Background <p>Transcranial Doppler (TCD) imaging is a key screening tool for stroke prevention in children with sickle cell disease (SCD). Despite clear guidelines recommending annual TCD screening, compliance remains low due to limited access and insufficient training among ultrasound technologists.</p> Methods <p>A quality improvement initiative was implemented at a quaternary care&#xa0;children’s hospital to increase the number of technologists proficient in TCD for SCD care. A structured coaching model was used, involving one-on-one training sessions, competency assessments, and collaboration with the hematology department to facilitate patient cases for practice. Progress was measured using surveys and control charts.</p> Results <p>Over the 32-month period of this project, the percentage of TCD-competent sonographers increased from 21 to 58%, and reliance on a single expert technologist for TCD exams decreased from 42 to 3%. Additionally, the percentage of SCD patients receiving TCD screening rose from 87 to 91%.</p> Conclusion <p>The implementation of a coaching model significantly improved the number of trained TCD technologists and enhanced screening rates for SCD patients.</p> Graphical Abstract <p></p>