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Abstract
Description Coaching is a key element to the success of Quality Improvement Collaboratives (QIC) in low- and middle-income settings where QI capacity and knowledge are limited. For the Mexico in Alliance with St. Jude Golden Hour Collaborative (MAS Collaborative), we used a structured coaching model (figure 1) with a two-fold aim: 1) to develop local coaches using a train of trainers approach (figure 2); and 2) to help teams achieve and sustain their local aim. To achieve these aims, we recruited seven senior and 11 junior QI coaches to accompany 85 QI teams throughout the implementation of the Collaborative. Key elements of the coaching strategy included: 1) developing a coaching curriculum to cover QI and coaching topics; 2) use standard agendas to guide coaching; 3) use a shadowing approach coupling senior with junior coaches during the first six months of the Collaborative; 4) observing and assessing coaching practices; 5) providing ongoing feedback; and 6) creating a learning system to share best practices. To-date, coaches have delivered over 1,900 coaching sessions with QI teams and team leaders, with a median of 70% QI teams (figure 3) and 63% team leaders (figure 4) receiving coaching every month. Teams have received an average of 16 coaching sessions over a period of 17 months. Teams with greater number of coaching sessions have shown better outcomes and a greater progress score.
Structured coach-to-coach model
Philosophy of the quality improvement coach
Percentage of coaching sessions to QI teams
Percentage of coaching sessions to team leaders (1:1 meetings)
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