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Transcript of 10 July 2014 Welcome Overview of our Health Coaching Workshop Karen Bloomfield, Leadership and...
10 July 2014
Welcome Overview of our Health
Coaching Workshop Karen Bloomfield, Leadership and
Organisational Development Manager
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
To increase understanding of health
coaching and its application
To increase understanding of health
coaching and its application
To network, share experience and explore how health coaching is
used in different settings
To network, share experience and explore how health coaching is
used in different settings
To consider interim findings and evaluation to inform further development of
health coaching
To consider interim findings and evaluation to inform further development of
health coaching
To consider how health coaching aligns with other organisational
strategies and across the system
To consider how health coaching aligns with other organisational
strategies and across the system
To start to develop a plan on how to increase the impact of
health coaching in your organisation
To start to develop a plan on how to increase the impact of
health coaching in your organisation
Aims
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
10.30 Welcome, Introductions and overview of the day
10.45
Overview and Interim ReportPenny Newman, Clinical Lead, Health Coaching Programme
11.15Sharing progress to date and learning with each otherKaren Bloomfield, Leadership and Organisational Development Manager
11.45Identifying the impact from Health CoachingAlison Carter, The Institute for Employment Studies
12.45 Lunch
13.30Targeting your training and using the modelsAndrew McDowell, Director, The Performance Coach
14.15Pulling it all together – the House of Care Penny Newman, Clinical Lead, Health Coaching Programme
14.45Essentials for on-going development and sustainability/ Next stepsAndrew McDowell, Director, The Performance Coach and Penny Newman, Clinical Lead, Health Coaching Programme
15:30 Close
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Please tweet …….
#EoEHealthCoaching@eoeleadership
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Who’s in the room ?Role (Trainer, Co-ordinator, Clinician) Geographical base/ workforce partnership Norfolk/ Suffolk : Essex : Beds/ Herts : Cambs/Pboro
Organisational / client base Acute: Primary Care: Community: Mental Health:CCG
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
5 mins discussion
What would make your day Fab or Drab ?
Post its please…
10 July 2014
Overview and Interim Report
Dr Penny NewmanGP, Consultant in Public HealthDirector of Service Integration,
Colchester Hospital NHS University Foundation TrustClinical Lead, Health Coaching Programme
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Penny slides
10 July 2014
Sharing progress to date and learning
with each otherKaren Bloomfield, Leadership and
Organisational Development Manager
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
20 min discussion• What’s your interest in Health Coaching?
• Then on flip chart note a few points …
• What’s working well about Health Coaching in your organisation so far? And not so well ?
• What do you need to more of …..?
10 July 2014
The Impact of Health Coaching
Dr Alison Carter
Institute for Employment Studies
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Impact/Evaluation mechanisms• Reflective practice by clinicians when using their health
coaching skills• Co-ordinators are encouraged to conduct their own local
evaluations to measure results• Programme team are conducting post-training and follow-up
surveys on programme quality and application of learning • Independent IES evaluation on impact of health coaching in
five clinical practice settings
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
IES Evaluation
IES Evaluation •Not a randomised controlled trial (RCT)•Exploring whether health coaching is a useful approach for clinicians and their patients•Case study approach in five organisations
Evaluation sitesNorth Norfolk CCGCambridgeshire Community Services NHS TrustNorfolk and Suffolk NHS Foundation TrustNorfolk and Norwich University Hospitals NHS Foundation TrustHawthorn Drive (GP surgery)
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
At each case study site
• Describe the intervention and process of implementation and contextualise it
• Explore views on usefulness for clinicians and their patients• Explore views on any changes to thinking or practice• Support local identification of relevant outcome data and
examine local evidence of impact (health outcomes and consequences for organisations)
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Evaluation methods QualitativeScoping
– Focus groups with (18) clinicians– Interviews with (3) experts
Organisational case studies – Interviews with co-ordinators & team
leaders (9)– Focus groups with (41) clinicians– Follow up interviews in progress with
25 clinicians & 5 co-ordinators– Interviews with 5 local stakeholders
Quantitative
• Patient experience surveys • Analysis of relevant local
outcome data (clinical and management) where available
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Professionals
Awareness
• Awareness of campaign
• Understand the challenge of behaviour change
• Willingness to train
Initial Training• Individuals
receive health coaching training
• Teams/ organisations engage with programme
“Mind-set”• Willingness to
coach• Greater self
belief in coaching skills
• Increased use of coaching
• Increased coaching skill
• More variety in patients coached
• Tool to use in specific situations
• Integration with existing style/practice
“Practice”
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
ProfessionalsAwareness
• Awareness of campaign
• Understand the challenge of behaviour change
• Willingness to train
Initial Training• Individuals
receive health coaching training
• Teams/ organisations engage with programme
“Mindset”• Willingness to
coach• Greater self
belief in coaching skills
“Practice”• Increased use of
coaching• Increased
coaching skill• More variety in
patients coached• Tool to use in
specific situations• Integration with
existing style/practice
Evidence?Focus groups with clinicians and Follow-on interviews with clinicians and stakeholders
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
PatientsInitial outputs“mind-set”
• Increased… • Awareness of
opportunity for self management
• Self belief• Willingness and
intention to change behaviour
Initial behaviour outputs
• Changed health behaviours
• Adoption of self management principles
Impact on outcomes
• Reduction in appointments
• Health indicators • Improved self-
assessment of well-being
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
PatientsInitial outputs“mind-set”
• Increased… • Awareness of
opportunity for self management
• Self belief• Willingness and
intention to change behaviour
Initial behaviour outputs
• Changed health behaviours
• Adoption of self management principles
Impact on outcomes
• Reduction in appointments
• Health indicators • Improved self-
assessment of well-being
Evidence? Evidence?Patient experience surveys Management /clinical
information
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Early observations• Implementation progress has
varied enormously • Targeting services or patient
groups & selecting the 'right' clinicians for training
• Creating the 'right' environment to allow the skills to be used & anticipating adjustments to clinical environments
• A highly valued approach for individual clinicians who can provide stories of success with patients
• Not yet articulating success criteria or measurement
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Measurement ChallengesImpact may take some time
Deciding what to measure
Identifying comparison groups can be difficult
No follow up appointments makes pre- and post-intervention comparisons difficult
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Organisation Evaluations• What are you trying to achieve with health coaching in
your organisation? Clinical practice and/or wider strategic goals?
