|Program Type:||Single-institution peer-to-peer surgical coaching|
|Institution:||Large academic medical center with multiple specialties|
|Goals:||Improving performance and outcomes of surgeons|
|Champion:||Jane Lea, MD. Otolaryngologist|
|Participants:||8 Academy-trained Surgical Coaches|
Dr. Jane Lea is an Otolaryngologist Head & Neck Surgeon from St. Paul’s Hospital in Vancouver, British Columbia, Canada and Associate Professor at The University of British Columbia. Also important, Jane was a competitive collegiate athlete who knew the value of having a coach. As she grew her practice, she missed the input from a coach and wanted to find a way to get a coach to help improve her surgical skills.
“As a surgeon, I was coached through medical school, residency and fellowship, and then one day, I was apparently ‘good enough’ and all means of performance feedback disappeared. It has been 10 years since I finished surgical training, and until the start of this surgical coaching program, no one set foot in my OR to observe what I was doing, provide me with feedback, help me improve, and help me be better,” said Jane in an interview with the Academy.
Jane connected with the Academy for Surgical Coaching and was trained as a Surgical Coach in 2019. She enjoyed the training enough, she convinced her colleague Dr. Brian Westerberg to also attend. They formed a peer-to-peer coaching partnership and worked together to improve their technical and non technical skills. Jane and Brian knew that the surgical coaching experience was facilitating professional growth and wanted to share the experience with more of their colleagues.
Jane reached out to her colleagues outside of the University and was able to coach a community ENT surgeon who was looking to improve endoscopic tympanoplasty outcomes. Unlike other ENT procedures that offer binocular vision through a two-lens microscope, this technique requires the surgeon to use a 3 millimeter endoscope to see into the ear and around the bends of the external anatomy. Her colleague was doing OK with the procedure, but had experienced some graft failures. Over 3 cases, Jane and the community ENT surgeon were able to create a plan and help the surgeon to improve their handling of the endoscope, and reduce the rate of graft failures. Jane could bring her own expertise to support her colleague, and make the partnership even more effective by using coaching skills.
Based on the success of these two early coaching relationships, St. Paul’s hospital, Providence Health Care, awarded Jane a $10,000 grant to grow the peer to peer surgical coaching program. With these funds, Jane was able to train an additional 6 Surgical Coaches affiliated with Providence Health Care. These eight surgeons created a peer coaching program where they would all help each other to improve their practice. They spanned specialities: gynecology, general surgery, orthopaedics, plastics and Otolaryngology. What they shared was a desire to change their thinking about how they can work together with their colleagues and make improvements to their practice, leading to better outcomes for their patients.
Currently, the program has 4 Surgical Coaching pairs that are working together to improve. Because they are all based in the same community, the surgeons were able to meet and scrub into each other’s operating rooms to observe practice. The focus of improvement is primarily operative efficiency. In the program evaluations, all of the coaches wanted to continue the program and all of the coaches would enthusiastically recommend the program to a colleague. Most of the participants also said the program was as valuable or more valuable than other forms of surgical professional development.
One participant shared, “Although the idea seemed a no-brainer, I did not know how [surgical coaching] can be implemented with well-established surgeons. I found out that experienced surgeons are capable of letting their guard down and being open to new concepts to improve.”
“I was not sure how much I could contribute, given the different nature of our specialties. But, of course, surgery is surgery and there are many commonalities that bridge across specialties.”
Providence Health Care has been enthusiastic about the peer-to-peer coaching program. For a small up-front investment, they have seen their surgeons re-engaging with their practice and forming stronger relationships with their colleagues, fully aligned with the culture change that is taking place within their network of hospitals.
The only downside is time. Jane says she spends up to 5 hours per coaching session – one hour to prepare with the surgeon and understand their needs, up to 3 hours in the OR observing a procedure, and another one hour after the procedure to debrief and explore next steps. As the program is growing, she is also identifying a need for administrative support to coordinate matching coaches and schedule coaching sessions.