coachingIn healthcare, employees who feel engaged with their work are more likely to provide quality care. Many healthcare organizations are finding that positive coaching is an effective way to increase employee engagement and increase quality care.

Rather than relying on one annual performance review, more and more organizations are moving to a model where managers provide constructive feedback to employees throughout the year. Trinity Health System in Steubenville, Ohio, for example, has embraced this type of positive coaching as a way to motivate employees and influence changes in behavior. “When healthcare organizations focus exclusively on disciplining poor performers, they forget about the rest of the employees who are doing a good job. That pulls people down,” said Kathie Pasquarella, Director of Education and Training. “Instead, we try to focus on things that are going well. We show people where they are at and how they can reach the levels of performance we are looking for.”

Trinity Health System’s approach is to integrate coaching throughout the organization. Each time a two-day leadership development institute is conducted, managers learn about coaching as a core skillset. Pasquarella noted that Trinity’s President & CEO, Fred Brower, believes that “leaders are the group that sets the tone for employees’ growth and development, and coaching plays an important role.” Managers are trained to take a thoughtful approach to help people move up a level. The focus is on conversations that help employees see how they can develop and grow.

Professional development and growth are characteristics that distinguish the healthcare industry — employees are always applying new technologies and medical techniques, as well as interacting with patients and staff. In this environment, on-the-job, performance-related feedback helps healthcare professionals learn more effectively. However, this type of coaching is most successful when it’s combined with other best practices like goal setting and ongoing performance management. Coaching in this broader context increases manager and employee engagement, resulting more cohesive patient care.

Based on conversations with leading healthcare organizations, here are five ways to improve employee engagement through on-the-job coaching:

  1. Use coaching to motivate employees to change their behavior

When managers provide feedback in a timely way, employees are more likely to modify the way they approach their jobs. Mercy Medical Center in Cedar Rapids, Iowa, for example, encourages managers to offer coaching that highlights positive work practices, as well as suggest areas of improvement. “We have a saying here, ‘If you see it, say it,” noted Heather Akers, Director of Organizational Development. Coaching may relate to clinical skills, as well as interpersonal and workplace skills such as diversity appreciation.

It’s fairer to provide employees with feedback in real-time, rather than waiting for the annual performance review. A good practice is for managers to engage in check-in conversations with employees at least once a month about what they are doing well and what roadblocks they are encountering. There should be no surprises at review time.

  1. Combine goals with coaching to generate positive results for employees and managers

In the 2013 Planetree and HealthcareSource HR Influence Survey, 516 healthcare professionals answered questions about human resource’s role in improving the patient experience. Roughly 40% of survey takers work in the continuing care environment, while 60% work in acute care. A majority of participants work in HR, 89%, while 9% hold clinical roles and 2% work in IT. According to the survey respondents, 42% agree and 46% strongly agree that their employees have goals around service excellence and improving patient or resident satisfaction. That means an overwhelming majority believe they have person-centered care goals set for their employees. However, when the question results are broken down by role, it appears that there may be a communication gap between leaders and their frontline employees. For example, 65% of the Directors of Nursing surveyed strongly agree that these goals are in place, while only 45% of Registered Nurses feel the same. In HR, the result is the opposite ─ 51% of HR Generalists and 50% of Recruiters believe their organization has employee goals in place for service excellence, while only 34% of HR Directors believe this to be true.

From the HR Influence Survey data on employee goal setting, absolute certainty cannot be draw that this communication gap between leadership and frontline employees exists since many of the participants come from different healthcare organizations. However, one of the biggest challenges a healthcare organization faces when it comes to setting employee goals is not creating them ─ it’s tracking those goals and improving results. In some instances, leadership might believe clear cut goals exist for their employees, while their employees lack the coaching and tracking necessary to see those goals as part of their day-to-day routine. In other cases, the employees might believe they are living up to goals around service excellence, while the leadership, lacking insight into results, believes this is something their organization must continue to work on. That’s why, in order to avoid communication gaps around goals between leadership and frontline staff, employee coaching and goal tracking is critical.

