High-quality health care is a priority for patients and clinicians alike. Quality improvement (QI) is a framework that guides health system actions to improve the delivery of high-quality health care. Quality improvement activities seek to promote high-quality health care by applying innovations, rapid-cycle testing, and spreading best practices that produce meaningful improvements. However, conducting QI activities in an effective and accurate manner may be challenging for health care teams with competing demands. Health care teams often need dedicated support to incorporate QI activities into busy clinical practices. One method for providing support around QI activities is through longitudinal coaching from an expert trained in QI and related methods (eg, Lean, Six Sigma, system redesign). Within the VA, transformational coaching is one commonly used strategy for the provision of longitudinal, expert support to clinical teams seeking to engage in QI processes.

Contents

• PREFACE
• ACKNOWLEDGMENTS
• EXECUTIVE SUMMARY
  • INTRODUCTION
  • METHODS
  • RESULTS
  • DISCUSSION
• INTRODUCTION
• METHODS
  • TOPIC DEVELOPMENT
  • SEARCH STRATEGY
  • STUDY SELECTION
  • DATA ABSTRACTION
  • QUALITY ASSESSMENT
  • DATA SYNTHESIS
  • RATING THE BODY OF EVIDENCE
  • PEER REVIEW
  • GLOSSARY
• RESULTS
  • KEY QUESTION 1
  • KEY QUESTION 2. What are the identified barriers and facilitators that impact the uptake of transformational coaching in a large health care system such as the VA?
• SUMMARY AND DISCUSSION
  • SUMMARY OF EVIDENCE BY KEY QUESTION
  • PRIOR SYSTEMATIC REVIEWS
  • CLINICAL POLICY IMPLICATIONS
  • LIMITATIONS
  • RESEARCH GAPS/FUTURE RESEARCH
  • CONCLUSIONS
• REFERENCES
• APPENDIX A. SEARCH STRATEGIES
• APPENDIX B. STUDY CHARACTERISTICS TABLES
• APPENDIX C. IMPLEMENTATION STRATEGIES TABLE
• APPENDIX D. EXCLUDED STUDIES
• APPENDIX E. CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH (CFIR) CONSTRUCTS
• APPENDIX F. CERQUAL EVIDENCE PROFILE
• APPENDIX G. PEER REVIEW COMMENTS AND RESPONSE TABLE
• APPENDIX H. GLOSSARY

Suggested citation:

Ballengee LA, Rushton S, Lewinski AA, Hwang S, Zullig LL, Ball Ricks KA, Brahmajothi MV, Moore TS, Blalock DV, Ramos K, Cantrell S, Kosinski AS, Gordon AM, Ear B, Williams JW, Gierisch JM, Goldstein KM. Transformational Coaching: Effect on Process of Care Outcomes and Determinants of Uptake. VA ESP Project 09-010; 2020. Posted final reports are located on the ESP search page.

This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the Durham VA Health Care System, Durham, NC, funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative. This work was supported by the Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), (CIN 13-410) at the Durham VA Health Care System. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement (eg, employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in the report.