The GNYHA Foundation developed the Quality Coach Fellowship (QCF) program, which focused in particular on the Centers for Medicare & Medicaid Services (CMS) quality measures, and was designed to optimize facility performance scores on quality report cards that are expected to impact future hospital reimbursement through a pay-for-performance (P4P) mechanism. The Foundation developed the training with support from a grant awarded by the New York State Department of Health through the Health Workforce Retraining Initiative.

Additionally, in response to requests for additional information within the QCF program regarding infection reductions practices, GNYHA decided to enhance the infection prevention aspects of the original training curriculum. The enhancements, related to improving hand hygiene practices, as well as environmental cleanliness, complemented the existing quality improvement curriculum and the coaching model. Coaches were encouraged to lead, support, mentor, and inform other health care team members about ways to improve quality outcomes that were a function of poor infection control practices.

Coaches were selected from a variety of job titles, including nurse, housekeeper, transporter, technician, dietary worker, and others. The goal of creating a cross-title group of coaches was to ensure that all levels of staff began to recognize their unique role in promoting institutional quality.