Göran Henriks (Jönköping County Council, Jönköping, Sweden) draws on his experience as a former professional basketball coach to lead hospital improvement teams to higher levels of performance.

Athletes learning to excel go through three stages, and each stage must be coached in a different way, says Göran Henriks.

First, players need to learn the right habits, such as doing their homework, eating right, and practicing an appropriate amount. They also need to “learn how to learn,” partly by watching experts demonstrate the right ways to perform.

Second, after mastering the right habits, each athlete must modify his or her own play to fit the situation, and to learn how to judge the results. This can be difficult and frustrating, and the coach will work with players individually or in small groups.

Third, if all goes well, the athlete’s performance takes off. At this point, they are “in the groove,” acting with the team as one smooth unified whole. They need competition that is a little above their level so that they keep learning and develop habits that contribute to winning more.

Substitute “team player” for “athlete” and you’ve got a useful model for coaching health care groups to higher levels of performance, says Henriks. A former professional basketball coach, he is chief of the department of learning and development at the Jönköping County Council (Jönköping, Sweden). The Council is responsible for the care of 330,000 residents in 13 municipalities in the south of Sweden. 

Leaders who are launching quality improvement programs, Henriks says, need to consider how they are coaching their teams. Here are some helpful pointers he picked up during his basketball career, which included coaching the Swedish national team.

• Establish common values. “You have to work a lot on your vision, your mission for the system, and your basic values,” says Henriks. “Winning teams always have signs of this.” (He gives the example of the Chicago Bulls during the Michael Jordan era.) The Swedish County Council has signed on to the quality improvement values embodied in the Malcolm Baldrige National Quality Award.

• Set high goals. Just as basketball players benefit from playing rivals who are slightly better, health care team members should benchmark themselves against best practices worldwide.

• Consider how your coaching will be received. The challenge is to get other people to accept the knowledge you want to transfer. In a basketball analogy, you want to “develop the receiver,” Henriks says. “Many coaches put a lot of effort into the technical skill of passing, but it’s almost more important to understand how players receive the ball.”

• Let team members improve their own performance. As a basketball coach, “you can’t change the player — you give him the picture so he changes himself,” Henriks says. The same applies to clinical professionals learning new skills. “You can’t just announce to them that they need new skills. They have to develop their own work processes to change their work habits.” Particularly in health care, people are highly motivated to do so, he adds. “It’s quite easy to make people change their performance if they get time for it.”

• Take different perspectives. After years of training and practice, health care professionals can “become narrow in their problem-solving capability, because they learn to think only one way — the biological/scientific way,” Henriks says. Using different creativity tools can help to solve problems, he suggests.

• Think of the whole system. Coaching basketball, you must grasp the entire situation, and so must every player on the team. “We have to teach the players directly to see where their teammates and opponents are on the court,” Henriks says. Similarly in health care, “the most important thing is the system approach. We are all part of the system, and it’s the system results that are important in the end.” Reaffirming this approach can be difficult if some participants “feel as if they are the system,” he points out, which can be a particular problem in environments with a lot of money.

• Create a learning culture. “In sports, we teach you to try to make your own move — to use your capability as much as possible,” Henriks says. In health care, “people understand they have two jobs — their current job, and the job to learn and improve. People need help and support to change their own views on what to do. They also need help to change their environment.” Asking individuals to try to improve their own performance, Henriks continues, is “the only way to do a quick change, because otherwise the old structure always wins.”

As part of their participation in the Pursuing Perfection program, Jönköping County Council began implementing a quality initiative for its 9,600 health care workers in 2002, working on patient access, patient flow, clinical improvements, and patient safety and medication issues.

“We can show results,” Henriks stresses. Jönköping County spends less per inhabitant than any other county in Sweden, he says, and offers the best patient access to many clinical programs.

“It takes some time if we really want deep change,” he adds. “When we get 30 to 35 percent of the system performing at a new level, the whole system will change.”

Further Reading

Improving Patient Flow: The Esther Project in Sweden