Posted on May 1, 2024
Dr Jane Lea knows the value of a good coach, whether on the sidelines of the soccer field or in the operating room.
A former Canadian national team soccer player and now clinical professor and surgeon at the University of British Columbia, Dr Lea has been on both sides of the coaching table. She now hopes to encourage other physicians to understand and reap the benefits of coaching with the launch of a new provincial Quality Improvement (QI) Coaching program.
“We’re looking at trying to make the best even better,” says Dr Lea, Provincial Physician Lead, QI Coaching. “That’s what coaching is all about; to unlock a person’s potential or the team’s potential to maximize and optimize their performance, to elevate where they are.”
The idea behind the Provincial Physician QI Coaching Program is to connect quality improvement trained physicians with subject matter experts leading QI projects or initiatives within Doctors of BC’s Joint Collaborative Committees (JCCs). This could include Shared Care (SCC) or other Specialist Services Committee (SSC) initiatives.
Holly Hovland, Quality Impact liaison, says the program is currently accepting applications for QI coaches and expects to open the intake for coachees in May 2024.
Physician Quality Improvement (PQI) is a flagship initiative of the SSC. Delivered in partnership with six health authorities, PQI delivers three levels of training built around the Institute for Healthcare Improvement’s (IHI) model for improvement and the Quintuple Aim. There are now over 700 physicians trained in PQI level 3 throughout the province and the Physician QI Coaching program is working to leverage some of these alums as QI coaches. Some of the Physician QI Coaching program goals are to:
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Deliver high quality, peer-to-peer QI coaching that is accessible and flexible.
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Contribute to a culture of continuous quality improvement within JCC projects and initiatives.
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Facilitate meaningful connections between QI coaches and coachees through best practices in coaching philosophy.
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Create a supportive community for QI coaches to advance their coaching skills and confidence.
Hovland says the program will support initiatives across the province. Someone in Northern Health, for instance, could lend their expertise to a physician in Island Health or elsewhere. All QI coaches will receive onboarding and training with access to additional resources and learning opportunities.
“This program is about creating impact. By bringing together the coaches, QI knowledge and the coachees’ expertise in a peer-to-peer coaching environment we can elevate those projects and enhance outcomes,” Hovland says. “There are so many good opportunities here.”
Coaching is a unique skill that requires active listening and curiosity, Dr Lea says. The goal is to help guide the coachee, using thoughtful questions and guided inquiry techniques, to allow them to problem solve, versus teaching or telling them what to do.
“Coaching is sort of like being a cheerleader,” she says. “Everyone’s coming with the purest intentions to make health care better and it’s invigorating to be around those people and a privilege to be involved in their projects.”
The coach will work alongside a coachee to design and implement a QI project and help them prioritize problems, analyze root causes, find and trial solutions, and understand the data. Unlike teaching models, with coaching, it is the coachee that drives the agenda.
“It’s a very different kind of approach. You sort of guide them to come to the answer themselves by asking guided questions,” Dr Lea says. “They usually know what to do, they often just need to talk it through to realize they already have the answers.”
“This also works because it is peer-to-peer and there is no hierarchy. We really want to help build the confidence and expertise in the coachee for sustainability,” she adds. “We’re not just trying to tell them what to do to get them through the project.”
Examples of potential QI projects are broad and varied, but tend to fall into one of the five Quintuple Aims of health care improvement:
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Improving patient or provider experience, such as reducing wait times, reducing provider administrative load.
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Improving population health, such as by reducing the CO2 footprint of care.
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Reducing cost. This could include streamlining services or removing unnecessary tests.
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Advancing health equity. For example, reducing disparities or gaps in access or provision of care among underserviced or disadvantaged groups.
“Grand ideas are often too large or complex to tackle all at once,” Hovland says. “Starting small and scaling up tends to be a more achievable solution that can then be scaled up over time. A coach breaks it down into manageable chunks.”
Patients and coachees are not the only ones to benefit from the work. Dr Lea says coaching has been an “antidote to burnout” for her as it’s usually one-on-one and it feels rewarding to help someone who is trying to do great things.
“Wherever there is growth, there is happiness,” she says. “Coaching can help facilitate growth, and it’s rewarding for both the coach and the coachee. A win-win really.”
Initiative
Physician Quality Improvement Initiative
