QIPS (Quality Improvement Patient Safety) Hot Topic-Suneela Nyack MS, RN August 2021

Innovations in Improvement: Virtual Improvement Coaching during the Covid-19 Pandemic

Learning Objectives

  1. Examine pros and cons of a virtual improvement coaching model necessitated by the Covid-19 pandemic
  2. Discuss the value of virtual coaching methods for healthcare improvement teams
  3. Determine opportunities to refine a Virtual Improvement Coaching Model

While the Covid-19 pandemic caused much disruption to established performance improvement workflows, it has also created opportunity for innovation and rapid transformational change.  To stay true to our MaineHealth Quality and Safety Mission, “Create a culture of continuous improvement that promotes quality and value in our healthcare system with an alignment of purpose…,” we resolved to innovate and adapt our traditional coaching methods.

To their credit, many MaineHealth care teams continued Key Performance Indicator (KPI) practice throughout the Covid-19 pandemic. Inspired by their engagement we turned to contemporary articles, blogs and webinars to learn more about remote and virtual coaching methods as a compliment to traditional techniques. Many authors underscored the value of establishing teamwork and camaraderie as key ingredients for the success of remote teams measured in terms of achieving strategic goals. Laura Spawn for Forbes (2020)1 writes, “Overall, achieving goals as a team creates a culture of clear communication, job satisfaction, and motivation”.  She asserts this outcome is best achieved when all employees pitch in to meet strategic goals.  In a similar vein, Graham Kenny, (Harvard Business Review 2020)2, discusses the importance of aligned top-down and bottom-up relationships for high value KPIs and strategy deployment, causality, and rapid responsiveness to change. In an earlier HBR publication, Dhawan and Chamorro-Premuzic3 suggest best practices to minimize the challenge of working with remote teams: clarity of written communications, avoiding digital overload, establishing communication norms, customizing approaches for individuals, and lastly, creating intentional space for celebrations.

Six months after we launched virtual improvement coaching, we conducted a survey of department leaders and teams active with KPIs and Operational Excellence to learn about what we could do better. All respondents agreed that their Op Ex Coach adequately addressed their questions and empowered them to advance their improvement work. More than 90% reported they had a strong relationship with their Op Ex Coach and were comfortable reaching out for help. This feedback suggests early success of our emerging Virtual Coaching Model and importantly, offers direction for improvement.  In combination with wisdom gleaned from the literature, we identified opportunities for refining virtual coaching techniques:


  1. Establish strong relationships early in the process to foster camaraderie and teamwork as precursors for successful virtual coaching.
  2. Invest time in pre-work such as agenda planning to improve productivity during coaching sessions
  3. When possible, concurrently engage key stakeholders located in diverse settings to optimize value for the improvement team
  4. Develop proficiency to fully leverage screen sharing capabilities on video conferencing platforms.
  5. Deploy specific facilitation techniques to empower problem articulation, explain complex processes, and generate improvement ideas in a virtual forum

In summary, in keeping with our core values and mission, we have innovated an effective Virtual Improvement Coaching Model to support care teams and leaders. Guidance from a range of authors and PDSA (Plan-Do-Study-Act) thinking has led to proven virtual coaching workflows, optimized by proficiency in videoconferencing applications. Unexpected wins of a Virtual Coaching Model are expanded capacity, and the opportunity to engage key stakeholders from different locations at the same time.  Lastly, emerging expertise with Virtual Coaching techniques adds to our improvement toolkit, and opens the door to further innovations.



  1. Spawn, L. (2020). Four Strategies for Setting Measurable Goals in a Remote Work Environment. Forbes. https://www.forbes.com/sites/forbeshumanresourcescouncil/2020/01/29/four-strategies-for-setting-measurable-goals-in-a-remote-work-environment/?sh=7f9441603014.
  2. Kenny, G. (2020). What are your KPIs Really Measuring? Harvard Business Review.


  1. Dhawan, E. and Chamorro-Premuzic, T. (2018). How to Collaborate Effectively If Your Team Is Remote. Harvard Business Review. https://hbr.org/2018/02/how-to-collaborate-effectively-if-your-team-is-remote.

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