Healthcare industry is amongst the largest economic sectors in US. As a result, it consumes a significant proportion of the country’s Gross Domestic Product (GDP). In 2006, the sector’s total consumption averaged $2.17 trillion. This represents 16.5% of the country’s GDP. The rate of consumption is expected to increase by 20% of the country’s GDP by the year 2015. Despite the high rate of consumption by the health sector on the country’s GDP, the sector requires numerous changes for it to operate effectively and efficiently (American Society of Mechanical Engineer) (ASME, 2007, Para. 1). Currently, there is intense debate in Washington in relation to the country’s health care system. President Obama hoped to sign into law a new plan geared towards overhauling the current health care system. As the bill passed through the Senate, several Republicans were geared to “slam the bill as a government takeover that would increase taxes and lead to rationing of healthcare” (Haas, 2009, p.1). As the plan continued to go through political avenues, it is making headway to become a law soon.
As the plan has maintained momentum, the general public has created opinions about the bill and many people are frightened. Many fear that a “government takeover” in healthcare will happen and the quality of services will diminish. The media continues to exacerbate the fear which is compounded by increased transmission through the internet. Upon reading various comments about the intended overhaul, one issue is clear; “The American people are more afraid of change than anything else.” However, change is inevitable in life and so it is in health care. In fact, the Americans themselves voted Obama in as their forty fourth president due to their desire to see change in the political arena. It was inevitable for this man to bring with him a myriad of changes, and the sudden aversion for change is unqualified as such.
Prior to the overhaul, many changes have already occurred in health care facilities. Hospitals and clinics have been forced to change their mode of operation. In addition, private insurance companies have also been forced to change the way they do business. All of these changes are efforts by the concerned parties to adapt to new needs and demands that arise from time to time in a society characterized by a high rate of dynamism.
Need of healthcare coaches
Currently, individuals are considering health as one of their greatest asset. This presents a challenge to leaders within the healthcare industry in ensuring that their organizations succeed at attaining customer satisfaction. Creation of a stimulating, harmonious and effective working environment in the healthcare industry is also vital in enhancing employee retention. According Hays (2008, p. 25), there has been emergence of a human resource crisis within the healthcare industry. This is not only affecting the delivery of healthcare services but also accessibility of the same. In addition, the rate of employee turnover has been on the increase culminating into an increment in the cost of operation.
Professionals within the health care industry are required to be very effective in their operation compared to those in other industries (Hays, 2008, p. 25). This culminates into stress and frustration amongst the professionals further aggravating employee turnover hence improper patient care. The resultant effect is that these firms are experiencing inefficiency in their operation since they have to replace individuals who exit from the field while the cost is recruitment is increasing. If leaders within the healthcare industry do not create a conducive working environment, their organizations will suffer from increased competition resulting into a high rate of staff turnover.
Numerous transformations have occurred within the healthcare industry. According to Hay (2008, p.26), organization in healthcare industry are currently suffering from two main problems. These include lack of efficient leadership infrastructure and proper management. This makes problem solving within these firms to be an uphill task. In order to save these firms from these challenges, it is paramount for firms in this industry to investment sufficiently in leadership development so as to develop a strong infrastructure. This makes healthcare coaching to be an important consideration for firms operating within the industry.
In their careers, leaders within the healthcare industry are increasingly seeking self improvement and continuous leadership. Through executive coaching, health care professionals can be able to attain these objectives.
Hadikin (2004, p. 183) posits that executive healthcare coaching plays a significant role in ensuring that there is effective organizational and personal transition. For example, doctors who have practiced for a number of years within the medical field face challenges when they are promoted to senior positions due to increased responsibilities. Such individuals would greatly benefit from healthcare executive coaching in that they would be able to deal with the challenges presented.
Considering increased consideration of health as their key asset, incorporation of executive healthcare coaching will contribute towards improving the value of healthcare organization leaders. Healthcare coaching is also necessary in an effort to unlock leadership capacity of healthcare personnel’s facing challenges in the course of executing their duties. The total effect is an increment in the benefits to hospitals, the medical practice and clinics. This arises from the fact that firms only excel if their executives such as Chief Executive Officers are performing optimally.
