Abstract
Introduction:Practice coaches are skilled consultants who work in health care service delivery systems to make changes designed to improve patient outcomes, yet research is limited regarding their use to support integrated health care. This article describes the use of practice coaches in a large-scale effort to implement integrated care in the United States for patients with complex care needs.Theory and methods:This immersive, qualitative project involved five implementation team members; eight practice coaches; and 77 staff members from 12 health care organizations. Semistructured interviews were recorded and transcribed verbatim. Thematic and content analyses were applied in multiple stages to understand the use of practice coaches.Results:Qualitative themes about the use of practice coaching in this initiative were: (a) development of “a very rich coaching model”; (b) moving from an organic to standardized coaching approach; and (c) coaches representing the “face of the initiative.”Discussion:A rich coaching model that includes an interdisciplinary coaching team can support integrated care transformation but challenges including finding highly qualified coaches and sustaining and disseminating the coaching model exist. Standardization was seen as a way to address such challenges.Conclusion:Practice coaches can provide individualized, hands-on guidance to support successful implementation of integrated care.
Highlights
Practice coaches are skilled consultants who work in health care service delivery systems to make changes designed to improve patient outcomes, yet research is limited regarding their use to support integrated health care
Practice facilitators, known as practice coaches, are skilled consultants who work in clinical practice environments and health care delivery systems to support changes designed to improve patient outcomes
Practice coaches have been previously used in general medical settings, research is limited about their use to support integrated physical and behavioral health
Summary
Practice coaches are skilled consultants who work in health care service delivery systems to make changes designed to improve patient outcomes, yet research is limited regarding their use to support integrated health care. Known as practice coaches, are skilled consultants who work in clinical practice environments and health care delivery systems to support changes designed to improve patient outcomes These individuals assist service providers and quality-improvement teams to develop the skills needed to adapt clinical evidence or new best practices to the specific circumstances of a given health care delivery environment [1]. Existing studies have suggested that practice coaches in integrated care settings can improve implementation and organizational outcomes, such as increasing the degree of change, ability to make changes ( known as adaptive reserve), referrals to behavioral health, and number of patients seen by behavioral health providers. These studies provided only a brief description of their coaching model and little in-depth information on the coaching or facilitation process [6,7,8]
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