With limited resources, how do you deploy practice coaches most effectively?

It’s all about balance.

To secure funding from internal and external resources, leaders are often asked to estimate the resources required to implement a practice coaching program. If the program will divert resources from other activities, leaders must strike a balance between providing adequate support at the practice level (by deploying practice coaches to work one-on-one with a practice) while maintaining a quality improvement infrastructure (such as a learning collaborative) to provide content, expertise, and cross sharing via a learning network. Practices must be able to learn from one another and build their internal capacity to run QI projects. 
 
A number of factors can drive how practice coaching resources should be allocated, including:
 
Number of practices targeted: If there are not enough coaches for the number of practices targeted, using a practice readiness tool could be beneficial.    
Number of practice coaches available: This may depend on intensity of intervention, geographic location of practices (travel time), and practice coaches’ capacity to interact with multiple practices and tap into additional practice coaching expertise in your community.  
Number of practices per coach: This depends on the role of the coach, the maturity of the practice in improvement processes and other key contextual factors, as well as the availability of improvement networks such as a learning collaborative.  
Scope of the change: Is the change focused on improving care for a single condition as opposed to a broader systematic change (such as planned care for all patients or advanced access)? 
Other practice facilitation resources available: If your practice facilitation infrastructure includes other team members to support practice change, such as an information technology/electronic health record expert or a dedicated physician who can work peer-to-peer with practice physician leaders, this will impact the time the practice coach needs.
 
Compiled by Jen Powell, an AF4Q technical advisor working with the Improving Performance in Practice (IPIP) Technical Support Team.