Introduction to the Training on Coaching Basics (TCB) Program Clemens Steinbock Director, NQC

2 NQC Mission The National Quality Center, in partnership with the HRSA HIV/AIDS Bureau, seeks to advance HIV care nationwide by providing innovative technical assistance and coaching for quality improvement to all Ryan White HIV/AIDS Program-funded recipients.

3 Intensity Information Dissemination: monthly newsletters, websites, publications, exhibits, QI awards Training and Educational Fora: monthly webinars, advanced trainings, online QI tutorials Consultation: On/off- site coaching of recipients to advance their clinical quality management programs Communities of Learning: collaborative, QI campaign, Regional Groups NationalQualityCenter.org | Together, we can make a difference in the lives of people with HIV. NQC provides assistance to RWHAP recipients to improve HIV care since gaps in HIV care still exist and advances are uneven across HIV populations. over 90% of the 587 RWHAP recipients accessed NQC services ~1,300 individuals (61% of recipients) graduated from 45 three-day advanced trainings 40% of RWHAP recipients received TA and 95% would recommend TA to others 40 online QI tutorials are available; over 25,000 have been taken so far 250 recipients participated in 28 Regional Groups 51% of all recipients joined the largest HIV QI campaign; viral suppression increased from 70% to 76%, a statistically significant improvement

4 Overview of TCB Program The aim is to close the educational gap of quality managers, increase quality improvement competencies, effectively guide other HIV providers in order to meet all RWHAP quality expectations, and to provide peer learning and networking opportunities to share best practices The target audience for this national training program includes those who have the capacity and responsibility to provide quality improvement guidance to other HIV providers This national program helps NQC meet its goal of nationally increasing the pool of competent quality improvement managers across all Parts and of building regional and recipient-wide capacity for quality improvement to better HIV care across the entire Ryan White community.

5 TCB Program Structure Pre-Work Phase: Participants are asked to complete standardized screening tools - a self-assessment and a peer assessment by their colleagues - to assess their coaching skills, prior coaching experiences, project management, QI knowledge, and participation in prior NQC-sponsored face-to-face trainings TCB Session: Participants attend a 3-day interactive workshop session to focus on the skills and behaviors of being a successful coach, and to develop their Personal Improvement Plan (PIP); the session provides hands-on, real- world exercises for effectively coaching individuals and teams Post-Work Phase: Participants are expected to begin improving their individual coaching skills with their Study Group partners and work on monthly coaching assignments

6 Goals of TCB Program Increase an individual’s mastery of effective coaching techniques to establish and sustain effective QM programs and QI teams Improve an individual’s ability to understand behaviors and interventions that promote a system’s QM approach using partnerships and shared vision Improve an individual’s capacity to engage individuals to work as a team and to maintain team motivation while building self reliance Improve self awareness of individual coaching, personal working styles and limitations Increase the understanding in the differences between contract monitoring and coaching

7 Target Audience Individuals who currently work in RWHAP-funded recipients, are instrumental in managing existing QM programs, and are charged in assisting other agencies within their network Individuals who have a quality management role across multiple HIV agencies, such as multi-agency networks, health care systems, including City and State DOH, or settings with subcontracted HIV providers Individuals who are responsible for building capacity for quality improvement among HIV providers and for supporting them to build sustainable clinical quality management programs NQC screens TCB applicants for current and future potential, and to ensure appropriate geographic and Part-specific representation

8 Pre-Work Two Pre-Work Conference Calls - these calls serve to clarify logistics as well as to review Pre-Work course material Reading Assignments - each TCB participant is asked to read selected articles which will be assigned at the first Pre-Work conference call Self-Assessment - an online self-assessment will be completed by each participant prior to the second Pre-Work Call 360 Degree Assessment - an online 360 degree assessment will be completed by five people able to review the TCB participant’s skills and abilities as a coach in quality improvement Organizational Assessment - each participant should bring with them to the face-to-face training a copy of an Organization Assessment which they have completed within the past twelve months Completion of Quality Academy Tutorials

