Coaching strategies for enhancing practice transformation

Abstract

Background. Current research on primary care practice redesign suggests that outside facilita-tion can be an important source of support for achieving substantial change. Objectives. To analyse the specific sequence of strategies used by a successful practice facilitator during the American Academy of Family Physicians ’ (AAFP) National Demonstration Project (NDP). Methods. This secondary analysis describes a sequence of strategies used to produce change in family medicine practices attempting to adopt a new model of care. The authors analysed quali-tative data generated by one facilitator and six practices by coding facilitator field notes, site visit reports, qualitative summaries, depth interviews and email strings. Results. The facilitator utilized practice member coaching in addition to consulting, negotiat-ing and connecting approaches. Coaching strategies encouraged: (i) expansive, multi-direc-tional, attentive styles of communication; (ii) solving practical problems together; (iii) modellin