Introduction to coaching in QI
Learning goals
• Understand the goals of coaching in
implementing QI
• Understand the skills needed for a good coach
• Explore the role of coaching in strengthening
QI leadership, activities and clinic quality
management
• Start to practice coaching in different
challenging situations.
Why do we need coaching?
• Help the worker (or team) perform to their
best and achieve professional goals.
• Adults do not learn well from lecturing alone
• Training is more effective when followed by
on-going supportive learning relevant to real
situations.
– (eg, gaps in the clinic quality, managing a specific
patient issue, etc)
What coaching is not:
• Classic supervision: where you tell a person or
clinic what they are doing wrong and then tell
them to fix them.
• Auditing (QA)
• Solving problems for the clinic.
• Taking over as the clinic quality lead.
• Telling the team what to do
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Coaching involves more than giving
knowledge in lectures
• Implementing QI needs both new knowledge,
as well as a change in culture
• Sometimes things do not happen as they
should even if knowledge and skills are
present
• Remember: “Quality improvement is a
journey of many small steps.”*
*National Quality Center and HIVQUAL
Goal of a QI coach
• Strengthen QI work and systems by providing
to QI teams:
– ongoing technical support and advice
– skills building
– Advice and support to manage the
inevitable problems that arise
Why do you want to coach?
What are some possible benefits to
coaching?
2 minute discussion
Where does coaching occur?
• Performance measurement
• Quality improvement
• Quality management
What an effective QI coach does (1)
• Promotes and advocates for quality,
measurement and improvement.
• Supports good QI methods
– Use of data to drive improvement
– Systems focused
– Good team work
• Builds a relationship and works with QI
teams but is not a member nor the leader
Adapted in part from NQC and ITECH
What an effective QI coach does (2)
• Teaches others how to do the task and then
supports their work.
• Checks-in regularly and is available as a resource
• Provides feedback on the team’s challenges and
accomplishments.
• Identifies why change is not happening
• Spreads lessons learned from other sites
• Helps the QI team engage leadership
• Helps build the quality management program
Skills needed for effective QI coaching
1) Technical skills in QI
2) General coaching skills
QI coaches must be able to teach and
coach in technical areas
• Performance measurement
– Indicator development
– Accessing/collecting data.
– Data analysis and communication of results
• Designing and implementing QI projects
• Evaluating status of QI projects
• Evaluating the status of a QM program
However, QI coaches must also have
general coaching skills
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Promoting Discussion
Active listening
Diagnosing and Overcoming resistance
Team building
Communication
Leadership and role modeling
Management and planning
People skills
sources
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National quality center (www.nationalqualitycenter.org)
The Team Handbook, Scholtes, Joiner & Streibel
HAIVN
HIVQUAL
JSI Research and Training
ITECH training on clinical mentorship www.go2ITECH.com
WHO
Partners in Health
FHI360
Among others
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Coaching exercise
• We are back with the clinic that was stuck
• Goal is to increase follow up visits. There are
data which show that rates have dropped
from 80% to 42% over the last 6 months. The
data come from the EMR
• You now have a coach who has been working
with the site for 6 months whose goal is to get
the clinic “unstuck”
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Exercise
•2 minutes-understand your character
•10 minutes role play-QI meeting: QI project
which has stalled/not started
•5 minute internal sharing•what did you learn,
•where did the coach help,
•where else could he/she have done more,
•what did it feel like to be the coach
•10 minutes group sharing
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