According to Hay (2008, p. 26), healthcare coaching is necessary in instilling a continuous learning culture within the industry. Hay posits that currently the successful organizations are those which have incorporated learning within their organization. Health care coaching would enable firms to cope with emerging challenges. In addition, there is need for firms in health care industry to incorporate executive coaching so as to exploit opportunities presented in the environment.
Statement of the Problem
Leadership is perhaps one of the most important facets of change and dynamism. The US healthcare system is currently being faced by numerous challenges. Some of these relate to shortage of human capital. It is in this light that many organizations such as those in the healthcare are required to work on their leadership in an effort to facilitate change and development. In each change, restructuring or re-engineering processes have to take place in order for these organizations to continue with their operation effectively and efficiently. In order to create these changes, executive coaches have been consulted in an effort to ensure that leaders understand how to help their employees through these changes. Many leaders have come to realization of the fact that their performance improved after working one on one with executive coaches.
According to Hadikin (2004, p.183), executive coaching is being incorporated by both individuals and organizations in an effort to accelerate their development. Firms in the healthcare industry are amongst the last organizations which have incorporated executive coaching. This arises from the fact that these firms had to deal with other factors within their organizations. Haas (2009, p.1) suggests that one of the reasons that coaching has not been used is because of the toxic culture it has created over the last several years. Many health care professionals work in environments that are toxic to their mental, physical and emotional health. In addition, many professionals have attested having submitted to bullying and intimidation by doctors. On the other hand, others have realized that they can learn to work more effectively with their employees (Haas, 2009, p. 2). Because of these actions, health care organizations today are realizing the importance of coaching executives in the process of restructuring their organizations.
It is important to note that coaching is not only conducted amongst the organization executives. However, even the low cadre employee stand to benefit from coaching which means that it is not a preserve for the top echelon leaders. New employees need to be coached as a way of enculturation. In addition, old employees need to be coached upon being moved to different positions. This can also be conducted when the management is of the opinion that boosting employee morale is required within the organization.
The same case applies for health organizations. Every employee within the organization stands to benefit from one form of coaching or another. This is especially so when restructuring is one of the policies that needs to be adopted by the managers. Restructuring means that new experiences are introduced to employees and the organization’s management team. Coaching is paramount in an organization in an effort to facilitate change and allow other parties within the organization to adapt to the new environment (Valerio& Lee, 2005, p.10).
In their operation, organizations in the healthcare system have not been effective. There has been increased concern over the performance of the healthcare system in US over the last decade. One of the key issues that have been of concern is the quality of services offered by firms in the industry at various levels. Healthcare professionals spend a lot of time handling sensitive situations. This limits their capacity to attain shared goals. In addition, the system is required to have a high degree of safety and equity by being patient centered. It is therefore vital to determine how effectiveness and efficiency can be attained. According to Executive Coaching Forum (2004, p.27),executive coaching is categorized as one of the key approaches or a form of intervention that can be incorporated in the process of enhancing development and maintenance of leadership within and organization.
Integrating the process of coaching executives by large and small organizations in an effort to evaluate behaviors of their employees, their attitudes at work, their level of enthusiasm and motivation is vital (Valerio& Lee, 2005, p.10).
. In addition, it is also important to evaluate the factors that make them to have a positive outlook towards their job. Organizations have a capacity to hire services of coaching executives because of their affordability. According to Executive Coaching Forum (2004, p. 19), most organizations will prefer outsourcing executive coaching for their senior level managers upon perceiving that those in management level are in a transition that might result into increased challenges if not handled well. The challenge is that they need to work with their managers before they get into trouble so that they can be more effective during the transition.
Objectives of the study
Every research that is conducted must have a set of predetermined objectives. These objectives guide the researcher throughout the entire process. In conducting the study, a main objective and a set of specific objectives were formulated as outlined below.
To determine the role of the coaching executive in the process of reengineering of a health care organizations.
- To explore how executive coaching contribute towards effective implementation of change management.
- To determine the effectiveness of executive coaching in the process of reengineering healthcare organizations.
- To determine whether it is efficient to hire executive coaches to come into the healthcare environment and work one-on-one with leaders.
- To explore the effectiveness and efficiency of creating in-house coaches to coach other employees.
In the process of conducting the study, the researcher will be guided by a set of research questions. These questions will act as road signs thus enabling identification of direction that the study will take. The whole of the study will revolve around answering the questions outlined below.
- What is the role of the coaching executive in the restructuring of a health care organization?
