Peer Coaching Creates a Safe Zone for Managers

When leaders at the Greenville Health System witnessed some of its managers struggling with employee engagement, they swung into action with a plan to get them back on track.

The Greenville Health System (GHS), a not-for-profit healthcare network in South Carolina, has 1,358 beds, 15 medical residency/fellowship programs, and the state's largest number of clinical trials. Its mission is to "Heal Compassionately. Teach Innovatively. Improve Constantly."

"Improving constantly" led to the Coaching Partnerships program launch in 2008. The program supports managers in work units that are struggling with employee engagement. It is a forum for sharing best practices and resources among managers, and for supporting managers with daily struggles.

The opportunity

Senior leaders at GHS believed that creating a highly engaged, committed workforce would help us become a high-performing organization. In 2007, the leadership team pledged to conduct annual employee surveys as a way to measure workforce commitment and engagement levels.

Data from the employee opinion survey are collected and reported at the system, campus, facility, and department levels. Reporting provides a national comparison of work unit data that identifies scores relative to three levels. Tier I indicates a highly engaged unit, while Tier III indicates less engagement and lower capacity for problem solving or action planning for improvement.

The solution

The Coaching Partnerships structure is simple. Managers of Tier III units are paired with managers of Tier I units for peer support. (Program nomenclature was deliberate: We use the term "managers of Tier III work units" rather than "Tier III managers" because labeling managers as Tier III assumes their low engagement levels are due solely to them. However, work units may have low engagement scores for various reasons.)

Employees complete opinion surveys in late February to early March, and managers receive reports for their units in April. Managers of Tier I units then are recruited by the program coordinator to serve as coaches. Almost all managers in the Tier I category accept the request.

With input from human resource managers to eliminate potential conflicts, the program coordinator establishes a partnership between managers without regard to roles. For example, it is not uncommon for a nonclinical manager to team with a clinical manager. Successful partnerships create a safe space and a willingness to share insights, lessons learned, and accountability. Peer coaches serving as accountability partners are a key component in helping managers focus on action plans and ongoing improvement.

Coaching Partnerships is coordinated by an organization development consultant from the learning and development department who manages program logistics, including pairings, initial communication, and understanding of coach and partner roles. The coordinator kicks off the program with an introductory meeting for both groups and helps define the role of a coach, particularly for first-time coaches. For some, stepping into the role of a coach has led to significant development.

Partners review survey results and, in collaboration with their coaches, identify one or two goals on which to concentrate for the next seven months. Partners and their coaches then arrange to meet face-to-face on a monthly basis (if possible). These meetings include a debriefing from the previous meeting, action planning for the next month, and sharing relevant experiences and insights.

Partners use Microsoft SharePoint to track their progress, where coaches add comments and words of encouragement. Partners only can see the posts from their coaches, while the coordinator can view all communications and occasionally offers guidance through this platform, which ensures teams stay connected and continue to document progress.

The coordinator also acts as the "coaches' coach," providing resources and being available to answer questions.

Results and lessons learned

Participants appreciate the support of their coaches, and coaches gain a valuable professional development opportunity from serving in this capacity. Measurable benefits follow.

• Ninety-five percent updated their progress on SharePoint one or more times.
• Participants responding to the final update reported "significant progress" or "completed" for 83 percent of goals.
• Ninety-six percent of participants responding to the final update "agreed" or "strongly agreed" that the program improved their effectiveness as managers.

Initially, the program coordinator manually tracked results for Tier III work units. In 2009, 58 percent of participants showed progress, with 20 percent of units advancing to Tier I and 38 percent to Tier II. In 2010, 70 percent showed improvement, with 15 percent advancing to Tier I and 55 percent to Tier II.

In 2010, we asked our survey supplier for an evaluation methodology to statistically quantify the impact of the 2011-2012 program. The supplier included the following question: "Do leaders of Tier III work units who participate in the program see greater improvement than leaders of Tier III work units who do not participate in the program? Key outcomes measures include (1) power item score, (2) commitment indicator, and (3) action planning readiness." (Power item scores are survey items that are shown to drive employee commitment; commitment indicators measure how committed employees are to the organization; and action planning readiness measures team readiness to engage in improvement planning.)

Data analysis revealed that, "overall, Coaching Partnerships was effective in improving scores on the key metrics for participants. Those managers who participated in the program saw greater improvement in 2012 than those who did not participate as measured by the commitment indicator, power item scores, and action planning readiness. The improvement on the commitment indicator was statistically significant."

The analysis further revealed that 37 percent of the work units that participated in the program moved to Tier I compared with 20 percent of the work units that did not participate.

Written feedback from participants also was positive, acknowledging the improvement in staff engagement and performance levels, and appreciation of the coaching partnerships.

Coaching Partnerships has been an innovative approach to developing frontline managers. It also supports a learning culture in which leaders expect to be aided in their growth and development by other leaders who want them to be successful.

In 2012, GHS exceeded the organizational goal related to employee engagement, achieving a commitment index score above the 75th percentile of all hospitals and health systems in the database. GHS scored at the 85th percentile. Progress made by Tier III work units through the Coaching Partnerships program was instrumental in meeting that target.

Lessons learned from the program can be distilled into the following points:

• The relationship between coach and partner is more important than technical understanding of the partner's work.
• It is critical to create a safe space in which to share work unit issues and discuss opportunities for professional growth and development.
• Regular follow-through from the coordinator ensures partners and coaches stay connected.
• Successful partnerships benefit both partner and coach.
• Viewing the opportunity to work with a coach as added support and not as punishment provides managers the greatest chance to see improvement in their engagement scores.
• Successful partnerships are ones in which both parties commit to the work.