With so much emphasis on efficiency, and so much bureaucracy weighing down our best intentions, it’s easy to let even basic human interactions become mechanized. We speak of “care delivery,” but the act of caring about the feelings and fate of another person is more intimate than such transactional language can capture. Thus it’s vital for healthcare organizations to nurture the skills that make such intimacy possible—effective communication, and effective coaching to help staff and providers connect and empathize with patients.
The Advancing Communication Excellence Program
For the last several years CCI has partnered with Blue Shield of California Foundation to deliver a unique communication training series to staff and providers at community health centers throughout California. The Treating Patients with CARE curriculum, developed and taught by the Institute for Healthcare Communication (IHC), offers a paradigm for staff and providers to communicate with patients (and each other) in ways that appreciate and empower.
In 2014 CCI launched its third round of BSCF-funded CARE training, the Advancing Communication Excellence program (ACE). ACE also included a second program option for organizations that had already been through CARE training in a previous year. This second training, Coaching for Impressive Care (CFIC), provided the opportunity to train managers and supervisors in coaching skills developed from the CARE curriculum.
Coaching in the Context of CARE
Supervision and coaching require a unique skillset, but too often clinics promote good employees into managerial roles without giving them the training they need to be effective managers. Such training is even more important when an organization wishes to value and promote communication skills like the CARE model. CFIC brought much-needed coaching skills, with a goal of enhancing staff satisfaction and encouraging patient partnership.
To teach supervisors how best to coach staff to use and strengthen their CARE skills, CFIC focused on a three-part model developed by IHC: 1) Care about the employee, 2) Assess current performance, 3) Plan steps to achieve impressive performance. This CAP method helps make clinic coaching more effective in much the same way CARE skills improve communications between staff/providers and patients.
CFIC also showed leaders and managers how to integrate CARE into their organizational culture and use it to further guide their staff to deliver high value care. This included setting up standards for coaching and supervising, and an expectation that managers and supervisors would employ coaching and CARE skills in their interactions with staff.
Overall CFIC was received very positively by the participating organizations and the specific managers who attended the training. For example, at Northeast Valley Health Corporation, managers and staff report that they are now more actively using CARE skills, particularly when managers coach staff to communicate more effectively. Managers and supervisors at Ole Health have expressed increased confidence in coaching staff on all issues, not just C.A.R.E. skills. Petaluma Health Center reported that team leads and managers found CAP to be a viable tool to promote and enhance an organizational culture of innovation, effective communication and collaboration. At Santa Rosa Community Health Centers, the training has set a standard for coaching skills among managers that employees have come to expect.
Though quantitative data measuring these successes have been hard to correlate, some organizations have reported that surveys taken since implementing CFIC have shown increased staff satisfaction, and increased rates of providers engaging with patients in a more empathetic manner.
Implementing the Coaching for Impressive Care training came with some difficulties, as well. Grantees struggled with scheduling the four-hour workshop the training program required. Another often cited challenge was mid-program turnover of CFIC trainers and managers/supervisors. Turnover problems were compounded by the need for managers who had already completed CARE training before getting their CFIC training.
Sustaining CARE Beyond CFIC
One significant mark of the program’s success: many grantees are now incorporating CFIC skills into their ongoing manager/supervisor training curriculum and workflow. Ole Health, for instance, has added CFIC/CARE “touch-points” for supervisors to use when staff report to them. In some cases grantees have picked specific parts of the CFIC curriculum to spread to their entire organization. For example, two organizations are using the “Even Better Yet” worksheet, the CFIC performance management tool designed to track the performance of managers and supervisors, as a template goal-setting tool for all of their staff. Another organization provided the managers and supervisors with “COACH” caps upon completion of the training. These small gestures help embed the CARE and CAP paradigms into the health center culture.
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