How to become a QI coach

There are a range of attributes that are useful for a QI coach to demonstrate and that you should look out for when choosing a QI coach. An absolute key responsibility is to help engage teams and people in QI. In our article ‘The role of a QI coach in an organisation’ we looked at the characteristics needed to become a QI coach. We also explored the values and benefits of having a QI coach within your organisation and how your QI function can benefit from their experience and support.

It may be that you’d like to become a QI coach yourself. Maybe you’ve been involved in a QI project and really enjoyed helping spread transformational change and you would like to help make further QI changes. In this article, we’re going to look in a bit more depth at how you go about becoming a QI coach and the skills needed for QI coaching and improvement change.

Things to consider when choosing a QI coach

Effective QI coaches can provide an organisation with a huge range of benefits. When choosing a QI coach, you need to ensure that you are picking the right person to become one.  The responsibilities and the time needed are significant, and include supporting teams to develop ideas and strategy, as well as teaching QI tools and methodology.  The QI coach must be dedicated and widely trusted, be comfortable working with a wide range of healthcare workers and must be able to create a culture of trust and motivate others. They must also have the capacity to build their coaching skills for QI.

The QI team at East London NHS Foundation Trust (ELFT) provide many resources and tools for QI coaching which you might find useful - both to choose and to become a QI coach.  ELFT define the role of the QI coach as:

• Coaching QI teams within directorates, meeting with the team regularly
• Having a deeper knowledge of improvement methods and tools
• Supporting the development of directorate structures and processes for QI

QI coaches also need to be able to help teams to develop ideas and strategy using QI tools. They also advise on how to complete project documentation and provide regular updates to the QI sponsor on teams’ progress. 

In the document ‘Building capacity and capability for improvement : embedding quality improvement skills in NHS providers’ the writers looks at how you can build coaching skills and describes QI coaches thus:  ‘They coach colleagues to test new ideas and support teams with implementation and spread. Quality coaches should also have access to and the support of the quality experts. In many organisations the quality experts organise and manage the quality coaches.’

Another element to be aware of when choosing a QI coach is the number of QI coaches within one organisation. In the same article, the writers recommend: ‘The number of quality coaches will depend on the number of projects. Typically, a coach who has protected time of 20% to 25% as a coach can support three to four teams. Another way to estimate the number of quality coaches needed is to figure that roughly 5% of employees should be developed as QI coaches. Again, for a 4,000-employee organisation this would be 150 to 200 individuals developed as quality coaches over roughly five years.’

This is something to bear in mind when recruiting and choosing your QI coaches.

Required skills to become a QI coach

The skills that a QI coach needs to demonstrate are many! They need to be organised and organise other people and also be motivated, while being able to motivate others.

The QI team at ELFT say QI coaches need to be: ‘bright and intelligent; deal with concepts and complexity comfortably; intellectually sharp, capable, yet practical and agile’. While the Point of Care Quality Improvement (POCQI) Coaching Guide explains that QI coaches need a wide range of skills which they need to adapt to their organisation. ‘Each coach will have a unique style, but all coaches apply the same basic principles to help develop the QI skills of the hospital teams and guide them to improve care more effectively. Most important is that the coaches need to work with external teams – in other departments or facilities where they do not work themselves.’

They point out that adaptability is required, as guiding people in a setting which is new or unfamiliar can be challenging. They also list technical skills, QI knowledge, strong interpersonal skills and organisational skills also.  A QI coach will be dealing with new people across an organisation from different job roles and competencies, so must be at ease and comfortable interacting with people in general.

Technical skills are also vital. A QI coach must be able to pass on their knowledge of complex QI methodology to the people they teach. This is where a specific QI solution can help support QI coaches. A quality improvement software such as Life QI helps you run and track improvement work in one place, while also accessing and learning from thousands of other QI projects from across the world. With the broad range of skills required from a QI coach, a QI software such as Life QI can really support QI endeavours.

How to build coaching skills

In our article ‘The role of a QI coach in an organisation’ we talked about the many different coaching programmes available to you if you wish to build your coaching skills.

The Institute for Healthcare Improvement (IHI) runs its renowned ‘Improvement Coach Professional Development Programme’. It is designed to help the aspiring QI coach to develop and drive sustained quality management in their organisation.

There is also a three-month QI programme, the ‘Scottish Leading and Coaching for Improvement Programme (SCLIP)’ which teaches aspiring QI coaches to support and coach QI teams and support improvement strategies within their organisation.

The Point of Care Quality Improvement (POCQI) Coaching Guide talks about how to build coaching skills, including a focus on building technical QI skills. The writers recognise that some QI skills can take longer to teach and learn than others. They add that the building of skills should take time. They recommend a focus on the easier skills first – looking at building the confidence of coaches. The writers also identify skills that might be easy to build on, in the first instance.

In the Health Foundation report ‘Skilled for improvement?’ the authors look at a number of organisations and their QI methods. For one site, they reported: ‘The CEO and the director responsible for organisational innovation and change told us that people tend to learn best by ‘doing’ rather than by formal training.’ One site used mentoring and coaching to spread its QI methods and were involved with the IHI, promoting its methods, including PDSAs – where ‘a core of local enthusiasts had imbibed and applied the IHI ethos and methods.’ This is a good example of where people became motivated and excited about a QI teaching method and were happy to share and motivate others.

As the Point of Care Quality Improvement (POCQI) Coaching Guide concludes: ‘Regular coaching is important for maintaining momentum in improving quality of care’. As we have read, there are lots of requirements if you want to become a QI coach. Someone who understands the science and methodology of QI and who has practiced it themselves. Someone who can build coaching skills, with great  communications skills and be able to stand up for those they're supporting. A QI coach also needs knowledge of the area they are working in or supporting and must be able to guide and teach new people about QI methods.

If you think you have what it takes to become a QI coach and share your QI learning across your organisation to help bring about change – or if you are in the process of choosing QI coaches for your organisation - we hope this article will give you food for thought!