Clinical coaches and patient safety - Just in time: A descriptive exploratory study

Abstract

Patient safety in hospitals is a key priority. Clinical coaches who educate, support and coach staff to deliver safe, high quality care, are ideally placed to positively influence patient safety.

Aim: This study aimed to understand how clinical coaches in an education role, manage risk and support patient safety at the point of care.

Background: Patient safety has developed from a find and fix reactive model towards an approach which focuses on human performance, aiming to understand how individuals adapt and respond in complex systems to ensure 'things go right'. Clinical coaches working as educators at the point of care, are uniquely placed to ensure 'things go right', supporting staff to anticipate and proactively respond to emerging issues, particularly when complex practice situations change unexpectedly. Clinical coach experiences of intervening 'just in time' to prevent errors incidents or omissions occurring at the point of care is unknown.

Design: This was a descriptive exploratory study conducted with registered nurses working in the role of clinical coach (n = 29).

Methods: Study data were collected through a purposefully designed survey.

Results: Clinical coaches intervened 'just in time' across a variety of clinical situations including medication errors, clinical procedures, documentation, assessment skills and clinical handover. Lower skill mix, higher patient acuity and the commencement of new staff influenced clinical coach 'just in time' interventions. Most of the clinical coaches had intervened with both junior and senior members of staff. Overall, clinical coaches spent up to 3-4 h every day proactively managing risk across a variety of clinical situations and staff.

Conclusions: Clinical coaches play an important role in ensuring patient safety by regularly intervening 'just in time' to prevent errors, omissions, or incidents from occurring at the point of care. The clinical coach role, which educates and supports staff to deliver safe, high quality care, makes a valuable contribution towards patient safety.

Keywords: Clinical coach; Clinical education, coaching; Nursing; Patient safety; Practice development.