- Is it more efficient to hire executive coaches to come into the healthcare environment and work one-on-one with leaders, or is it better to create in-house coaches to coach other employees?
- Is executive coaching effective in reengineering healthcare organizations?
- What is the degree of effectiveness and efficiency associated with creating in-house coaches to coach other employees as a strategy for restructuring healthcare organizations as measured by performance of healthcare firms?
Significance of the Study
The American health sector is in a brink of change. The proposed overhaul of the system will mean that the managers are put into a context of new situations that they have not experienced before. Restructuring, as result, will be inevitable. Restructuring will be required so as to enable organizations adapt to new regulations and mode of operation that will be set out. Considering the objective of the study, stakeholders involved in management of healthcare firms will greatly benefit through integration of executive coaching. The study will explore the key areas that the coaching process will involve. Some of the areas to be considered include employee motivation, change management, employee empowerment, employee involvement and psychological issues related to the employees and their behaviors. Findings of the study will be of great importance to managers in American health sector as they try to formulate policies aimed at ensuring that there is a smooth transition. In addition, the results will help managers to deal more effectively with internal and external challenges that arise in the course of their firm’s operation (Executive Coaching Forum, 2004, p. 19). As a result, firms within the US healthcare sector will be able to delivers services more effectively and efficiently. The resultant effect is that they will develop their competitive advantage considering the challenges resulting from increased rate of globalization.
Many fields within which various studies have been conducted are extensive in nature. As a result, they cannot be covered exhaustively through conducting a single study. This being the case, there are some basic assumptions that have to be incorporated in conducting the research. The assumptions are considered to be constants which do not change throughout the study. In conducting the research, a number of assumptions were considered as outlined below:
- The research assumes that the organizations researched have a basic understanding of coaching. As such, the researcher will not be concerned with explaining what coaching entails since the organizations have a background of the same. Even if the organization is not currently adopting coaching, the study assumes that it is not out of ignorance but is rather out of choice.
- The organizations are also assumed to be open to the idea of using executive coaching within their organizations.
- Another assumption is that the organizations may have had a few individual leaders who may already be coaches for others inside the organization or used coaching in the past.
- Since it is only one health care organization that will be studied, it is assumed that the findings from this study can be generalized to apply to other health care organizations in America. The experiences of this organization are not to be considered as being unique to the particular organization studied. However, the experiences are common to all organizations within the country.
Scope and Limitations of the Study
As earlier stated, it is not possible to cover every facet of the field under scrutiny in one study. For clarity, most studies have clearly demarcated boundaries within which they are carried out.
The study will be limited to healthcare firms which are located in US. This limitation arises from the fact that it is not possible to conduct the research on a wide scale. However, the sample selected in the study will be a representative of the entire healthcare firms in US industry. It will not be possible to study each and every health care organization in America. Also, the study is limited to the role that executive coaching plays amongst organizational leaders. As such, other employees, apart from the leaders, are excluded from the study. The aim of the study is to analyze the interplay between coaching health care managers and restructuring of health care organizations. Other effects of coaching, for example improved productivity and such will also be considered.
A questionnaire will be the initial contact between the research and the target audience. This means that there may be a margin of error in the questionnaire. In order to resolve this, focus groups and interviews will be used to create a case study. As stated, the focus group will specifically be executive organizational leaders within healthcare institutions. Due to resource scarcity in terms of time, finances and human capital, the study will only be limited within US.
Definition of Terms
There are several terms used in the study and which need to be defined to ease the understanding of the entire research process.
Coaching is defined in many ways depending on the orientation and intentions of the scholar. For the purpose of this project, coaching refers to one-on-one relationship where one individual (the coach) guides another to the realization of specific goals. It can also be conceptualized as the process of helping the client develop a capacity to analyze a multitude of situations such that they are able to meet their goals.
Executive coaching is very dynamic which makes it challenging to stakeholders such as researchers and other practitioners. According to Executive Coaching Forum (2004, p. 19), executive coaching entails a number of key stakeholders. These include the executive, organization and the coach. Alternatively, executive coaching can be defined as a form of individualized and experiential development of leadership. The process is aimed at ensuring that there is improvement in leadership capacity amongst executives. The resultant effect is that the organization is able to attain its stipulated long term and short term goals thus surviving as a going concern entity. This involves upper level management whereby a one-on-one relationship between the executive and the coach is established. The client in this form of coaching is the executive of the organization. In order for executive coaching to be successful mutual trust between the parties involved is vital.
