Coaching & Mentoring

Managing Continuous Change

The challenge of organizations in the 1990s is one of managing continuous change. Organizations are meeting that challenge by creating learning organizations in which the focus is on sharing information, creating intelligence and nurturing innovation. The rapid pace of change that the world has known in the 20th century is especially prevalent in medicine and healthcare. (Berwick, 53-56) Since the beginning of this century, there have been dramatic changes in the morbidity and mortality profiles of populations. Sanitary and standard of living improvements, as well as technological and medical innovations, have been both the causes and the consequences of these rapid changes.

The way in which healthcare is being delivered; financed and held accountable has also been subject to change. This has forced healthcare providers, who operate in an extremely competitive market, to focus more of their attention on market share, cost containment and quality improvement. (Berwick, 53-56) The continuous improvement model which is being adopted by industry as the necessary model for survival is making its inroads into the healthcare market as well.

Coaching And Mentoring: Elements Of A Definition

In short, coaching and mentoring is concerned with the management of organizational change toward continuous improvement of the processes which govern the way work gets accomplished. While the definitions and applications of coaching and mentoring can vary widely, based on which `guru' one adheres to there seems to be a general consensus about the essential elements of coaching and mentoring. (Berwick, 53-56) First, coaching and mentoring is geared to the continuous improvement of quality in an organization. Generally, the goal of `perfect' quality is unattainable because of the limitations inherent in people and technologies. Therefore, the attainment of quality is a never ending journey. Continuously improving work flow processes is a quest for quality in itself. In healthcare, this notion of an `imperfect' world is well imbedded in the work of its professionals who are confronted with life and death challenges on a daily basis.

Secondly, coaching and mentoring is based on customer expectations, and on meeting and anticipating customer requirements. This, obviously, entails the proper identification of who the customers are (i.e. the internal and external customer in the customer chain), accurate knowledge of these expectations and developing action plans to close the existing gaps in meeting customer expectations. (Berwick, 53-56)

Identification of the customer chain is a relatively new concept among healthcare providers. The patient is traditionally viewed as the ultimate `external' customer. The idea of the existence of other external customers, such as the buyers or financiers of healthcare services, has only recently been acknowledged. In addition, in an environment characterized by professional dominance, the identification of an internal customer chain (i.e. one department serving another) is rather alien. (Deign, Watson, Nestor Conlon, Connaughton, 11-12)

Thirdly, coaching and mentoring requires an organization's long-term commitment. coaching and mentoring is most adequately described in terms of a `process'. It is a process of many small incremental changes rather than a short-term drastic intervention. Hospitals and ...