Bakgrund: Kvalitetsutveckling inom vården pågår i hela världen. Internationell forskning indikerar att förbättringscoacher kan vara en framgångsfaktor i förbättringsarbetet. Det är i dag oklart hur man kan utveckla interna coacher till att stödja kontinuerliga förbättringar. Studien utvärderar ett lokalt, tvärprofessionellt coachprogam inom vård och omsorg i ett geografiskt område i Sverige med en etablerad samverkanskultur. För att främja ökad kundcentrering ingick en pensionär i programmets planeringsgrupp. Deltagarna introducerades i grundläggande förbättringskunskap och i lösningsfokuserat arbetssätt som ett sätt att bättre kunna hantera komplexiteten i vård och omsorg. Programmet utformades med åtta gemensamma träffar under perioden mars till oktober 2011.   Syfte: Att identifiera faktorer i ett lokalt coachprogram som framstår som mest väsentliga för att medarbetare i vård och omsorg ska kunna gå in i rollen som förbättringscoacher. Metod: Studien är en observerande fallstudie med inslag av aktionsforskning och en induktiv kvalitativ ansats. Deltagare i studien var blivande coacher, pensionärer, planeringsgruppen och erfarna coacher. Sju semistrukturerade intervjuer med totalt 17 personer genomfördes, samt analys av lokala dokument och fyra enkäter. Data analyserades genom en manifest kvalitativ innehållsanalys och triangulering. Resultatet validerades av samtliga deltagare i studien. Resultat: Involvering av pensionärer ansågs vara en viktig faktor eftersom det förstärkte kundfokuseringen. Deltagarna i studien poängterade att kundfokus, ett lösningsfokuserat förhållningssätt, nätverk och systemförståelse var grundläggande för utvecklingen av coachrollen. Dessa faktorer bedömdes som viktigare än de specifika förbättringsverktygen. Diskussion: De mest väsentliga faktorerna kan delas in i det som uppmuntrade till idéer, vilja, görande och uthållighet. Pensionärsinvolveringen förstärkte kundfokuseringen, och det lösningsfokuserade arbetssättet framstod som ett bra komplement till de sedvanliga förbättringsverktygen. Det vore intressant att jämföra detta program med förbättringsprogram i andra kontexter. / Background: Internal improvement coaches can support quality improvement efforts. The study is about a local interprofessional coach training program in a region in Sweden with an established culture of collaboration. The program included participants from different health care disciplines and was organized over eight days between March and October 2011. A senior citizen was involved in faculty and participated during all training sessions. The participants were introduced to basic improvement knowledge and a solution focused approach.Purpose: To explore essential elements of a local coach training program and what appears to be crucial in moving into the role of being an improvement coach.Method: The study is a mix methods case study with elements of action research and an inductive qualitative approach. Participants in the study were prospective coaches, senior citizens, the program team, and experienced coaches. Data were collected through seven semi-structured group interview sessions with a total of 17 individuals, document analysis and 4 questionnaires. Data were analyzed using a manifest content analysis and triangulation. The results were validated by all participants in the study.Results: The data suggest that the involvement of a senior citizen was essential for strengthening customer focus. Participants in the study pointed out that customer focus, developing a value base, networking skills with a solution focused approach and systems thinking were fundamental to the development of the coaching role. These factors were assessed as more important than improvement tools.Discussion: The results can be divided into those which encouraged ideas, will, execution, and endurance. Senior citizen involvement enhanced customer focus and the solution-focused approach seems to be a valuable addition to the usual improvement tools. It would be interesting to compare this program with other improvement programs or in other contexts.

This study provides a qualitative look at Texas' Professional Service Providers' (PSPs) strategies for supporting low-performing schools. Four PSPs were selected for participation based on the number of schools they helped exit the Texas Title I School Improvement Program from 2007-2012. Data collected and analyzed included provider and principal interviews, providers' progress reports documenting services, and principals' evaluations of provider services. Results indicated key support strategies in two of four cases were supporting and mentoring/coaching while communicating and building trust were important in the other two cases. Communicating, reviewing information, and planning were important across all cases. The quality indicators aligning with the PSPs' strategies were fit, comprehensiveness, and coherence. They were also the most common across all cases. Finally, analysis of the evaluation of provider services revealed PSP-1 with the highest ratings, followed by PSP-2, PSP-3, and PSP-4 respectively. The findings suggest, first, that PSP support has a dual nature. Contextual support was provided based on the campus leaderships' skills and requests. PSPs also ensured coherence among the strategies of all stakeholders. Secondly, a hierarchy of quality service indicators aligned to the PSPs' strategies: fit, comprehensiveness, and coherence. Finally relationships are vital to a successful provider-campus relationship. The findings have implications for PSP selection, professional development, and evaluation.