• What will success look like?• How will know you know when you have got there?• Can you use data already collected by the organisation or
will you develop and implement something new?
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Organisation Evaluations (2)• WHY are we evaluating?• WHAT was the purpose of the coaching?• WHO is the evaluation for?• HOW much resource do we have for the evaluation?• WHO should be involved in the evaluation?• WHERE will we look for impact?• Do we really need RoI?
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Top tipsPlan before coaching starts
Tell people you will be evaluating
Focus on key indicators
Get perceptual data from multiple sources
Organisation benefits are always asked about
‘Stories’ can be powerful
10 July 2014
LunchRun photo slide deck
10 July 2014
Targeting your Training and using the models
Dr Andrew McDowell, Psychologist and Director of the Performance Coach
A Health Coaching Approach• Mindset
– Principles and beliefs inherent in a coaching approach
• Skills– General coaching skills that can be used widely in health
consultations
• Techniques– Specific coaching techniques and conversation frames that can
be applied in health consultations
• Opportunities– What are your top tips for seizing opportunities to have
coaching conversations with patients
29
Review of Models
• What do I remember about this technique or concept?
• How have I used it?
• In what areas do I believe it can be applied?
30
Notes
31
32
Source: Whitmore
The TGROW Model
Components of Managing Health – Diamond model
Control
Learning
Motivation
Confidence
Managing Health
33
Questions:1.Where are you now and what has contributed to that?2.Where would you like to be and what are the reasons for that?3.What can you do that is within your control to move this forward?
Source: McDowell
1. Define the behaviour
2. Antecedents
3. Consequences
4. Eliciting personal meaning
5. Eliciting goals
6. Eliciting resources
7. Way forward
Raise Awareness
Increase Responsibility
ABC Health Coaching model
34
Source: McDowell
Antecedents & Consequences
35
Source: McDowell
Managing interferences
Performance = Potential – Interference
Desired Behaviour = Could do it – What’s in the way
The Inner Game Coaching conversation
36
Last 3 Questions•What gets in the way MOST?•What gets in the way LEAST?•Where would you like to START?
Source: McDowell, adapted from Gallwey
• What do you feel you are ready to change?
• What is currently happening regarding this behaviour?
• What would you like to achieve?
• What’s helped you to achieve this in the past?
• What are your options now?
• What else could you do?
• Which do you think might work for you now?
• What specific goal could you set?
• What would support you to achieve this goal?
• What would you need to do to achieve this?
• What ELSE would you need to do?....
• What ELSE would you need to do?....
• What do you need to do to remember this?
Solution focussed coaching questions
37
Source: McDowell
1. How important is ……….. to you? On a scale of 1–10 (1 = not important, 10 = very important)
2. How confident are you about make a change?On a scale of 1–10 (1 = not confident, 10 = very confident)
3. Tell me about how you scored yourself?
4. What would help to move you higher on the scale?
5. How high on the scale would you need to be to change?
6. What makes your “current score”(e.g., 5) not an “lower score” (e.g., 2) ?
Quick Motivational Interview
38
Adapted from: Miller & Rollnick
Don’t Change Anything Make Some Changes
GoodOutcomes
1. What’s working for you now?•Easier, less effort•Less stressful•Less time required•Can do what I like
4. What benefits would you expectfrom changing things?•What’s in it for me?•What short & long term benefits will I get?
Not soGoodOutcomes
2. What’s the downside of whatyou are doing now?•Short term negative consequences•Long term negative consequences
3. What’s the downside of changingthings?•Harder, more effort to break habits•More stressful•More time & planning required
Decision making – Motivational Interviewing
39
Adapted from: Miller & Rollnick
Technique Application
TGROW
Diamond
Inner Game
ABC
Solution focussed
Brief MI
Decision making matrix
Techniques and application
About the Performance CoachThe Performance Coach is proud to offer a range of innovative services to help organisations and individuals with an interest in leadership development, performance coaching and health coaching.
We pride ourselves at being the ‘best’ at collaborating with our clients, closing the ‘knowing/ doing’ gap and sustaining performance improvement over time.
For further information:Dr Andrew McDowell, The Performance Coach
M: 44 (0) 7984 464 407 T: 44 (0) 203 637 0970E: [email protected] W: http://www.theperformancecoach.com
The Performance Coach, Marble Arch Towers, 55 Bryanston Street, London, W1H 7AA
41
10 July 2014
Pulling it altogether – the House of Care
Dr Penny NewmanGP, Consultant in Public HealthDirector of Service Integration,
Colchester Hospital NHS University Foundation TrustClinical Lead, Health Coaching Programme
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Pennys slides
10 July 2014
Essentials for on-going development and
sustainability/Next stepsDr Andrew McDowell and Dr Penny Newman
www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Pennys slides
Thanks for being part of discussions today
… next events include …17th September – Facilitation workshop
30th September – Trainers/Co-ordinators workshop 11th November – Overall Health Coaching conference
10 July 2014