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Better Meetings and Deeper Listening: The Underrated Keys to Improvement

Why It Matters

By running effective meetings, asking the right questions, and deeply listening, improvement coaches help to move improvement forward.


People are often surprised to hear that one of the skills we teach in the Improvement Coach Professional Development Program is how to run effective meetings. On the surface, it may not sound like an improvement skill.

The reasons for focusing on meetings become clearer when I ask a few questions:

Do you always know why you’re in (or have been invited to) a meeting?

Do you always have an agenda? Do you always cover every item on that agenda?

Do you always have a plan by the end?

Are you always clear on next steps?

Do most of your meetings feel productive?

Or do most of them feel like a waste of time?

Many of us attend a lot of unhelpful meetings. You may even assume that they are all that way. It is often not until you participate in a great one that you understand that meetings should not be something we just endure. We have too much to do and no time to waste.

Don’t Go It Alone

One of the best things about an effective meeting is being clear that we all have a role to play. We are equal partners, and there is no one person who has to handle all the responsibility for the meeting. When you share the responsibilities, you can be more confident that you are going to use your time productively and not allow distractions to take you away from your agenda.

Learn to Coach Your Team to Success

Before coming to work at IHI, I was the team leader for 10 improvement advisors. As the head of the team, I chaired all the meetings. I came in with my agenda. I probably had some preconceived ideas about the conclusions I wanted to reach. I saw it as my job to take it all on myself to get us through the discussions and get the solutions I wanted.

And then three members of my team attended the Improvement Coach program. They taught me how to be a good chair. They helped me make sure that everyone in a meeting contributed. They showed us how to rotate roles, including notetaking and timekeeping.

Also, they helped us become more efficient and effective during our meetings. We had many thoughtful people taking part with good ideas to discuss. Our challenge was that the richness of our discussions often led to losing track of time or neglecting our agenda items.  

Improvement coaching helped us be more thoughtful about our discussions. For example, at the end of our meetings, they taught us how to take a little time to reflect and self-evaluate. How did that go? How could we do better next time? We learned, adapted, and carried what we did forward in the next meeting. We became much more productive and made better use of our time together.

The Power of Asking Good Questions

As my colleagues helped to show me, the best coaches know how to pay attention. But, to deeply listen, coaches need to know the right questions to ask.

I often start a coaching conversation by asking about a time when a team had to carry out a test of change. I then ask what happened. And then I ask what happened next and what happened after that.

I then ask why they think things happened the way they did. Without offering any solutions, I keep asking open-ended questions to help the team explore what is going on. I try to support their self-analysis while they are sharing their challenges.

Having to explain their actions and why things turned out as they did can help a team think differently. Often it will bring to light something that they had not discussed as a team.

For example, improvement teams often spend most of their time thinking about tools, methods, and technical issues. They focus on their Plan-Do-Study-Act (PDSA) cycles or measurement. These are important, but it is also crucial to address team dynamics or team engagement. Teams sometimes forget to spend time on how they are connecting as a group. How are we doing as a team? Is everyone feeling like they can contribute? Is everyone able to give the time necessary to do the work? An improvement coach helps address the holistic needs of improvement work and not just the technical issues.

A good coach can be so valuable to an improvement team. They help a team explore deeply what matters most for their project. They can assist when a team feels “stuck.” By teaching them how to make the most of their time, being good listeners, and responding with helpful nudges, they can help improvement teams move their work forward.

Susan Hannah, RN, is an Institute for Healthcare Improvement Senior Director and faculty for the Improvement Coach Professional Development Program.

You may also be interested in:

Improvement Coaching: More Than Tools and Methods

IHI Quality Improvement Essentials Toolkit