In AHRQ’s The Practice Facilitation Handbook: Training Modules for New Facilitators and Their Trainers, the experts suggest that most coaches engage practices in a six-stage intervention, with stage one identified as practice recruitment and readiness assessment. This phase typically takes place before active facilitation starts and includes conducting an assessment of the practice’s ability to undertake the proposed improvement effort and setting practice goals.
There are many practice assessments that are open sourced and easily available to practice coaches. Selecting the right assessment for your practices will depend on several factors:
• Is there a specific area of focus that has been predetermined for a group of practices? Practice assessments are available that are designed for specific improvement activities, such as patient-centered medical home (PCMH) or chronic illness care. The Practice Facilitation Handbook provides a list of assessments by content area for easy reference.
• What is the practice’s organizational context/starting point to determine areas of need and focus? Regardless of content focus for the proposed improvement effort, contextual factors can have significant impact on the practice’s ability to engage in quality improvement activities. The Humboldt County Alliance recently developed and prototyped the Practice Improvement Capacity Rating Scale Tool, which allows a practice coach to interview a practice leader on key organizational factors to predict readiness and determine areas of focus as part of the practice coach engagement. A scoring schema has been developed to assist practice coaches in identifying whether a practice is ready for consultation. Factors include senior leadership and financial commitment to QI, prior experience executing QI projects, level of physician leader and practice administrator support, data collection capability, IT support, compensation and payment strategies linked to the QI project, and competing priorities.
Compiled by Jen Powell, an AF4Q technical advisor working with the Improving Performance in Practice (IPIP) Technical Support Team.
How do practice coaches work with patient partners (patients who are engaged in QI efforts) to improve ambulatory care?
Learn from AF4Q Alliances’ pioneering work.
When do practice coaches end engagement with a practice?
It depends on a number of factors.
What is a practice coach?
Making meaningful change to improve outcomes.
Does practice coaching improve practice performance?
Evidence reveals improvement in the quality of primary care.
How do you learn to be a practice coach?
Focus on quality improvement and organizational change, for starters.
How is practice coaching a resource for ambulatory practice improvement?
AF4Q Alliances have developed practice coaching programs to support primary care practices' work in health care quality improvement.
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