Research Paper by Roxanne Croates
(Career Coach, CANADA)
Area of Study
Coaching physicians within a medical clinic is the area of study chosen for this paper using a case study to illustrate how coaching is used as a tool to improve patient quality of care. Following is a case study of a small health care clinic /hospital in northern rural British Columbia where one-on-one clinic practice coaching has changed the way health care is delivered to community members and the way it is practiced in the clinic. The concept is related to the evolving role of coaching and the impact it is having on physician, staff and patient behaviours in the changing environment of health care.
I will begin by describing the role and responsibilities of the newly introduced Practice Support Coach in physicians’ medical clinics, with the goal of comparing and contrasting a pre-coaching environment to one where a coaching role has been introduced. I will then describe ways in which coaching has impacted the physicians and staff in the practice through empowerment and taking ownership of the changes being implemented.
Connection to Coaching
A new position was created within the health care system to work in communities throughout the province to work specifically with physician’s practices. The aim was to implement primary health care activities (see below for primary health care goals). The position was originally called ‘Primary Health Care Developer’ (PCH Developer) and subsequently changed in late 2012 to ‘Practice Support Coach (PSC)’ to reflect the changes in the position’s focus. The PSC’s focus is solely on primary health care advancement in the physician’s clinic through the use of coaching skills and practices to facilitate change.
The change in title and job description reflects the path (one towards coaching) that the provincial government and British Columbia Medical Association (BCMA) have embraced and implemented in many Northern BC communities. The objective is to meet the goal of the ‘Triple Aim’: improve the health of the population; enhance the patient experience of care (including quality, access, and reliability); and reduce, or at least control, the per capita cost of care (Institute for Health Care Improvement). Lessons learned in the past indicate that coaching is more likely to effect change in people’s behaviour, as opposed to attempting to change behaviour through the presentation of a prepared package of tools. The latter put less importance on what changes the physicians wanted to undertake in their clinics.
The responsibility of the PSC is to facilitate primary health care activities within the clinic practice. To illustrate the role more clearly, a primary health care definition and benefits are listed below:
Primary health care is about:
- Helping people avoid getting sick or injured
- Managing chronic conditions like diabetes or high blood pressure
- People playing an active role in their own care
- Making the most effective use of care providers' expertise
- Efficiency and coordination
- Understanding that factors outside the health care system can influence health (for example, air quality)
Benefits of primary health care:
- Provides continuous, coordinated, comprehensive care for the "whole person"
- Helps keep waiting lists down
- Reduces pressure on emergency rooms
- Makes the health care system more sustainable in the long term
This paper describes a two year period of time (2011 to present) during which a transition from PHC Developer to PSC took place along with the resulting behavioural changes that resulted in both staff and patients.