9 Participant Handouts TCB Guide TCQ Handout of Handouts Assessment Findings (Self/360) Participant Contact List Post-work Guidance

10 Self/360 Coaching Assessments

11 3-Day Agenda

12 What are Study Groups? Groups of 5-7 of your peers working together for the next 6 months past this TCB session Groups connect at least monthly to provide peer support and jointly complete post TCB assignments Study groups provide  Support and feedback for coaching skill improvement  Offer strengths where you may have a weakness in a specific skill  Keep commitments to each other and to the TCB session

13 “A good coach will make his players see what they can be rather than what they are.”

14 What is a Coach? Formal Definition Coaching is… "a process that enables learning and development to occur and thus performance to improve. To be a successful coach requires a knowledge and understanding of process as well as the variety of styles, skills and techniques that are appropriate to the context in which the coaching takes place.“ Eric Parsloe, The Manager as Coach and Mentor (1999). He is a respected author and Director of the Oxford School of Coaching and Mentoring.The Manager as Coach and Mentor

15 Coaching Others: How Providers Feel You

16 The athlete decides the goal, the coach helps him get there.

17 Framework for Coaching Quality Improvement

18 Skill Set of Improvement Coaches QI Expertise - proficiency of QI methodologies/tools; access to state-of-the-art quality improvement resources; first-hand knowledge of QI applications in HIV care; knowledgeable about pivotal practices; ability to transfer recent QI advances into practical front-line provider applications Communication Skills - effective listening skills; ability to assess verbal and non-verbal clues; non-judgmental communication style; enable motivating interactions with teams and individuals; effectively elicit and summarize information; effectively deliver QI presentations using a variety of communication channels Operational Skills - proficient in developing action plans and tracking progress over time; aware of next steps and plans accordingly; hold individuals and groups accountable for moving forward; maintain clear documentation; demonstrate a respectful attitude and professionalism

19 Self-Awareness - self-aware of own strengths and limitations; aware of how others perceive you; recognize your own personal working style to effectively meet the overall objectives; recognize one’s own biases, misunderstanding and limitations; ability to develop personal improvement plans Adaptive - demonstrates an empowering approach; flexible to adapt to changing needs; pursuit of mastering their domains of expertise over time; familiarity with different learning styles and teaching formats; identifies and respects team values, including boundaries and cultural issues Skill Set of Improvement Coaches

20 Quality Improvement Catalyst Promotes QI activities and assists organizations to maintain momentum toward their QI goals.

21 Collaboration Builder Works collaboratively and helps providers build collaborative partnerships with individuals and groups of health care providers to achieve their improvement goals.

22 Strategic Thinker Strategically develops an organization-wide QM program and assists providers in doing the same within their networks and agencies.

23 Capacity Builder Trains HIV providers to build their capacity for quality improvement.

24 Facilitator Guides individuals and teams through group processes.

25 Measurement Advocate Develops system-wide performance measurement system reflective of the internal and external needs of an organization.

26 Objective Assessor Assesses individual and organizational performance, gives informative feedback and tracks progress over time.

27 Competing Dimensions Asking questions versus giving answers Self-sufficiency versus dependency Coach solutions versus re-inventions of coach solutions Short-term fixes versus long-term solutions Contract monitoring versus coaching for quality improvement

28 Build Capacity, Not Dependence ‘You are the coach, not the athlete! The athlete has to run the race!’

29 “Probably my best quality as a coach is that I ask a lot of challenging questions and let the person come up with the answer.” Phil Dixon

30 AETC TCB Training Is there a need for this type of training among the AETCs? Would you participate when offered to you? What changes/additions should be made to this training to make it most relevant to AETCs? How many trainings should ideally occur to bring this coaching training to the AETCs? What are the ideal dates/locations for potential trainings in the late 2016/early 2017?

Thank You :-)

National Quality Center (NQC)