The headlines screamed, “Local Hospital Leads the State in C-Sections!” The gist of the story was that this hospital had more cesarean section births than any other hospital in the state. Indeed, it had led the entire Southwestern region for five years running. It’s well-established that C-sections are more expensive and riskier than natural childbirth and, therefore, they should only be conducted when there are good medical reasons for doing so. It seemed unlikely that this hospital’s patients were different from those delivering babies at dozens of other hospitals year after year. In response to this public embarrassment the hospital Administrator formed a team to look into the problem.The team of doctors, nurses and other health care professionals worked for more than a year with little to show for their efforts. I began working as a consultant with the hospital to help the team move forward. After observing a couple of team meetings, I had a pretty good idea of what it would take to nudge this group off of dead-center, but it wasn’t something that I could do as an outsider. I spoke with the hospital administrator and he agreed to lead a meeting with the team if I agreed to provide a bit of coaching.

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