You're the hub of this program and need a good understanding of the coach and secret shopper roles, in particular, so that you can support those staff and maximize the value you receive from them.

While this program is designed around your needs, it can't rest entirely on your shoulders: in fact, it's intended to help share the responsibility of monitoring and ensuring high-quality infection control.

Your center routinely rolls out and monitor new changes by creating quality improvement teams responsible for planning, monitoring progress, and making mid-course corrections to ensure success.

When launching this program, start by identifying your team:

• Administrator
• Director of Nursing
• Director of Quality
• Secret Shopper
• One or more coaches
• Others, as needed

Identify someone responsible for scheduling meetings, recording decisions, and following up on them. Set the expectation that the work will be shared and that the team's goal is to ensure that coaching becomes embedded in routine care delivery.

Getting Started walks you through forming the team and, importantly, choosing coaches and secret shoppers.

Gold standard: Conduct quick huddles, or stand-up meetings, with the coaches each day to learn from them and direct their focus. Huddling is an evidence-based practice to improve communication.

During each huddle, use the daily huddle guide to facilitate sharing by asking the coaches:

• What have they observed or heard from coaches on different shifts?
• What problems are they seeing?
• What solutions do they propose?

As one coach shares thoughts, encourage others to add relevant information from their experiences. Capture any important ideas or action items that you'll need to assign to appropriate staff for follow-up. These are not rote reports; they are opportunities for critical thinking and problem-solving.

This forum is important, because it reinforces the teamwork necessary to make the program successful: everyone hears the same information and leaves with the same charge.

Other options: Can't do huddles? If you're not familiar with huddling or can't implement it while facing competing priorities, like short staffing, or because of logistical challenges, think creatively about other ways to ensure there's bi-directional communication (to and from the coaches): this is integral to ensuring that you have the information you need to tailor the program. Maybe you schedule video or conference calls instead of convening huddles; maybe you talk to people one-on-one; or maybe you send emails. It could be some combination of all of these.

Whatever you choose, you may want to focus on the day shift — that's most likely when you're on site, too. If you're conducting huddles or calls, scheduling them close to shift changes might enable evening and night coaches to participate. But if evening and night shift coaches can't participate, ensure that the day shift coaches "carry forward" what they learn from the other coaches on their units via the shift hand-offs. The feedback loop operates best when you learn from all of the coaches.

The program targets hand hygiene, masking, and transmission-based precautions — practices that are critical for preventing transmission of coronavirus and other infectious diseases and that have been identified by state surveyors and others as common problem areas.

However, based on what you learn from coaches, the audit data, and your COVID-19 team (among other sources), you and your team have flexibility to shift the emphasis. Be sure to critically consider what you're hearing and seeing in the data, to inform the guidance you give to the coaches.

The coaches' feedback and the adherence data give you eyes on all units and shifts. Use this information in your center's fight against coronavirus! Share these data with your COVID-19 team, administrator, and others in leadership who can reinforce infection control practices, allocate resources where needed, and otherwise champion the program to ensure its success.