How does a practice coach assess a practice to determine areas of need and focus?
Focus on the practice’s ability to undertake improvement efforts, for starters.
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.
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