Coaching Evaluation by Coachee
Results Summary and Reflection
Please record the total number of responses your Interdisciplinary Quality Improvement team members gave for each of the following questions on the Quality Improvement Coach Assessment.
A. Coach Engagement
/ Strongly Disagree / Disagree / Neutral / Agree / Strongly Agree /1. Our coach has participated in meetings with our team.
2. Our coach is easily accessible.
3. Our coach has been timely in responding to our requests.
4. Our coach has provided needed materials, resources and advice.
5. Our coach offers valuable encouragement.
6. Our coach has kept us on track with an eye toward the goals and completion of tasks.
7. Our coach has been effective in clarifying tasks to be completed.
B. Coach Effectiveness
/ Strongly Disagree / Disagree / Neutral / Agree / Strongly Agree /1. Our coach has been effective in encouraging the development of the self-learning and self-leading capacities of our group.
2. Our coach has been effective in learning about and responding to local conditions and issues that are particularly significant at our site.
3. Coaching has resulted in our group having the ability to know when we are performing well and when we are not.
4. Once we have assessed our performance we are able to make adjustments independent of the coach.
5. We have measures and evidence that demonstrate our microsystem’s performance.
6. As a group, we believe we can always improve and continuously seek ways to increase our knowledge, skills, abilities and outcomes.
C. Coach Site Visit
Yes / NoDid your coach visit you in your workplace?
/ Strongly Disagree / Disagree / Neutral / Agree / Strongly Agree /
1. During the coach visit, my coach assisted our group to understand our tasks.
2. Our coach supported our efforts to communicate the improvement goals and tasks to the microsystem members.
3. Our coach communicated with leadership outside our unit to explain improvement goals and processes.
4. Our coach actively engaged with all staff during the visit to the practice.
5. Our coach observed our microsystem in action.
6. Our coach encouraged us to increase family/patient involvement in the unit.
7. The coach visit was useful to support our continued progress toward our goals.
8. The coach visit contributed to improving the coach-team relationship.
D. Learning Sessions
Yes / NoHave you participated in formal learning sessions about developmental improvement capabilities (i.e. Learning and Leadership Collaborative or other program in partnership with TDIMA)?
/ Strongly Disagree / Disagree / Neutral / Agree / Strongly Agree /
1. Our coach was effective in facilitating our exercises and passing along the knowledge of TDIMA Improvement Curriculum
2. Our coach was able to help us out when we got “stuck.”
3. Our coach provided support and guidance to help us become an effective team.
4. Our coach developed a positive working relationship with our team.
1. Review the answers your Interdisciplinary Quality Improvement team members provided for each of the following questions. Record any themes you see in these responses.
Describe what you have accomplished as a result of having coaching.
Theme 1:
Theme 2:
Theme 3:
What is going well with your coach?
Theme 1:
Theme 2:
Theme 3:
What could be improved with your coach?
Theme 1:
Theme 2:
Theme 3:
Please provide any additional comments or insights about your team coaching experience.
Theme 1:
Theme 2:
Theme 3:
2. Based on the feedback you received from your Interdisciplinary Quality Improvement Team, describe your coaching development plan and timeline.
Ó2016 The Trustees of Dartmouth College
The Dartmouth Institute Microsystem Academy Updated May 11, 2017