1. Introduction to coaching in QI

2. Learning goals Understand the goals of coaching in implementing QI Understand the skills needed for a good coach Explore the role of coaching in strengthening QI leadership, activities and clinic quality management Start to practice coaching in different challenging situations.

3. Why do we need coaching? Help the worker (or team) perform to their best and achieve professional goals. Adults do not learn well from lecturing alone Training is more effective when followed by on-going supportive learning relevant to real situations. – (eg, gaps in the clinic quality, managing a specific patient issue, etc)

4. What coaching is not: Classic supervision: where you tell a person or clinic what they are doing wrong and then tell them to fix them. Auditing (QA) Solving problems for the clinic. Taking over as the clinic quality lead. Telling the team what to do

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6. Coaching involves more than giving knowledge in lectures Implementing QI needs both new knowledge, as well as a change in culture Sometimes things do not happen as they should even if knowledge and skills are present Remember: “Quality improvement is a journey of many small steps.”* *National Quality Center and HIVQUAL

7. Goal of a QI coach Strengthen QI work and systems by providing to QI teams: – ongoing technical support and advice – skills building – Advice and support to manage the inevitable problems that arise

8. Why do you want to coach? What are some possible benefits to coaching? 2 minute discussion

9. Where does coaching occur? Performance measurement Quality improvement Quality management

10. What an effective QI coach does (1) Promotes and advocates for quality, measurement and improvement. Supports good QI methods – Use of data to drive improvement – Systems focused – Good team work Builds a relationship and works with QI teams but is not a member nor the leader Adapted in part from NQC and ITECH

11. What an effective QI coach does (2) Teaches others how to do the task and then supports their work. Checks-in regularly and is available as a resource Provides feedback on the team’s challenges and accomplishments. Identifies why change is not happening Spreads lessons learned from other sites Helps the QI team engage leadership Helps build the quality management program

12. Skills needed for effective QI coaching 1)Technical skills in QI 2)General coaching skills

13. QI coaches must be able to teach and coach in technical areas Performance measurement – Indicator development – Accessing/collecting data. – Data analysis and communication of results Designing and implementing QI projects Evaluating status of QI projects Evaluating the status of a QM program

14. However, QI coaches must also have general coaching skills Promoting Discussion Active listening Diagnosing and Overcoming resistance Team building Communication Leadership and role modeling Management and planning People skills

15. sources National quality center (www.nationalqualitycenter.org)www.nationalqualitycenter.org The Team Handbook, Scholtes, Joiner & Streibel HAIVN HIVQUAL JSI Research and Training ITECH training on clinical mentorship www.go2ITECH.com WHO Partners in Health FHI360 Among others 15

16. Coaching exercise 16 We are back with the clinic that was stuck Goal is to increase follow up visits. There are data which show that rates have dropped from 80% to 42% over the last 6 months. The data come from the EMR You now have a coach who has been working with the site for 6 months whose goal is to get the clinic “unstuck”

17. Exercise 2 minutes-understand your character 10 minutes role play-QI meeting: QI project which has stalled/not started 5 minute internal sharing- what did you learn, where did the coach help, where else could he/she have done more, what did it feel like to be the coach 10 minutes group sharing 17