June 14, 2018

Practice Coaching for Primary Care Transformation comes to Seattle

Left to right: Thomas Bodenheimer, MD, MPH, Nicole Van Borkulo, MEd, and Marcelle Thurston MS, RD
From left: Thomas Bodenheimer, MD, MPH, Nicole Van Borkulo, MEd, and Marcelle Thurston MS, RD

The MacColl Center’s Nicole Van Borkulo describes an exciting program that can prepare health care practices to transform into patient-centered medical homes.

By Nicole Van Borkulo, MEd, Research Associate, Kaiser Permanente Washington Health Research Institute

I’m thrilled to announce that the Practice Coaching for Primary Care Transformation Training (PCPCT) will be held for the first time in our state from August 21 to 24. A multi-faceted training program designed for leaders at all levels, this workshop is designed for practice coaches working with primary care practices to assist with transformation efforts towards high performing patient-centered medical homes (PCMH.) The Patient-Centered Primary Care Institute in partnership with CareOregon will host the program, with content provided by the University of California San Francisco (UCSF) Center for Excellence in Primary Care and my team here at the MacColl Center for Health Care Innovation. UCSF and CareOregon have been teaching this course material since 2013 in an effort to bring clarity to the world of health care transformation.

When people ask me to define practice coaching, I love this quote from a paper by Jo Rycroft Malone because it’s such a good descriptor of the role (the terms ‘facilitation’ and ‘coaching’ are used interchangeably):

“Facilitation: a technique by which one person makes things easier for others”

The MacColl Center has a long history of supporting clinics throughout the United States and around the world in their efforts to change — a way of making things easier for others. One of the very first projects I worked on as a quality improvement (QI) consultant was with MacColl Center founder Ed Wagner, MD, MPH, and his team in the early 2000s, on the Indiana Chronic Disease Management Program. So much of the field of health care quality improvement was built on Ed’s Improving Chronic Illness Care program based here at Kaiser Permanente Washington Health Research Institute. Simultaneous to our work with the Chronic Care Model, practice facilitation was emerging in the UK, Canada, and Australia. In the last several years, coaching has gained a lot of traction and feels like a nice blend of health information technology consulting, QI consulting, and coaching. I’m now part of the MacColl Center team, so practice coaching has led me on a full circle journey.

Filling a need right in our own backyard

Now is a perfect time to bring this training to Seattle. So much work is currently underway to improve care and lower costs for Washington residents, with the result that primary care practices statewide have great need for support. Healthier Washington is the overarching strategy: an agreement with the federal government that tests new and innovative approaches to providing health coverage and care. The Washington State Accountable Communities of Health (ACH) initiative is a component of Healthier Washington that’s comprised of nine regions aligned with our state’s Medicaid service areas. The ACHs bring together leaders from multiple health sectors who have a common interest in improving health and health equity, and give us the chance to make significant, lasting change right here at home. Some folks from the ACHs will be participating in our August training, and it’s exciting for us to be part of that.

While this training is appropriate for those brand new to the profession of coaching, we typically have a mix of skill levels. We’re expecting a wide spectrum of participants: from those just starting out, to those with many years of broad experience who want grounding in this PCMH content.

Four days of assessment, education, and resources

Practice Coaching for Primary Care Transformation Training (PCPCT) is built around the 10 Building Blocks of High Performing Care model and explores national best practices implemented in high-performing clinics such as team-based care, prompt access to care, and population-based care. Practice facilitators use this methodology by focusing on a few building blocks at a time, encouraging a health care clinic to start with the foundational blocks. Although every Building Block is important to implement and address in transformation efforts, the foundational blocks of strong leadership, knowing your patient panel, robust data collection and usage, and functioning teams are essential for lasting change to occur.

In addition to four full days of classroom training, the PCPCT program also includes a pre-training assessment, curriculum materials that coaches can use with practices, three months of optional post-training mentoring support, and a site visit to at least one local high performing primary care practice. This robust approach educates participants on the fundamentals of practice coaching while providing the resources needed to empower clinic teams in utilizing quality improvement methods for sustainable change. It is effective for all coaches, regardless of their experience.

Investing in change 

True transformation depends on behavior change. I’m hopeful that the field of practice coaching will evolve and grow, and that health care systems will come to view it as an investment on par with health information technology (HIT). The case for investing in practice coaching is bolstered by the research literature showing that it works. Computers and software don’t change behavior, though putting appropriate HIT in place is a piece of the puzzle. Only people can change behavior. Practice coaching can support those behavior changes as well as practice changes necessitated by new payment models. With it, I think we’ll have a fighting chance to create the better health care that we’re all working toward.

Due to the intensive structure of the training, space is limited to 25 registrants. Because space is limited, we ask those who want to participate to first submit an interest form. Once your form has been received, our staff will contact you with additional information and instructions on how to register.

Nicole Van Borkulo, MEd
With more than 18 years of experience, Nicole Van Borkulo, MEd, has worked on both large- and small-scale change initiatives aimed at improving patient outcomes, increasing patient, provider, and staff satisfaction, and positively impacting bottom-line results. She oversaw and provided technical assistance to the coaches in five regions across the United States in the multi-year Safety Net Medical Home Initiative, which included the coaching and development of materials related to the implementation of patient-centered medical homes. Her current work for the MacColl Center includes directing the coach learning community for the Healthy Hearts Northwest initiative and providing coaching support to clinical teams in the Team-based Safe Opioids Prescribing initiative.

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