Coaching for safety in the pharmacy

Abstract

In the summer of 2016, a Nebraska family was vacationing at Walt Disney World Florida when tragedy struck. Their 2-year-old son was pulled by an alligator into the seemingly safe water of a pond within the park grounds. Before anyone could react, the little boy’s life was taken. Following this event, a Disney intern within the Disney College Program tweeted a picture that enlightened cast members on how to respond if an alligator is spotted on the grounds. The intern was approached by a manager and informed that her employment with the Disney College Program would be ending early, effective immediately. In fact, she was escorted out of the park. Fortunately, once Disney leadership became aware of the situation, the intern was quickly rehired and asked to complete the remainder of the summer program. This event represents an opportunity to initiate positive changes in workplace training and the surrounding mindset. This is where workplace coaching may come into play. Workplace coaching focuses on employee training, development, and retention. When optimized, it also promotes a cultural shift from command-control management to empowerment of employees. In a 2011 article in The New Yorker, Atul Gawande, surgeon, author, and CEO of the nonprofit health care venture Buffett, Bezos and Dimon, advocated for the role of coaches in improving health care in America. Gawande espoused that many high-performing professionals—athletes, professional musicians, schoolteachers, and yes, surgeons—already benefit from coaching targeted at their performance. He described his own interactions with a surgical coach and explained how his performance had improved as a result. Coaches are prevalent in many settings, so why not health care? Imagine how valuable safety coaches could be in pharmacy and health care environments. In 2007, Cincinnati Children’s Hospital Medical Center implemented a hospitalwide patient safety initiative that had been piloted in the radiology department. The new approach introduced workplace coaches into an error prevention training course to facilitate didactic teaching and exercise-based participation focused on patient safety. Volunteer coaches were recruited across employees at all levels, including nonclinical staff, and asked to uphold a set of standards that would exemplify effective leadership and compassion. Core beliefs emphasizing a culture of safety and leadership support were vital components of initial coaching success. The Cincinnati patient safety initiative introduced core safety behaviors into established training. These behaviors included a five-to-one positive feedback model, structured communication behaviors, and behavioral observational tools. In the five-to-one positive feedback approach, coaches provided five reinforcing comments for every one critical comment. In other words, coaches were to identify and recognize five positive safety behaviors for every incorrect or aberrant safety behavior identified. In addition, coaches provided feedback on structured communication techniques, such as the use of SBAR (situation, background, assessment, request/recommendation) and/or phrases used by personnel in key safety moments. Finally, safety coaches conducted observational assessments, intended to supplement the safety behavior growth and development. Workplace coaches have the potential to guide the future development of those they coach. Workplace coaches should possess traits such as excellent leadership and interpersonal skills, an ability to recognize specific organizational factors, and a desire to fulfill leadership roles (both formal and informal). Studies have shown that interpersonal skills, compared with other managerial attributes, are more likely to influence others. Examples of interpersonal skills vary significantly but could include motivating others, encouraging growth and development, and communicating openly and transparently. In general, the ideal workplace coach has a unique arsenal of skills that can garner positive impact. Using a safety coach in the pharmacy could yield significant safety improvements.