The Coaching Approach to Relationship-Centered Care Gerontological Society

The Coaching Approach to Relationship-Centered Care Gerontological Society

The Coaching Approach to Relationship-Centered Care Gerontological Society of America New Orleans November 2010 PHI South-Bronx Headquarters Three roles: Model development Technical assistance Policy / advocacy State / Federal Strategy PHIs Coaching ApproachSM

A suite of interventions designed to build the universal skills necessary to deliver relationship-centered care driving decision making closer to the consumer and her/his care partners. PHIs Five Universal Coaching Skills Active Listening Clear Communication w/o Judgment Self Reflection / Self Management Collaborative Problem Solving Participative Leadership

PHIs Center for Coaching Supervision & Leadership Design: Four-Year R&D Demonstration Purpose: Break the cycle of instability Strategy: Prepare nurses/managers to become more effective supervisors Funding: $4.7 Million PHIs Center for Coaching Supervision & Leadership Intended Outcomes:

Improve direct-care jobs Improve supervisory jobs Improve staff relationships 30 Provider Sites: Home care / nursing home Varying levels of intensity PHIs Center for Coaching Supervision & Leadership Interventions:

Executive Leader Seminars Train the Trainer Cross Functional Team Meetings On-site Boosters Peer Gatherings / Executive Leader Summit Technical Assistance / Executive Coaching Coaching Communication Training DCWs PHIs Center for Coaching Supervision & Leadership Evaluation Activities:

Baseline Survey Endline Survey Turnover Data Executive Leader Interviews Trainer Interviews Cross Functional Team Focus Groups Supervisor Focus Groups Direct-Care Worker Focus Groups PHIs Center for Coaching Supervision & Leadership Nursing Homes: Beth Abraham - New York - 300 CNAs Loretto Fahey - New York - 150 CNAs Medilodge of Howell - Michigan - 150 CNAs

Fairview Beth Pike - Pennsylvania - 91 CNAs Sterling - Pennsylvania - 90 CNAs Loomis House - Massachusetts - 52 CNAs Orchard Cove - Massachusetts - 38 CNAs PHIs Center for Coaching Supervision & Leadership Home Care: Partners in Care - New York - 8400 HHAs/PCAs Partners Boston - Massachusetts - 400 HHAs VNA of Central Jersey - New Jersey - 200 HHAs VNA of Indiana - Pennsylvania - 90 HHAs CH&H - New Hampshire - 82 HHAs/PCAs Keystone - Pennsylvania - 55 HHAs/PCAs

Coaching Supervision uptake: Before/After Questions % Reporting Often or Always Practicing Before CS training I held people accountable for doing their job well 63% After CS training I hold people accountable for doing their job well 88% Before CS training I practice d active listening at work

44% After CS training I practice active listening at work 88% Before CS training I practice d pull back at work 34% After CS training I practice pull back at work Significance & Effect Size (low, medium, high)

p < .001 Effect Size = .45, medium p < .001 Effect Size = .86, high p < .001 Effect Size = 1.01, high 82% {Retrospective Questions: 240} n CCSL Supervision & Job Satisfaction Scale

Satisfaction p = .040* All Staff p = .004* Pre N = 1270 Post N= 1392 p = .039* Direct-Care Workers Supervision Pre N = 1007 Post N=

1120 Pre N = 1298 Post N= 1406 p = .003* Pre N = 1038 Post N= 1143 Increased efficiencies Nurse supervisors and leaders reported their time had been freed to focus on other responsibilities: 25 supervisors reported an average of three hours saved per week following

As an executive director, I cherish As an executive director, I cherish supervision training. the gift of time. My staff have learned to work together to solve problems at the appropriate level, leaving me the ability to focus on strategic issues ~ Margaret Franckhauser , CEO, CH & H Residents and clients Coaching with consumers and their families: As an executive director, I cherish Coaching promotes a feeling of mutual

respect. trying to understand where people are coming from, not making assumptions, applies not just to staff, but also to patients and families. (supervisor)supervisor) As an executive director, I cherish As soon as I said to [a very upset family member] that I wasnt sure what she was asking, so I wasnt sure how to help her, she calmed down (supervisor)nurse) One Sites Health Outcomes Residents with a Urinary Tract Infection High Risk Residents with Pressure Ulcers 18% 18%

16% 16% 14% 14% 12% 12% 10% 10% 8%

8% 6% 6% 4% 4% 2% 2% 0% 0%

Orchard Cove National Average Trend Line (Orchard Cove) Orchard Cove National Average Trend Line (Orchard Cove) Organizational transformation Profound change initially individuals, then entire As an executive director, I cherish Coaching Supervision has transformed organizations: the culture of this organization. Relationships between our office- based supervisors and

home health aides are much more positive even the office is quieter. ~ Marki Flannery, CEO, Partners in Care As an executive director, I cherish Coaching Supervision provided the educational foundation for our culture change, which is all about relationships. ~ Paul Hollings, CEO, Orchard Cove Qualitative evidence PHIs Distillation Five universal skills Can be learned How to teach How to build capacity (supervisor)teach teachers)

How to sustain For more information, contact: Steven L. Dawson, President PHI [email protected]

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