Grasping Your Current Condition: I don’t know how!
We were in the planning stages of new Improvement Kata story board in a small outpatient doctor’s office. I was coaching the coach, a director was in the coach role and the manager of the clinic, Ellen, was in the learner role. Ellen was striving for patients to be seen by the doctor within 5 minutes of their appointment time. She was focusing on Dr. Smith’s schedule on Mondays and Wednesdays – his busiest days. Ellen had done some initial analysis of patient wait times as well as observation of the clinic several weeks prior and so she thought her current condition was done.
The Actual Condition Today
I felt we were missing information regarding the actual condition today. Over several coaching sessions, I encouraged Ellen to ‘go-see,’ to observe the clinic and find out more about what ‘Mondays with Dr. Smith’ looked like. How many staff were supporting Dr. Smith? Could she draw a process map of what the day looked like? How many patients were on the schedule? How late where they? How long did patients wait in the waiting room? How long did they wait in the exam room? Ellen did spend a day observing, but in follow-up cycles, she had nothing written on her story board. She said she had lost the notes that documented what was learned during observation.
Realized I Missed Something
One day, Ellen’s director/coach was gone for the day and asked me to take over. We came to the story board and I could see that again, there was nothing written for the current condition. Ellen went on to say that she was covering for staff absences and didn’t have time to sit and observe Dr. Smith all day. This statement made me realize something. Ellen was equating grasping her current condition with observing Dr. Smith’s clinic for an entire day. I said, ‘Ellen, you don’t have to observe all day. There are other steps we can take to grasp the current condition.’
Ellen replied, with frustration, ‘I don’t know how to do that!!’
‘Ahh! I’m so glad you said that!’ I said with a smile. I realized I had missed something. I had been asking Ellen to update her current condition, but she didn’t know what that meant. In her mind, it was impossible to get her current condition because she didn’t have time to sit and observe the clinic all day. I asked her if she was open to a suggestion, and then offered a simple data collection tool that a tech could use to track patient appointment time against the time they were called back from the waiting room. I explained how a step as small and simple as this would give us great information about Dr. Smith’s schedule, how behind he was and tell us what we needed to learn next.
Ellen was relieved, and we left the coaching cycle with positive feeling and motivation.
I was Telling, Not Asking
It was a huge lesson for me as a coach. I was telling Ellen to grasp her current condition, observe, and go-see, all the while assuming she knew what I meant. Because I was telling instead of asking, I didn’t realize her frustration or overwhelm. When I realized she thought she had to observe the clinic for an entire day, I was able to get back on course with a small correction. Had I asked this earlier, so much time would have been saved.
A great reminder that the intention of the Coaching Kata questions is to understand what the learner is thinking. Once you hear that as a coach, your job is to compare that to the Improvement Kata model, and instruct the learner to get back in the corridor of scientific thinking.
Next time you’re stuck, make sure you understand how the other person is thinking!