Coaching to Strengthen Health System Performance

The Power of Coaching and Follow up: Lessons in strengthening health system performance

 

   Following various training's in leadership, management and governance in the Eastern region of Kenya, It evidently showed that coaching is a unique approach to developing health care providers potential in a more effective and sustainable way. During the post training coaching, one could not help but notice the uniqueness of making the follow up coaching sessions to participants in their work place other than converging them to one venue.

      A number of organizations use a lot of resources for training and updating the health care providers, with the expectation that the outcome would be positive and sustainable. But in most cases, change does not happen and when it happens it does so very slowly and after consuming a lot of resources and time. Upon participating in various coaching session, the genuine value added by this activity is noticeable as described below.

           

Value: During the coaching session, many team members expressed that these strategy of coaching after training, made the teams feel valued. The Coaching focused on practically building the skills and resources of the team. While at the work place, the teams do not rely on a review schedule, but now support one another along the path to meeting their goals. It was easy to realize that the best learning moment for many teams and the majority of these people were not direct participants of the training. During coaching, the teams start getting the time and space to explore areas of their work that get pushed to the side and they start believing in higher values like courage and altruism to achieve results.

Team Work and Mutual Trust: During coaching the direct training participant are encouraged to involve and invite the larger team and colleagues at work. This strategy has made the whole team to understand better what is expected and they were all able to discuss the anticipate had results and brainstorm on alternative ways to achieve their results. It was realized that coaching language was adopted within the organization. In one of the health facility, one nursing officer in charge, once said that “We realized coaching after trainings was the best way to make follow up for our staffs after continuous medical educations (CMEs) or any updates. In this way the trained personel gets to practice what was taught and to demonstrate to others the skill gained” Isaac Ithiki, Nursing Officer in charge, Siakago Hospital. Most teams that were coached voiced out the realization of a positive change among all staffs because of continuously being acknowledged and involved during the coaching sessions and this was building a more workable workplace.

 Enhancing Governance: During the post training coaching, the teams understood the value and importance of giving continual performance feedback to their larger supporting teams, both positive and corrective. To strengthen performance and support all the teams consistently gave feedback and meeting held were well documented.   The teams focused on progression and this was a motivation to many. The coaching provided staffs with the opportunity to grow and achieve optimal performance through the consistent feedback.

      One mistake that a number of Organizations offering capacity building to health care providers commit is the overlooking or avoiding the performance issue and assuming the health worker understands the significance of the training. This is a typical mistake. To support the team in improving their performance, the trainers must be able to make follow ups to the institution and recognize the nature of issue, challenges and opportunities available for enhancing the changing behavior. This can best be done through a coaching session at the work environment.                                                                                                                        

Keep Growing and exploring alternatives:  The coaching sessions helped the health care workers choose sustainable alternatives ways of achieving results.  After discussions, a number of teams gave their verbal commitment regarding what action will be taken and when it will be taken. The teams explored ways that an issue can be improved or corrected by brainstorming alternative solutions and maximizing the number of choices to consider. One facility wanted to meet their measurable result of immunizing 1250 children with Vitamin A. They had a number of challenges and one of them was the lack of a community unit which could not be formed for that level of hospital.  During the coaching sessions with the larger team many of who were not the direct participants of the training, they found a way of linking a dispensary with a community unit, to the hospital. The team surpassed their target and by the end of 6 months they had immunized 1608 children with vitamin A and achieved a number of secondary results too. Dr Ann, the district Medical officer and the acting medical superintendent, was one of the training participants, and she pointed out that the coaching that was conducted to all the facility staffs made the difference and enhanced the team to reaching their potential as high performers. Dr Ann said “It seems people fear to ask enough from themselves.  When you stretch yourself, and set higher aspirations, then you know you have it in you. This achievement was a motivation and inspiration”.

Conclusion

Post training coaching develops the team capability and competencies allowing people to see new perspectives around their actions leading to greater performance. A number of capacity building organizations have expressed their admiration to using this strategy to strengthen the health workers performance. A Chinese philosopher, Wang Yang-Ming (1472-1529) believed that knowledge is incomplete until it becomes conduct, and conduct is not complete until it becomes knowledge at work. Coaching can be the key to achieve and replicate this success.