Background: MS-CQI is the first multicenter improvement research collaborative for MS. MS-CQI was a three-year study (2018-2020) of variation in outcomes, and leverages benchmarking, site specific data and patient reported outcomes to inform improvement using a learning health system approach. Here we describe team reported outcomes of the coach supported QI intervention featuring a standardized Toolkit. Objectives: To describe system readiness to engage in QI, assess the culture of QI and the effectiveness of a modified Coach supported QI program on QI team development, skills, knowledge, and outcomes in multiple sclerosis (MS) centers randomized to coach-supported QI intervention in the MS-CQI research collaborative. Methods: Centers randomized to QI participated in site visits and regular meetings with the QI coach. IHI Improvement Progress and QI Knowledge Application and Skills (QI-KAT) assessments were collected. Results: Teams demonstrated improvement in defining aims (6.3% to 60%), cause & effect diagrams (9.1 to 53.5%), process flows (0% to 44%), and PDSA (8% to 20%), as well as perceived team functioning and team planning (40% to 80%), learning from working with the team (21% to 100%) and IHI Collaborative Assessment Scale (start range = 1 – 1.5, end range = 3 – 3.5). Conclusions: Teams perceived gains in knowledge, skills, progress, and experience, suggesting that the approach helped teams with the how to and the experience of improvement.