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


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


Please tweet …….

#EoEHealthCoaching@eoeleadership


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


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


Penny slides

10 July 2014

Sharing progress to date and learning

with each otherKaren Bloomfield, Leadership and

Organisational Development Manager


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


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


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)


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)


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


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”


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


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


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


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


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


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?


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?


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

What are your Evaluation issues?

What would help you?

[email protected]

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

mailto:[email protected]

http://www.theperformancecoach.com/

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


Pennys slides

10 July 2014

Essentials for on-going development and

sustainability/Next stepsDr Andrew McDowell and Dr Penny Newman


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

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