10 july 2014 the impact of health coaching dr alison carter institute for employment studies
TRANSCRIPT
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