Employee or Team Coaching
Employee coaching involves the organization’s staff (excluding the executives) in one-on-one relationship with the coach. Team coaching takes place when these employees are coached by one or more coaches as a team.
This is an individual who has several years experience in a specific field who has obtained coaching credentials. In order to be categorized as and executive coach the parties have to be at the very least being certified as an executive coach.
Health Care Professionals
This term will be used to describe staff in this sector who include doctors, nurses, technicians and any other leader or employee who works within health care organizations.
Methodology of the Study
The research will use several methods to attain the specified goals and objectives. The steps to be followed in conducting the research is are described below:
- In conducting the research, qualitative and quantitative research designs will be used. Integration of the two research design will contribute towards improving the quality of research. Data collected using this method will be will be primary in nature. This results from the fact that it will be fresh from the field. Both open-ended and closed ended questionnaires will be used in collecting data from the field. Closed ended questions will restrict the responses of the subject. Selection of close ended questionnaires was considered due to the need to collect data that is specific.On the other hand; open ended questions will encourage the respondent to express their opinions. The aim will be to collect qualitative data, mainly attitudes and opinions. In addition, use of interviews was considered due to its capacity to give the respondents opportunity to explain their views at length.
- Focus group interviews will also be used. This will involve bringing together upper level managers in the target health care organization in a group. The group will engage in a discussion that will be facilitated by the researcher. It is called focus group because the researcher will focus the discussion to cover the issues that are important to the study only. Selection of focus group was informed by the need to obtain diverse information from a group of respondents who are conversant with issues related to the study.
- Observation will also be used in collecting data. The researcher will adopt naturalistic mode of observation. This is whereby subjects are observed by the researcher as they engage in their day to day activities. The observation is naturalistic because the subjects will be observed in their natural settings. The researcher or observer will maintain a low profile and will not actively participate in the activities that they are observing. In this case, the managers will be observed as they go about their duties in the setting of their particular health care institution.
Context of the Study
The desire for conducting a study on executive coaching in the context of a health care institution was borne out of a personal experience. The researcher’s family has been in the medical field for a number of years. Apart from being in the medical profession, my aunt is a manager who supervises 120 employees in her place of work. Of late, she has been in and out of a psychologist’s office. She was diagnosed with severe stress, which, if left unchecked, may lead to cardiac arrest and other complications. This got the researcher thinking as to the reasons why a seemingly high flying health care professional may be under stress. After questioning my aunt, the researcher found that a lot of restructuring has been going on in the nursing facility where she works. This has necessitated movement of staff from one department to the other. Her work load has increased two fold which is one of the major causes of her stress. The researcher, having attended a class on coaching in organization, was interested to know whether the same process can be effective in a health care organization setting. From this curiosity, it was found necessary to conduct a research related to this issue.
Coaching is an effective way to assist leaders in many areas. This is especially so for health care leaders who are faced with constant need for change. In addition, executive coaching is vital for healthcare organizations since they are required to develop a high level of efficiency in their operation. Healthcare professionals are also required to offer a high degree of personalized services since they handle very sensitive cases. Within the health care arena many leaders are faced with stress and constant change. Stress and change are inextricably intertwined. Change destabilizes the environment that the manager has been used to. The effort to adapt to these destabilizations brings about stress and a vicious cycle is subsequently established. Hiring the executive coach can help the managers to move through this transition easier. This arises from the fact that they will be able to acquire skills associated with effective organizational leadership. The study will be of great benefit to healthcare professionals since they will be able to acquire knowledge on how they can effectively integrate executive coaching in an effort to attain organizational goals in an environment characterized by a high rate of dynamism.
The next section of the paper will involve reviewing literature that is relevant to the study. This will be followed by a detailed section outlining the methods that will be used for collecting data from the field. The data collected will be analyzed and discussion of the findings given. Finally, a summary of the entire study will be given and a number of recommendations on how to enhance effectiveness of executive summary in reengineering healthcare organizations given.
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Hadkins, R. (2004). Effective coaching in healthcare. San Francisco: Elsevier Health Sciences.
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Valerio, A.M. & Lee, R.J. (2005). Executive coaching: a guide for the HR professional. New York: John Wiley & Sons.