Case study: Expanding the capability of Emergency Department clinicians with coaching.
Overview:
With nurses now being the most in-demand workers in Australia, the business case for healthcare organisations to invest in professional coaching – one that is likely to create improved clinician psychological well-being and career longevity – is here .
Kudos to the Sydney Local Health District (SLHD) Emergency Department (ED) team for their commitment to supporting ED nurse leaders across the District whilst the New South Wales health system continues to suffer a post-pandemic exodus of highly trained staff. Significant improvements in psychological well-being from pre- and post-program assessments, and increased engagement to their career and career longevity, validate the consistently noted benefits experienced by exhausted clinicians when professional coaching is available. Augmenting the clinical efficacy of highly capable ED clinicians with professional coaching has proven to be a welcomed and successful investment.
100% of clinicians registered for the program completed and recommend the program.
Challenges and context:
- SLHD ED medical leaders were seeking to support clinicians/senior nursing staff with an evidence-based professional development intervention to augment their highly competent clinical skills, knowledge and experience at this challenging time.
- The entire health system has been under unrelenting strain including senior medical and nursing staff.
- SLHD EDs have mentoring programs and were looking for some additional support to incorporate into their practices.
- This program was co-funded by the NSW Health Workforce Wellbeing Collaborative for Wellbeing Initiatives and SLHD.
Insights:
Two recent JAMA reviews highlight that a critical role for organisations is to provide a safe space for all staff to reflect, learn, and find solutions to their challenges[1], and that professional coaching may be an effective way to reduce emotional exhaustion and overall burnout as well as improve quality of life and resilience for some physicians[2].
[1] Shanafelt T, Ripp J, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA. 2020.
[1] Dyrbye L, Shanafelt T, Gill P, Satele D, West C. Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial. JAMA 2019
Program goal:
To improve the psychological wellbeing and capability of senior clinicians/nursing staff in SLHD EDs by providing individual professional coaching.
Method:
16 senior clinicians/nursing staff participated in a virtual Individual professional coaching program . Participants
- received six confidential, one to one virtual coaching conversations with a professional coach.
- received their first coaching session by 30 June 2022. The remaining five sessions, usually held at three-week intervals were completed 31 October 2022 where possible.
- brought their important challenges and goals to their sessions and committed to reflection and action between sessions
- received information about the coaching relationship including expectations and confidentiality considerations in the coaching agreement, signed prior to starting their coaching program
- completed two confidential online surveys including psychometric assessments debriefed in session one and six. These surveys included the DASS (Depression, Anxiety and Stress Scale), WHO-5 Wellbeing Scale and Solutions Focussed Inventory. The final survey includes program evaluation questions.
Results:
Pre and post program average psychometric results
| N=13 completions Average scores | Depression | Anxiety | Stress | WHO- 5 wellbeing (max 25) | Flourishing (max 56) | Solution focussed thinking (max 72) |
|---|---|---|---|---|---|---|
| Pre-Program | 5.2 (mild) | 3.4 (mild) | 8.0 (severe) | 15.2 | 43.6 | 49.8 |
| Post-Program | 1.9 (normal) | 1.2 (normal) | 3.5 (mild) | 18.3 | 51.7 | 59.6 |
| Change | -3.3 | -2.2 | -4.5 | +3.1 | +8.1 | +8.8 |
Post program evaluation and feedback
| N= 13 completions | Agreed or strongly agreed |
|---|---|
| Coaching provided me with practical ways to address my professional development needs. | 100% |
| I would recommend this coaching program to colleagues. | 100% |
| My coach gave me a safe space to reflect and feel listened to. | 100% |
| My coach helped me make progress on issues that I had previously found hard to tackle. | 100% |
| My motivation to be a better clinician has improved because of this program. | 77% |
| My commitment to the longevity of my career as a clinician has improved because of this program. | 69% |
What elements of the program worked well for you?
- Coachee-focused, specific goals
- Open discussion recourses provide
- My coach was just the best
- Timing of appointments and length, structure and flow.
- Being able to bounce ideas with someone external to the organisation helped
- Being able to discuss any issues and being given tools to help deal with these issues
- The coach triggered me to reflect. She also encourages me to carry out my plans.
- Discussing issues confidentially, easy to talk to
- Able to focus on aspects I wanted to improve and give clarity
- Helped me to identify what my professional goals were. I hadn’t actually identified that prior to the sessions. I also learnt that a lot of what I was aiming for was already part of my practice, but coaching gave me the confidence to name it and adapt it to the organisation.
- Mainly how coach approach the program and her guidance
- The discussions between the coach and myself was quite thought and reflection provoking
What elements of the program didn’t work so well for you?
- Being on zoom
- I am so pleasantly surprised how the program had helped me. It worked well for me.
- Initial coach who didn’t understand and added to the issue
- Finding a suitable time. But I don’t think that’s reflective of the coaching sessions – more just secondary to working in a busy ED
- Not so much that it didn’t work for me. I’m really enjoying the program. Perhaps extending it to 10 sessions in the future
Do you have any further comments on how you would describe your coaching experience?
- I found this to be a really positive experience with professional benefits as well as personal ones.
- Good experience, I enjoyed my sessions
- It did not start well from session 1 due to the things I learnt about myself. I was rather upset. As the program progressed, I have learnt to reflect more and have been able to “let go” and had implemented a few changes. I am in a better place. Hope I can continue once the program ends.
- No
- Having a coach who knew what I was talking about and understand the topic to be clarified gave a lot of progress and focus.
- I’ve really enjoyed it. I think I now approach conversations with executive etc feeling like I’m more in control
- More sessions to be added
- This has been a very beneficial experience for me, both personally and professionally. Thank you. I wanted to say a big thank you to you and your team especially my coach for the coaching sessions that I have been privileged enough to attend over the last 8 weeks. It has been an invaluable resource for me that has given me the tools to positively move forward both personally and professionally. I am more than happy to be contacted should you wish to detail my own experience with the program.
For more information about Individual Professional Coaching for clinicians, please contact Rita Holland, Director and Professional Certified Coach (ICF) | Capstan Partners
November 202