|Health Factors:||Quality of Care|
|Decision Makers:||Healthcare Professionals & Advocates|
|Population Reach:||50-99% of WI's population|
|Impact on Disparities:|
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Practice coaches or facilitators work with clinic staff to redesign clinical practices and improve the quality of care they deliver. Efforts can center around ensuring care timeliness, increasing practice efficiency and patient-centeredness, improving continuity of care, and improving preventive and chronic care (CWF-Grumbach 2012). To improve care quality, coaches organize quality improvement (QI) efforts, help staff understand and use data to drive QI (Taylor 2013b), use team-building exercises to improve communication, share best practices, and explain how other organizations have improved care. They also help motivate interest in change, and help practices choose goals, adopt new work processes, interactively solve process problems, and incorporate health information technology (AHRQ-Coleman 2009).
There is strong evidence that primary care practices that work with practice coaches adopt more evidence-based guidelines than practices that have not engaged coaches (Baskerville 2012, CWF-Grumbach 2012). Coaching also increases the number of quality improvement (QI) initiatives that practices undertake (CWF-Grumbach 2012, Baskerville 2012).
Interventions that are more time intensive and those tailored to practice context and needs appear to yield stronger effects than weaker or more generic interventions (Baskerville 2012). However, additional research is needed to determine the most effective coaching models (CWF-Grumbach 2012).
Practices that work with coaches appear to deliver more preventive services than practices that do not. Coaching can improve care for chronic conditions such as diabetes and asthma, and lead to increases in teamwork, an improved work environment, and a more learning-focused culture (CWF-Grumbach 2012).
In general, quality improvement efforts that use data, specific targets, tools such as Plan-Do-Study-Act, and a long, sustained process are associated with greater success than QI efforts that do not. Strong team leadership and a culture that supports QI are also associated with successful efforts (Kaplan 2010).
Practice coaching can cost from $7,500 to $60,000 depending on project goals, coaching and intervention design, and travel expenses (AHRQ-Knox 2011).
Practice coaching is growing in the United States and globally (AHRQ-Knox 2011). Coaching is often funded through federal programs such as Area Health Education Centers (AHEC), Health Information Technology for Economic and Clinical Health (HITECH) Regional Extension Centers, state governments, Medicaid waivers, and philanthropic organizations (Taylor 2013). In 2011, the Agency for Healthcare Research and Quality (AHRQ) granted Oklahoma, North Carolina, New Mexico, and Pennsylvania funding to assist primary care clinics with practice facilitation (Taylor 2013).
From 2008 to 2010, 14 small Wisconsin primary care practices participated in the Improving Performance in Practice (IPIP) initiative and received tools and coaching to evaluate performance and implement quality improvement activities (WCHQ-IPIP).
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