Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Medical Home: Care Coordination.

MCHbest Logo

Strategy. Practice Coaches/Facilitators

Approach. Encourage practice facilitation for primary care to increase access to primary care providers for children

Return to main MCHbest page >>

Overview. Practice facilitation efforts include comprehensive approaches to ensuring care timeliness, increasing practice efficiency and patient-centeredness, improving continuity of care, and improving preventive and chronic care.[1] Efforts are led by practice coaches or facilitators who work with clinic staff to redesign clinical practices and improve the quality of care delivered. Coaches organize quality improvement (QI) efforts, help staff understand and use data to drive QI,[2] use team-building exercises to improve communication, share best practices, and explain how other organizations have improved care. They also help motivate interest in change and help practices choose goals, adopt new work process, interactively solve process problems, and incorporate health information technology.[3]

Evidence. Scientifically Rigorous Evidence. Strategies based on scientifically rigorous evidence are proven effective across multiple robust studies. While success is highly likely, local impact may vary. Monitor outcomes and use data to tailor these strategies to the community's unique needs.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Practice facilitator activity logs
  • Provider and staff satisfaction surveys
  • Patient satisfaction surveys

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Provider Experience of Care. This strategy improves healthcare professionals' perceptions, feelings, and satisfaction with the work environment and systems they use.
  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Direct Care (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of primary care practices partnered with Title V engaged in facilitation initiatives to strengthen their care coordination capabilities for pediatric populations. (Measures practice participation in transformation efforts)
  • Number of primary care team members trained by Title V to serve as care coordinators for children and families. (Assesses expansion of workforce for care coordination)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of primary care practices partnered with Title V engaged in facilitation initiatives to strengthen their care coordination capabilities for pediatric populations. (Measures practice participation in transformation efforts)
  • Percent of primary care team members trained by Title V to serve as care coordinators for children and families. (Assesses expansion of workforce for care coordination)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of regional pediatric care coordination coalitions catalyzed by facilitated practice partnerships and leadership that report high levels of engagement. (Measures development of community-wide care coordination infrastructure)
  • Number of shared data systems and communication platforms that enable primary care practices to coordinate care seamlessly across settings that results in improved health outcomes. (Shows development of enabling technologies for care coordination)
  • Number of communities that achieve meaningful improvements in measures of pediatric care fragmentation and gaps through care coordination initiatives. (Indicates population-level impact on system inefficiencies)
  • Number of initiatives that successfully align healthcare, education, and social service systems to address root causes of health for children, with facilitated primary care as a central hub. (Shows cross-sector collective impact)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of regional pediatric care coordination coalitions catalyzed by facilitated practice partnerships and leadership that report high levels of engagement. (Measures development of community-wide care coordination infrastructure)
  • Percent of shared data systems and communication platforms that enable primary care practices to coordinate care seamlessly across settings that results in improved health outcomes. (Shows development of enabling technologies for care coordination)
  • Percent of communities that achieve meaningful improvements in measures of pediatric care fragmentation and gaps through care coordination initiatives. (Indicates population-level impact on system inefficiencies)
  • Percent of initiatives that successfully align healthcare, education, and social service systems to address root causes of health for children, with facilitated primary care as a central hub. (Shows cross-sector collective impact)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] CWF-Grumbach 2012 - Grumbach K. Facilitating improvement in primary care: The promise of practice coaching. New York: The Commonwealth Fund (CWF); 2012: Issue Brief.

2 Taylor 2013a - Taylor EF, Machta RM, Meyers DS, Genevro J, Peikes DN. Enhancing the primary care team to provide redesigned care: The roles of practice facilitators and care managers. Annals of Family Medicine. 2013;11(1), 80-;83.

3 AHRQ-Coleman 2009 - Coleman K, Pearson M, Wu S. Integrating chronic care and business strategies in the safety net: A practice coaching manual. Rockville: Agency for Healthcare Research and Quality (AHRQ); 2009.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.