This article describes the development and implementation of the Clinical Literacy Coaching Framework (CLCF) as a promising practice that was implemented in a large elementary school in the Southeastern part of the United States. The framework was implemented when the school was improving literacy instruction and student achievement. This article shares how a literacy coach used the CLCF, which includes adapted medical teaching practices and coaching rounds, to enact the roles of the literacy coach more effectively as defined by ILA's 2017 Standards. This article also explains how a literacy coach built leadership capacity in the school to support the implementation of the CLCF. Specific examples are shared throughout the article to illustrate the components of the CLCF, including how medical teaching practices with rounds can be used, and to allow for replication.