High-quality health care is a priority for patients and clinicians alike. Quality improvement (QI) is a framework that guides health system actions to improve the delivery of high-quality health care. Quality improvement activities seek to promote high-quality health care by applying innovations, rapid-cycle testing, and spreading best practices that produce meaningful improvements. However, conducting QI activities in an effective and accurate manner may be challenging for health care teams with competing demands. Health care teams often need dedicated support to incorporate QI activities into busy clinical practices. One method for providing support around QI activities is through longitudinal coaching from an expert trained in QI and related methods (eg, Lean, Six Sigma, system redesign). Within the VA, transformational coaching is one commonly used strategy for the provision of longitudinal, expert support to clinical teams seeking to engage in QI processes.