When I began my career at the world’s premier cancer center more than 17 years ago, leadership coaching was not embraced with the same appreciation it is now. Often, coaching was treated as a last resort to remedy issues, and some colleagues were embarrassed to be meeting with a coach.
Fortunately, over time, we have built a strong culture that recognizes and celebrates the benefits of coaching. In 2024, The University of Texas MD Anderson Cancer Center was awarded the International Coaching Federation’s (ICF) Coaching Impact Award for Distinguished
Organizations, representing excellence in coaching and celebrating a strong coaching culture. Leaders now routinely introduce their coaches to colleagues and openly discuss the benefits and challenges they have overcome with the help of their leadership coach. All employees can access coaching, and all leaders are accountable for coaching others as part of their role.
3 Elements for Success
There are three key elements that made MD Anderson’s transformation to a sustainable coaching culture possible.
- Demonstrate the value of coaching.
When connecting with new departmental leaders, we learned they often face a wide range of new scenarios in adjusting to the complexity of a large, multifaceted institution. Many are working for the first time in an academic, research-driven healthcare organization that is also a state institution and, therefore, receives funding from state and federal agencies, along with other authorities. They also are charged with the need to think strategically, as well as to plan for and lead change.
The difficult assimilation into these roles resulted in a higher-than-average turnover rate. Therefore, we developed the onboarding coaching program to address the turnover rates and associated costs of losing our senior leaders within the first two years in the position.
Rather than asserting the value of coaching, we asked a few key influential leaders to test the onboarding coaching program. We carefully matched 15 to 20 new departmental leaders with external coaches. They met for a minimum of 10 individual coaching sessions and three triad meetings (meetings with the coach, leader, and leader’s immediate supervisor) that occurred at the beginning, middle, and end of the coaching engagement.
Those leaders who participated in this pilot program were significantly more likely to stay with the institution and were more likely to be promoted within a year of coaching. Moreover, this group of leaders became our coaching champions, volunteering to become our first group of participants in a cohort coach education program to become internally certified coaches.
The success of the pilot allowed us to expand our onboarding coaching program. Through a matched control sample study comparing leaders who participated in onboarding coaching with those who did not, we reduced turnover rates by 52 percent (turnover rate of those coached is 11 percent vs. 23 percent in the control group). Now, everyone hired in a departmental leader role or above is enrolled in the onboarding coaching program.
Due to the success of onboarding coaching, we expanded our coaching offerings exponentially. We began offering many different types of coaching, including other modalities and scope, developing sustainable coaching resources, and cementing a coaching culture throughout the institution.
- Coaching as a strategic advantage.
As a leading healthcare institution, MD Anderson must continually evolve and adapt to make progress in its mission to end cancer. Therefore, change is routine. The institution continues to use the one-on-one and team support offered by coaching to help employees feel empowered to lead that change.
In fact, coaching is available to all employees and is infused into our leadership competency model: “Coach and Develop,” as an expected behavior of all leaders, and “Coachability” as an expected competency of all employees. Moreover, to promote accountability of coaching behaviors, the competencies were integrated into annual performance evaluations.
Coaching is integral to our selection, development, and performance management systems, and it is ingrained in our culture. With senior leadership support, we continue to strategically expand the reach of leadership coaching, informed by internal and external research evidence showing positive effects. Our senior leaders extol the value of their coaching experiences in open forums. Not only does this remind others of the importance of being an effective coach in their own day-to-day jobs, but leading by example creates a culture of coaching that helps MD Anderson move effectively into the turbulent future of healthcare.
- Equip leaders with coaching conversation skills.
Developing coaching competencies and utilizing coaching practices is critical to our talent and development strategy. All learning and development programs have a session dedicated to the competency of “Coach and Develop” centering on teaching competencies and skills of coaching. We also have a variety of standalone courses for leaders to learn coaching skills. Together, these give leaders the tools/skills to use coaching with their direct reports.
Additionally, we established a continually growing internal coaching cadre through a cohort coach education program with our external ICF-accredited training partner. Since our first cohort in 2019, approximately 200 leaders have graduated and serve as active internal coaches throughout the institution. Beyond providing coach education, this program is the cornerstone of our scalable and sustainable model for building a coaching culture.
Graduates of the program commit to coaching at least three leaders annually, allowing leader-coaches to continue refining their coaching skills and accumulate the required coaching hours to obtain ICF credentials. This approach also has allowed the institution to expand the reach of our coaching programs to include all employees, groups, and teams. Thus, it simultaneously promotes scalability through year-over-year increases in the internal coach population and embeds leaders-as-coaches into the fabric of the coaching culture in our institution.
When embarking on building a sustainable coaching culture, it is important to remember, as American philosopher Ralph Waldo Emerson noted, “It is a journey, not a destination.” It takes perseverance, partnership, patience, and a dash of leadership support. At MD Anderson, we have learned that a sustainable coaching culture is critical to delivering on the institution’s promise of providing exceptional care and, ultimately, to achieving its mission to end cancer.
