PCMH Resources for Practices and Practice Facilitators

In an effort to create a high-quality health care system in the United States, many payers, providers, delivery systems, and other organizations are using quality improvement (QI) initiatives to improve the performance of the Nation’s primary care practices. QI requires practices to assess performance continually, to plan changes and monitor their effects, and to refine as needed.

External organizations that support primary care practices to build and sustain QI capacity may be QI organizations, regional extension centers, professional societies and payers, and health care organizations that own or contract with practices.Practice facilitation, also known as practice coaching, is one type of support these external organizations can provide that can be helpful to practices in new and ongoing QI efforts.

What are strategies for supporting the transition to new models of primary care?

Explore resources in this section that feature:

  • Information on building QI capacity in primary care practices
  • Ways practices and practice facilitators can work together to improve performance in primary care
  • Approaches practice facilitators and external support organizations can take for engaging primary care practices in meaningful and sustained QI efforts
  • Training for practice facilitators.

PCMH Resources for Practices and Practice Facilitators

Tip Sheet


These briefs describe the need for external infrastructure to help primary care practices develop quality improvement (QI) capacity and describe approaches and supports for ongoing QI.


A How-To Guide on Developing and Running a Practice Facilitation Program
(PDF Version — xxxKB) PDF Help
This how-to guide is for organizations interested in starting a practice facilitation program aimed at improving primary care. The practice facilitation programs described in this guide are designed to work with primary care practices on quality improvement activities, with an emphasis on primary care redesign and transformation. The guide focuses on how to establish and run an effective practice facilitation program, and is intended for organizations or individuals who will develop, design, and administer such programs.

This guide was developed based on information and resources shared by more than 30 experts in the field of practice facilitation. AHRQ convened the expert working group through a series of webinars and conference calls over a nine month period in 2011. These experts provided practical knowledge and hard-won lessons from their experiences in practice facilitation, and shared resources that they developed or found useful.

Topics covered in the guide include:

  • Background and existing evidence for practice facilitation
  • Creating the administrative foundation for your practice facilitation program
  • Funding your practice facilitation program
  • Developing your practice facilitation approach
  • Hiring your practice facilitators
  • Training your practice facilitators
  • Supervising and supporting your practice facilitators
  • Evaluating the quality and outcomes of your practice facilitation program

In addition, the guide includes an extensive collection of tools and links to resources relevant to the development, operation and maintenance of your practice facilitation program.

White Paper

Engaging Primary Care Practices in Quality Improvement: Strategies for Practice Facilitators
(PDF Version — 1MB) PDF Help
This white paper describes approaches practice facilitators can take for encouraging primary care practices to undertake quality improvement (QI) activities. It presents a framework for engaging primary care practices in QI and provides practical strategies for gaining initial buy-in from practices, maintaining meaningful and sustained engagement in QI efforts, and working with multiple QI programs.

PCPF Curriculum

AHRQ’s Primary Care Practice Facilitation Curriculum
AHRQ’s Primary Care Practice Facilitation Curriculum is designed to assist in the training of new practice facilitators as they begin to develop the knowledge and skills needed to support meaningful improvement in primary care practices.

Explore the curriculum >>


AHRQ Practice Facilitation Webinars
In December 2011, AHRQ published a how-to manual on practice facilitation titled Developing and Running a Practice Facilitation Program for Primary Care Transformation: A How-To Guide. In conjunction with the release of this manual, AHRQ also created a Primary Care Practice Facilitation (PCPF) learning community. As a part of this learning community, AHRQ hosted a series of webinars on practice facilitation, all of which are outlined on the Webinars page.

Go to Webinars page >>

Case studies of exemplar practice facilitation training programs

This brief summary highlights characteristics of three exemplar Primary Care Practice Facilitation (PCPF) training programs that are featured in this section as individual case studies. Case studies include information about the program's background, design, course components, trainees, faculty, process for internal quality improvement, outcomes, and administration. Lessons learned and next steps for the program are described also.

HealthTeamWorks' Coach University
This case study features one of the country's leading medical practice coach training programs that convene groups of trainees for a weeklong educational program, or "boot camp," to teach knowledge and skills for successful practice facilitation. After attending boot camp in Colorado, trainees are provided support throughout the next year as part of the program's collaborative coaching model.

Millard Fillmore College Practice Facilitator Certificate Program
This case study describes an online distance-learning course that teaches core competencies of practice facilitation work, as well as specialized skills facilitators will need when working with a medical practice. The program's online format includes seminars and virtual group discussions to encourage participants to leverage each other’s expertise.

Practice Coach Training for the North Carolina AHEC Practice Support Program
This case study features a training program in North Carolina that prepares practice coaches to serve on regional practice facilitation teams. These teams work with primary care practices to improve quality of care, transform to patient-centered medical homes, implement electronic health records, and attain meaningful use certification.

For more case studies on practice facilitation programs and lessons learned from the field, visit the Case studies section of the Practice Facilitation page.

Research Articles

Toolkits provide practical guidance on the medical home to providers or patients.

Comprehensive Care
Includes resources that describe how the medical home’s own team of providers work together to treat the large majority of each patient’s physical and mental health care needs, including what types of providers are on the team, workflow, and communication among the team members. Disease management and case management fall under this topic when they work with patients on chronic illness self-management.

Patient Centered Care
Care that is oriented toward the whole person. Refers to how practices strive to understand and reflect the needs, culture, values, and preferences of the patient and their families; and help them manage and organize their care at the level they choose. It includes topics such as family/caregiver involvement, patient involvement/activation, patient satisfaction, cultural competence, and end-of-life care.

These resources discuss the experiences of practices as they transform into medical homes

Primary Care Workforce Issues
Refers to medical education and training, workforce supply and demand projections, and the role of providers such as nurses, social workers, nutritionists, pharmacists in the medical home.

Care Coordination
Refers to how the medical home coordinates care across all elements of the broader health system, including specialty care, hospitals, home health care, and community services and supports. Topics include provider integration, accountable care organizations, medical neighborhoods, incentivizing specialists, and hospital transitions and discharge planning. Disease management and case management fall under this topic when they work to coordinate care across outside providers.