In our coaching engagements across the country, we see common themes in the aftermath of the pandemic: unsustainable operating losses, closed services, decreased engagement scores, nursing strikes, and unprecedented staffing shortages.

In the U.S., employee engagement has slipped to 32%, with 17% of the workforce being actively disengaged, which Gallup defines as “disgruntled and disloyal because most of their workplace needs are unmet.” These are astounding figures. The healthcare sector suffers the greatest decline in engagement, falling 12 percentage points last year, Gallup reports.

While leaders develop their roadmap forward, it is the staffing shortages and engagement of the workforce, particularly in nursing, which tend to be the most vexing as there does not seem to be any immediately sustainable solution. After bonuses and pay adjustments, what we see is leaders focusing on strategies to increase leadership, productivity and retention as more long-term strategies evolve to rebuild their bench of nurses, physicians and other critical staff. Deliberately Developmental Organizations (DDOs) and coaching can offer clues to inform these strategies.

Countering shortages, disengagement with DDOs 

DDOs, a term coined by Kegan and Lahey in their book, An Everyone Culture: Becoming a Deliberately Developmental Organization, are organizations which have two interdependent missions:

  1. The first mission reflects the purpose of the organization. In healthcare, this usually revolves around a mission of taking care of patients.
  2. The second mission is to foster the development of their people, intentionally and continuously. Instead of relying on offsite seminars, mentoring, corporate leadership programs for high potential leaders and the like, they strive to create a growth culture where personal development and improvement practices are woven into the day-to-day operations and culture for everyone. The culture aligns with a person’s inherent motivation to grow thereby improving engagement, productivity and retention.

Creating a DDO is no easy task and certainly not quick, but what they demonstrate is the power of investing in the growth of an organization’s people.

Coaching as the bedrock of growth

At the heart of a DDO’s growth culture is a culture of coaching. In his book, Helping People Change, Richard Boyatzis discusses coaching models within organizations and notes:

“A high-quality coaching relationship amplifies both job engagement and career satisfaction, and can be leveraged to help organizations develop and retain their best and brightest talent, especially among special and at-risk groups such as emerging leaders, minority groups, and women.”

Boyatzis reviews executive coaching, peer coaching and trainer coaching as potential models for organizations who want to scale coaching throughout their organizations. Importantly, he also makes a clear distinction between coaching for performance (think performance evaluation) and coaching with compassion.

The distinction is important as neuroscience has shown that coaching tied solely to job performance goals stimulates a negative neural pathway which ends up being demotivating. On the other hand, coaching with compassion, focused on individuals, stimulates a positive neural network which stimulates engagement, becomes self-motivating and leads to improved job performance. His research demonstrates sustained impact on performance: 50% at 5–7 years, compared to 11% at three months with training programs and 2% at one year for MBA programs. (The coaching with compassion methodology aligns with the transformational coaching model at MEDI Leadership.)

Nurturing long-term wins

As it relates to today’s healthcare landscape, sustaining meaningful change hinges largely on investing in the growth and development of people. To make that possible, coaching is an unmatched tool for fueling and sustaining engagement, wellness, resilience and performance improvement — all vital components for a thriving workforce.

Gary Hoffman
About the author

Gary Hoffman, MD, is a seasoned executive coach with rich, first-hand experience as a physician executive. His expertise is working with fast-changing healthcare organizations, executive and physician leaders, and clinical leaders transitioning from clinical to executive roles.
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