A lot of practice driving with a “coach” FreedomFreedom Knight, Jim. Instructional Coaching. California: Corwin Press, Print

Listening and watching Listening and watching Asking questions about what you see or hearAsking questions about what you see or hear Trying to improve people’s performance Trying to improve people’s performance Getting people to understand how to help themselvesGetting people to understand how to help themselves What is Coaching? A Quick Review

Telling Telling Criticizing Criticizing Instructing/Teaching Instructing/Teaching What Coaching Isn’t

Show Me/Teach Me Watch Me Give Me Feedback C O A C H I N G

When You Give Feedback Keep it simpleKeep it simple Keep it focusedKeep it focused Be respectfulBe respectful Be kindBe kind

Rules To Guide You Think about: What you sawWhat you saw Will coaching be effective for this team:Will coaching be effective for this team: Is the culture ready for coaching in the OR?Is the culture ready for coaching in the OR? Should I coach in a one-on-one setting?Should I coach in a one-on-one setting? Am I right the person to coach?Am I right the person to coach? What is going on in the ORWhat is going on in the OR Is it a good time to coach?Is it a good time to coach?

How Feedback is Usually Given CriticizingCriticizing TellingTelling YellingYelling One-sidedOne-sided People are incompetentPeople are incompetent

Coach By Asking People Questions You are coaching adultsYou are coaching adults You want them to figure things out on their own – through REFLECTIONYou want them to figure things out on their own – through REFLECTION You want them to come to their own solutions if possibleYou want them to come to their own solutions if possible You are guiding them – not telling them… you want the “light bulb” to go offYou are guiding them – not telling them… you want the “light bulb” to go off

Your Observation: I saw.... Your Opinion: I think it is important to.... Your Question: I wonder...

Part 1: Your Observation Tell them what you saw:Tell them what you saw: Be specific and clearBe specific and clear Stick to the “facts” as you saw themStick 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 importantWhy you think what you saw is important This is your chance to explain why you pointed out what you didThis 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 whyIt 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 happenedYou 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?”“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.Instead, give specific examples.

Avoid Assuming You Understand People’s Actions "I noticed that you skipped the introductions because you were in a hurry.”"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]“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…”“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?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?”“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?“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?

Coaching Part II

Lets Head Into The OR

How would you have coached the team to remember the Heparin? Write it on a sticky noteWrite it on a sticky note Use memoryUse memory Write it on the white boardWrite it on the white board Paging the surgeon right awayPaging the surgeon right away It wasn’t appropriate to coach the team about the heparin at this point in the caseIt 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 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 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.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:How do you think the coach did? Give him a grade: A = ExcellentA = Excellent B = Above average, but it could have been improvedB = Above average, but it could have been improved C = AverageC = Average D = Below AverageD = Below Average F = PoorF = Poor

How Would You Coach The Coach?

Coaching the “Difficult” Team Our coaching skills can be challenged sometimes by situations and personalitiesOur 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 OROften, 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 longWe will be using observation tools all day long We have observation tools available for you to use to coach in the ORWe 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 forCan Keep you focused on what you want to look for Can keep you organizedCan keep you organized Can help you watch each team in a standardized wayCan help you watch each team in a standardized way Give you something to coach off ofGive you something to coach off of

The Results of Good Coaching Are: Everybody on the team is on the same pageEverybody on the team is on the same page Better moraleBetter morale Better functioning teamBetter functioning team Better patient careBetter patient care TeamSTEPPS®: Strategies and Tools to Enhance Performance and Patient Safety. Agency for Healthcare Research and Quality, Rockville, MD.