Ambulance - Is your business still breathing?

Image Copyright Alan C Clark 2019

Image Copyright Alan C Clark 2019

Are you feeling pain in your business or is it just below par? Is it fit and healthy enough?

When watching the documentary series Ambulance on BBC One TV, you hear the 999 Call Handler in an ambulance call centre start by asking the question “Is the patient still breathing?” How healthy is your business?

Well. Is your business still breathing? Is there a positive cash flow? Is there a flow of orders? Do customers return and bring their friends?

These and many more measures are the vital signs of your business. Too often businesses ask for help only when they are in crisis when the options for progress and time are more limited.

When your business’s vital signs are starting to look poor, take action early. Yes, it’s hard to ask for help, especially when society seems to expect business owners, directors and managers to have all the answers.

Equally when a business does ask for help, is there the expectation that the outside help, whether consultancy, mentoring or coaching, will tell them what to do?

But is that the best way forward? Will those responsible for taking action really own and carry out what is being recommended?


An outside view can actually bring in new ways to understand what’s happening and the action to take . There is the risk though that an outside consultant might bring either their favourite solution or what’s in fashion.

This might not be the best way forward when you think about it, because every business and the people in it are unique. In addition, of course, as i say, the client may not own what is being recommended.

When you ask for outside help it is useful to know that there can be three different types of outside help, which Edgar Schein described in his book Process Consultation Revisited as:

  • Purchase of Expertise Model

  • Doctor-Patient Model

  • Process Consulting Model


In the purchase of expertise model, as the name suggest, new knowledge is brought in by the external expert. For example, help might be requested with digital marketing.

Digital marketing is a rapidly changing field with things like Artificial Intelligence and Virtual Reality making it hard to keep up, hence the need for outside help.

Such experts would be bringing in the required up to date knowledge. Provided the organisation takes responsibility for its learning and the implementation of the new knowledge, this can be a useful course of action.


The doctor-patient model brings with it greater risks. In this model the client approaches the consultant very much in the manner of a patient with some ailment going to see their doctor.

As in the medical case the consultant investigates the symptoms, possibly carrying out an in-depth investigation interviewing people across the company and, where available, studying performance data.

Based on this the consultant makes their recommendations for action as a doctor would prescribe treatment for a patient. This advice may be absolutely correct based on the evidence that is shared with the consultant.

Unfortunately the extent to which the doctor-patient model works is dependent a number of factors:

  • Has the client identified the correct area for the consultant’s work?

  • Are people willing to reveal accurate information about the situation?

  • Do those in the company believe in, accept and own the proposed course of action?

  • Do both the consultant and the company properly understand and accept the likely outcomes of recommendations

  • Is the company willing or able to take action on the recommendations? Might they be too near a precipice? Is the business still breathing?


If you are not looking for specific knowledge or expertise then Process Consulting can be a more effective course of action to deal with problems.

The word ‘process’ here refers to the interpersonal interactions between the client and the outside helper. Importantly in process consulting as the client you own your problem and continue to own it throughout the project.


Solutions-Focused Coaching is a way of doing process consulting. Central to solutions-focused coaching is that it is very much focused on what works for the client in their situation, today.

You and your business or organisation are unique. You want to build on what you have achieved, working to ensure this continues over the long-term. Solutions-focused coaching positively and practically achieves your desired future.

That is, the future you really want.

Experience has shown that resolving problems by focusing on the solutions is simpler, quicker and cheaper than focusing excessively on the problems. Often effective solutions can be developed in six sessions, sometimes less.

Focusing on cause and effect in man-made systems and equipment maybe a useful way to solve problems. However, as problems get more complex or if they wholly or partly involve people, then complexity can cloud the issues.

Also the more a problem is talked about the more complex and difficult it can appear due to the emergence of the multiple different points of view.

Rather than the usual approach of focusing on what you do not want, i.e. the problem, you focus on what you do want or are trying to achieve, the solution, which is why it is called solutions-focused coaching.

The critical point is that if something is working in a complex, often human, situation the more likely it is that doing more of it will create more success.

This is because whatever is happening results from all the complex relationships and interactions in the situation. It is very practical and in saying this, a solutions-focused approach also only deals with solvable problems.

Solvable problems can be defined, have outcomes that can be measured and, most importantly, everyone involved accepts that they will be doing something differently.

Here’s the solutions-focused process:

Image Copyright Alan C Clark 2016. Adapted from Jackson and McKergow (2007)

Image Copyright Alan C Clark 2016. Adapted from Jackson and McKergow (2007)

Although the usual sequence is problem – platform – (miracle question) – ideal future – resources – small actions – review, if for some reason this is not working we do what works.

In more detail the steps are:

Defining the problem, particularly what you are trying to achieve

Then the platform is how you would know you had moved forward, e.g. might you have some measure or key performance indicator

If possible the critical next step is visualizing what the ideal future would be or look like after the solution has been successfully implemented

It is all too easy to become buried in the problem or the current situation. Sometimes it may be difficult to imagine the ideal future. It may then be necessary to ask the Miracle Question

The miracle question consists of imagining that everyone goes home for the night, with everything remaining the same, when during the night a miracle occurs and in the morning the ideal future has occurred

What does your ideal future look like?

This leads to the next step, which is estimating on a scale of 1 to 10, where 10 is your ideal future, how close you are to it; often 2 or 3 is typical, let’s say 2.5

Next, what small step can you take to get you from 2.5 to 3? What resources can you use that are already working in your situation? They may be called or doing something else

When this has been carried out and, hopefully successfully, recognize and appreciate the shift that has occurred

Now what small step can you take to move from 3 to 3.5? And so on

This might all seem slow compared with the business-as-usual approach of endless discussions about the problem and rushing solutions that may not work because they do not have the sign-up of all those involved.

The point is that more time is spent moving towards the ideal solution. Progress may not be even, sometimes there might be only a small step forwards, at other times there might be a massive step.

The important thing is that as the improvements are applied, learning is taking place, which brings us to the final step:

Reflect upon what has happened and what has been learnt that can help move towards an even better future

The essence is, therefore, quite simple, although it benefits from some subtlety in use. It boils down to:

Finding out what is already working and doing more of it

Stopping doing what does not work and doing something else, often what is already working elsewhere in your organisation

Personally I continue to use solutions-focused coaching to help directors, managers and business owners because it works in solving issues with their relationships, teams, business operations, partners and organisations.

What is more it often resolves issues overall in a shorter, finite time, which is often faster than business-as-usual approach of having endless debate and applying ill-conceived compromises.

Also solutions-focused coaching is a useful technique for you as a manager to use in your work as you encounter issues and challenges with people and problems at every level of your organisation.


Is your business still breathing? Do you have an issue or problem that is causing you pain? If it looks like you need specialist expertise, call in an expert, making sure you retain control of the project and implementation.

If your pain appears to be within your normal field of knowledge and operation, and especially if it’s a people issue, consider taking a solutions-focused approach, either doing it yourself or with an outside coach.

This approach enables you to maintain control of the resolution of the issue, usually getting to a solution faster and, importantly, doing what works for you and your organisation at this time. It may already be working somewhere!

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