Goals must go hand in hand with coaching. When employees receive coaching, it should be tied to actions or behaviors that are realistic and attainable. Goals provide a way to implement coaching by establishing accountability and promoting development. Without coaching on goals, it’s impossible for managers to provide useful feedback because both managers and employees aren’t aligned on the same set of expectations that the employee is working towards. A best practice is to derive employees’ goals from the responsibilities outlined in their job descriptions.

Goals give greater clarity to feedback and provide the foundation needed to make coaching specific. The most effective coaching offers details about employee goals and their performance on-the-job. “Specific goals facilitate conversations about accountability and those conversations result in actionable information for employees,” said Pat Bayles, Leadership Development Coach at Mercy Medical Center. “Employees also find that positive coaching feels more genuine when it’s linked to a goal.”

It’s important to remember that when managers and employees set goals, they should also define how those goals will be evaluated. When employees understand how they will be measured, they are more likely to succeed in achieving their goals. Many organizations try to align individual goals with broader organization-wide objectives. For example, if a hospital has an organization-wide goal to increase HCAHPS scores along a certain dimension, it may be useful to define employee goals that are consistent with that initiative.

  1. Use a performance management system to make the coaching process easier and more structured for managers

In busy work environments like healthcare, it’s important to make coaching a structured process. Performance management systems can help introduce that structure into the organization. Performance management software can be used to remind managers about employee goals and offer a centralized online system where they can record notes about positive behavior. “Before we implemented a performance management system, managers had to maintain feedback on employees that came from colleagues in email folders,” said Akers. “That was just one more thing to maintain and then review when it was time to provide staff with performance feedback.”

Trinity Health System also takes advantage of the feedback feature in its performance management system. Managers use the notes functionality to record information about employees throughout the year, with an emphasis on positive coaching. If an employee needs to improve in a particular area, the manager works with them to create a mini action plan. “We stress using manager notes and positive commendations,” said Pasquarella. “It’s important to focus on the positive, because according to The Studer Group, what you permit, you promote.”

  1. Leverage technology to make employees more active participants in the evaluation process

Performance management systems also benefit employees. The feedback that managers and peers provide is documented and visible online. Meredith Merriman, HR Specialist at Eisenhower Medical Center in Rancho Mirage, California, noted, “With performance management software, employees are more active participants in the evaluation process. The information is always accessible online and they can see what their goals are, where they are in meeting those goals, and what they need to do to improve.”

Performance management technology helps create an environment of higher employee satisfaction. It’s easy for managers to document employee progress over time and for employees to see their accomplishments in a tangible way. Performance management systems can enhance communication between employees and managers. When employees feel that their voices and concerns are heard, they are more likely to remain engaged and connected to their purpose. Coaching and goal-setting are good ways to facilitate these dialogues. Pat Bayles observed: “When people commit to work in healthcare, they are committing to lifelong learning. That means we need to have lifelong conversations about performance.”

  1. Reinforce positive behaviors with recognition

In addition to coaching, it’s a good practice to highlight positive employee behavior with recognition programs. Trinity Health System has an active Employee Reward and Recognition team that rewards and publicizes employee achievements. The employee of the month award, for example, recognizes individuals who exemplify the organization’s core values which include reverent service, stewardship, and a positive attitude. In addition to major award programs, managers can give out gift cards and coupons on an ad hoc basis when they see employees engaging in desirable behavior on the job.

Even small gestures of recognition can make a big difference in keeping employees engaged and motivated. This is essential in a field like healthcare where staff must provide consistent and high quality patient care.

As organizations strive to deliver quality patient care and meet the demands of healthcare reform, they are realizing how important employee engagement is. Setting and monitoring goals is an effective way to motivate employees to become top performers. Healthcare leaders recognize that successful employee goal initiatives require commitment from senior executives, as well as managers. Performance management technology can play an important role in supporting supervisors and employees, as they continue on a path to outstanding patient service and care.


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Editorial Note: This post was originally published in HR Pulse Magazine.

About The Editorial Staff

The Editorial Staff is a team of writers with a passion for helping healthcare organizations manage their biggest and most important investment: their employees.