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Team Coaching in Healthcare: Floundering Clinical Team

October 30, 2023
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Some newly hired leaders need help navigating challenges that make it tough to be effective in their roles. One issue that some new leaders need help with is creating and sustaining a high-performing leadership team. Team coaching in healthcare plays a critical role in helping clinical teams thrive.

In this case, a newly hired director assumed the leadership of a for-profit healthcare organization comprised of five managers. His facilitative, extroverted approach clashed with the style of the former director, an introverted, traditional top-down manager. This director contacted me to help him address resistance from his management team toward his efforts to enhance team functioning.

What is team coaching?

Team coaching is helpful because it promotes effective communication, resolves conflicts, aligns teams with organizational goals, enhances collaboration, and improves team performance and success. It provides a structured and supportive framework for teams to grow, adapt, and excel in a dynamic environment. There are specific skills needed by team coaches to ensure success. While the primary focus of team coaching is the group, an essential factor to consider is the leader's teaming skills. We have found that many team coaching in healthcare engagements need to start with assessing the skills of the team leader.

Presenting Team Issues

The newly hired director needed help to help his team become high-performing. Team meetings with his managers were often quiet despite his attempts to facilitate dialogue. Managers on the team came to him with issues about their colleagues instead of engaging the peer with whom there was conflict. Collaboration and communication among the managers were limited, leading to unproductive strife and a lack of alignment on essential priorities.

Team Coaching Engagement Approach

The engagement I introduced to this manager and his team consisted of three phases: Initial executive coaching for the director, team coaching with the director and his five managers, and follow-up executive coaching for the director.

Phase 1: Executive Coaching

In a team coaching engagement, it is essential to begin with one-on-one work with the team leader to build a trusting partnership and help the leader understand how their behavior may impact the team. In this phase, I administered the Hogan Personality Assessment to the director to help him understand his strengths and weaknesses that may impact team dynamics. Key findings included:

  • He was perceptive about others' needs and skilled at managing relationships but was reluctant to confront poor performers.
  • Lack of confidence in leading.
  • Tendency to doubt his abilities, become overly self-critical and take criticism personally.

We explored ways to help the director feel more legitimate and confident in his role, including building greater alignment with his boss and developing supportive relationships with peers. Since the former director in his role embraced a more directive style, his attempts to be facilitative and engaging came across to his managers as tentative. With this awareness, he began experimenting with balancing facilitative and directive styles, becoming more mindful of how he was overusing a strength.

Phase 2: Team Coaching

In Phase 2, I began the team coaching in healthcare project by administering a team assessment instrument for the whole team, including the director, to help identify strengths and weaknesses in the team dynamic. The assessment helped pinpoint critical challenges:

  • A sense of exhaustion and overwhelm among the team.
  • Fuzzy decision-making and other essential processes.
  • Lack of alignment in the team on critical priorities.
  • Inability of the team to be forthright and honest with each other.

Once we formulated a vision for the team and specific team development goals, we conducted a series of team coaching sessions with the director and his five managers. Each session included a participant-led icebreaker, a team issue or challenge raised by the director, facilitated discussion of an article by a participant, and a final reflection of the session identifying essential discoveries. 

Phase 2 concluded with a post-assessment to measure any changes in team functioning and a wrap-up session to consolidate and integrate participants' learning. Based on the post-assessment, the team achieved several improvements:

  • Enhanced team renewal through recognition and celebration of achievements.
  • Clearer processes, including decision-making authority.
  • Greater alignment on key team processes and direction.
  • Reduced tension and more spontaneous and fluid interactions
  • Enhanced communication, including a greater willingness to surface and resolve conflict.

Beyond the post-assessment results, participants exchanged genuine validations of team member's talents and contributions.

Phase 3: Follow-Up Executive Coaching

Finally, in phase 3, I resumed executive coaching sessions with the team leader for three months to help him deepen his awareness and team leadership skills. Faced with a new manager joining the team, the leader used our coaching sessions to explore how best to integrate him with minimal impact on the solid trust established through the coaching process.

Lessons Learned and Key Insights

Several factors contributed to the success of this team coaching engagement, including:

  • Preparing the team leader for the experience of team coaching through one-on-one executive coaching.
  • Actively engaging the team in facilitating parts of the team coaching sessions.
  • Intervening throughout team sessions to highlight progress, key insights, and robust teaming behavior.
  • Coaching the director before the team sessions began to help him develop greater self-awareness of the impact of his behavior on team functioning.
  • Using a team assessment instrument to pinpoint areas of strength and weakness, then focusing on these in the coaching sessions.
  • Supporting the leader after the team coaching phase with additional executive coaching sessions to help her tap her newly developed insights and skills in managing her team.

In summary, for team coaching to have the most significant impact, it needs to include an upfront coaching opportunity for the leader to gain awareness of the effects of their behavior, a role for team members to play in the sessions, and opportunities for reflection at the end of each session to deepen and integrate insights.

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Dr. Kevin Nourse is an executive team coach helping teams create amazing results. He founded Nourse Leadership Strategies, an executive and team coaching firm based in Palm Springs, CA. Kevin works with leaders and teams throughout California including Riverside, San Bernardino, Los Angeles, Irvine, Orange County, San Diego, Ventura, Santa Barbara, San Francisco, and Sacramento.  Contact him at 442.420.5578 (call or text) or kevin@nourseleadership.com

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