• Denise D Quigley, Marc N Elliott, Mary E Slaughter, Efrain Talamantes, and Ron D Hays.
• RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA. quigley@rand.org.
• J Gen Intern Med. 2023 Aug 1; 38 (11): 249425002494-2500.

BackgroundShadow coaching, a type of one-on-one provider counseling by trained peers, is an effective strategy for improving provider behaviors and patient interactions, but its effects on improving patient experience for English- and Spanish-preferring patients is unknown.ObjectiveAssess effects of shadow coaching on patient experience for English- and for Spanish-preferring patients.DesignWe analyzed 2012-2019 Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) data (n=46,089) from an urban Federally Qualified Health Center with 44 primary care practices and 320 providers. One-third (n=14,631) were Spanish-preferring patients. We fit mixed-effects regression models with random effects for provider (the level of treatment assignment) and fixed effects for time (a linear spline for time with a knot and "jump" at coaching date), patient characteristics, and site indicators, stratified by preferred language.ParticipantsThe 74 providers who had a 6-month average top-box score on the CAHPS overall provider rating below 90 (on a 100-point scale) were shadow coached. Similar percentages of English-preferring (45%) and Spanish-preferring patients (43%) were seen by coached providers.InterventionTrained providers observed patient care by colleagues and provided suggestions for improvement. Verbal feedback was provided immediately after the observation and the participant received a written report summarizing the comments and recommendations from the coaching session.Main MeasuresCG-CAHPS Visit Survey 2.0 provider communication composite and overall provider rating (0-100 scoring).Key ResultsWe found a statistically significant 2-point (small) jump in CAHPS provider communication and overall provider rating among English-preferring patients of coached providers. There was no evidence of a coaching effect on patient experience for Spanish-preferring patients.ConclusionsCoaching improved care experiences for English-preferring patients but may not have improved patient experience for Spanish-preferring patients. Selection and training of providers to communicate effectively with Spanish-preferring patients is needed to extend the benefits of shadow coaching to Spanish-preferring patients.© 2023. The Author(s).

12 keywords...

hide…