High turnover among frontline staff challenges healthcare organizations’ ability to deliver high quality care. To improve job quality and reduce turnover, high performing organizations use managers and supervisors to coach frontline staff. A supervisory coaching style focuses on building relationships to support staff and team members to grow their skills and advance their careers, rather than traditional disciplinary-focused supervision. As a people-centered management strategy, coach supervisors increase employee satisfaction, reduce turnover among supervisors and frontline workers, and improve quality of care.
How to Implement this Practice
Making the Case
Coaching is critical to improving service delivery, according to global management consulting leader McKinsey & Co.
The key to unlocking the potential of frontline managers requires a shift in thinking. Organizations must move away from the traditional paradigm in which frontline managers communicate decisions after they are made and ensure compliance with policies toward a paradigm in which frontline supervisors are empowered to improve people and processes.
An organization that embraces supervisory coaching does just that.
Successful implementation of coaching throughout an organization requires a shift in the culture. When this relational model of leadership and management is fully embraced at all levels, it is truly transformative. CareerSTAT’s case study of skilled nursing facilities in Massachusetts perfectly illustrates this transformation. Here are key steps to implement a coaching style:
Train leadership and supervisory staff in core coaching skills: active listening, self-awareness and self-management, and communicating without judgment or blame.
Model coaching skills at the very top of the organization. This sets the tone for supervisors at all levels.
Fully integrate this training into all processes, for example, new hire orientation and supervisory training programs.
Reinforce skills with regular and ongoing reminders and boosters.
Redesign the performance review and disciplinary processes to incorporate the coaching style.
How to Ensure Success
Because implementing the coaching style requires such a dramatic cultural shift, successful implementation requires a high level of organizational readiness. Here are some critical success factors:
Strong, stable leadership who champion the practice
Sufficient staffing to accommodate a robust training schedule
A culture that positively recognizes managers for their role in frontline worker advancement
Financial resources to hire temporary staff for backfill during training
Experienced staff educators able to facilitate highly interactive, sometimes challenging material
See This Practice in Action
In 2010, Hebrew Rehabilitation Center Boston was suffering from low morale after losing a significant number of its staff to a newer sister facility. Under new leadership, the organization implemented the PHI Coaching Approach to Supervision® and trained all staff, including frontline workers, in interpersonal communication skills. The result: a transformed workforce culture. Frontline supervisors and assistants were empowered to make decisions and solve problems as close to the resident as possible. Residents experienced more control over their lives and reported an improved quality of life. The changes also gave workers a greater sense of satisfaction which in turn led to more staff stability.
UnityPoint Health is a large, nonprofit health system employing 5500 workers in its Des Moines-based hospitals and clinics. Facing high turnover among frontline workers and their supervisors, UnityPoint designed a leadership training program to grow skills of internal leaders, improve retention of frontline staff by giving them more career opportunities, and reduce replacement costs of frontline workers and first-rung managers.
The training curriculum teaches effective communication, working with people with different personality types, and problem-solving, all of which strengthen the coaching skills of team leaders. Participants and managers reported that the program not only improved morale, but also addressed other human resource issues. The result: UnityPoint has filled 92 percent of its supervisory positions with incumbent workers.
“Two-thirds of our frontline staff travel past three other competing facilities to come to us. We have to give them a value proposition that makes that worthwhile, and we can’t always do it in dollars. With coaching supervision, we hope to create a workplace environment that they can’t get elsewhere.”
— Bill Bogdanovich, President and CEO, Broad Reach Healthcare in Massachusetts
“It feels fairer. The CNA has input. The supervisor has more understanding, and we can find out how to help the CNAs do their jobs better. When everyone has the tools to be successful in their jobs, the organization does a better job in carrying out its mission to deliver quality care.”
— Bill Kittler, administrator at Kimball Farms, a Berkshire Healthcare facility in Massachusetts
A coaching culture that supports frontline workers can have a significant impact on business outcomes. The strongest results are those in three key areas:
Increased worker availability measured by reduced turnover, reductions in vacancy rates and temporary staffing, and reduced recruitment costs.
Improved employee engagement measured by improved scores on employee satisfaction surveys and reductions in unplanned absences.
Improved patient or residence experience measured by fewer readmissions and more successful care transitions.