Transcript Implementation and System Change

Implementation
and
System Change
NHSC 2008
Dean L. Fixsen, Karen A. Blase,
Michelle A. Duda, Sandra F. Naoom,
Melissa Van Dyke
National Implementation Research Network
NCLB Act & IDEA 2004
Implementation of scientifically
based research
Ensure that school personnel have
the skills and knowledge necessary
to improve the academic
achievement and functional
performance of children, including
the use of scientifically based
instructional practices, to the
maximum extent possible;
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
High School Education
15 million high school students
1.2 million high school teachers
20,000 high schools
3,143 counties
60 states & U.S. jurisdictions
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Research to Practice
RESEARCH IMPLEMENTATION
PRACTICE
GAP
Improved Student Outcomes
Improved Education Systems
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
“In theory there is no difference
between theory and practice; in
practice, there is.”
Yogi Berra
Thanks to Joanne Cashman, The National Association of State
Directors of Special Education
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Research to Practice
Research to Practice Gap
What is known is not what is
adopted to help students,
families, and communities
Implementation Gap
What is adopted is not used with fidelity
and good outcomes for students.
What is used with fidelity is not sustained
for a useful period of time.
What is sustained is not used on a scale
sufficient to impact all high school students.
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Teaching–Family Model
Fixsen, Blase, Timbers, & Wolf (2001)
900
300
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≤1972
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
1974
1976
1978
1980
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Cumulative
Homes
Cumulative
Couples
Implementation Reviews
Human service prevention and treatment
program literature (e.g. substance abuse,
MH, justice, education, health)
Literature re: advanced manufacturing
technologies, business, management,
agriculture, engineering
Successful practices on a national scale
(e.g. SW-PBS, SFA, MST, FFT, NFP, SE,
IDDT, DBT, MI, PMTO, Incredible Years)
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Insufficient Methods
Implementation What Works
Clearinghouse
Pretty small
Implementation What Does Not Work
Clearinghouse
Very large
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Insufficient Methods
Excellent experimental evidence for
what does not work
Diffusion/dissemination of information
by itself does not lead to successful
implementation (research literature, mailings,
promulgation of practice guidelines)
Training alone, no matter how well
done, does not lead to successful
implementation.
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Insufficient Methods
Excellent evidence for what does
not work
Implementation by edict/ accountability
by itself does not work
Implementation by “following the
money” by itself does not work
Implementation without changing
supporting roles and functions does not
work
Paul Nutt (2002). Why Decisions Fail
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
What Works
Effective intervention practices
+
Effective implementation practices
=
Good outcomes for students
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Implement Innovations
IMPLEMENTATION
INTERVENTION
Effective
Effective
NOT Effective
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Student
Benefits
NOT Effective
Implementation
An effective intervention is
one thing
Implementation of an effective
intervention is a very
different thing
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Implementation
Letting it happen
Recipients are accountable
Helping it happen
Recipients are accountable
Making it happen
Purposeful use of implementation
practices and science
Implementation teams are accountable
Based on Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou, 2004
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Sustainable Benefits:
Goal
Start with the end in mind
What will it take to:
make statewide use of high school
innovations
that produce increasingly effective
outcomes
for the next 50 years?
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Sustainable Benefits:
What
Rigorous curriculum and instruction
Assessment and accountability
Teacher quality/ PD
Student and family supports
Stakeholder engagement
Leadership and governance
Organization and structure
Resources for sustainability
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Sustainable Benefits:
How
Choosing an innovation
Implementation drivers
Implementation stages
Implementation teams
System improvement
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Choosing an Innovation
Core intervention components
Clearly described (who/what)
Fully operationalized (do/say)
Practical measure of fidelity **
Field tested (recursive revision)
Contextualized (org./systems fit)
Effective (worth all the effort)
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Sustainable Benefits
Choosing an innovation
Implementation drivers
Implementation stages
Implementation teams
System improvement
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Implementation Drivers
Reliably produce
predictable outcomes
for students, families,
and communities
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Implementation Drivers
STAFF
PERFORMANCE
EVALUATION
CONSULTATION
& COACHING
DECISION SUPPORT
DATA SYSTEMS
INTEGRATED &
COMPENSATORY
PRESERVICE
TRAINING
RECRUITMENT
AND SELECTION
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
FACILITATIVE
ADMINISTRATIVE
SUPPORTS
SYSTEMS
INTERVENTIONS
Integrated & Compensatory
OUTCOMES
(% of Participants who Demonstrate Knowledge, Demonstrate
new Skills in a Training Setting,
and Use new Skills in the Classroom)
Knowledge
Skill
Demonstration
Use in the
Classroom
Theory and
Discussion
10%
5%
0%
..+Demonstration
in Training
30%
…+ Practice &
Feedback in
Training
60%
60%
5%
…+ Coaching in
Classroom
95%
95%
95%
TRAINING
COMPONENTS
20%
0%
Joyce and Showers, 2002
Sustainable Benefits
Choosing an innovation
Implementation drivers
Implementation stages
Implementation teams
System improvement
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Stages of Implementation
Implementation occurs in stages:
Exploration
Installation
Initial Implementation
Full Implementation
Innovation
Sustainability
Fixsen, Naoom, Blase, Friedman, & Wallace, 2005
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
2 – 4 Years
Stages of Implementation
Implementation occurs in stages:
Exploration
Implementation
Outcomes
Installation
2 – 4 Years
Initial Implementation
Full Implementation
Innovation
Sustainability
0%
Fixsen, Naoom, Blase, Friedman, & Wallace, 2005
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Intervention
Outcomes
100%
Sustainable Benefits
Choosing an innovation
Implementation drivers
Implementation stages
Implementation teams
System improvement
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Implementation
Letting it happen
Recipients are accountable
Helping it happen
Recipients are accountable
Making it happen
Purposeful use of implementation
practices and science
Implementation teams are accountable
Based on Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou, 2004
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Implementation Team
A group that knows the innovation
very well (formal and craft
knowledge)
A group that knows how to
implement that innovation with
fidelity and good effect
A group that accumulates data &
experiential knowledge -- more
effective and efficient over time
(information economics, K. Arrow)
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Implementation Team
Implementation Team
Simultaneous, Multi-Level Interventions
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Teachers & Staff
School
Management (leadership, policy)
Administration (HR, structure)
Supervision (nature, content)
District
State and Community Context
Implementation Team
Prepare
Communities
Prepare Districts
Implementation
Team
Work with
Researchers
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Prepare schools
faculty, staff
Assure
Student
Benefits
Assure
Implementation
Sustainable Benefits
Choosing an innovation
Implementation drivers
Implementation stages
Implementation teams
System improvement
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
A Sobering Observation
"All organizations [and systems] are
designed, intentionally or unwittingly,
to achieve precisely the results they
get."
R. Spencer Darling
Business Expert
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
System Change
To scale up interventions we
must first scale up
implementation capacity
Building implementation
capacity is essential to
maximizing the use of EBPs and
other innovations
Large scale, real time change
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
System Change
Initiate & Manage
Change
Implement
Innovations
Sustainable
Infrastructure
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
System
Change
Policy Enabled
Practice (PEP)
Implementation
Team #1
(Up to 50
Schools)
Practice Informed
Policy (PIP)
State Transformation Team (STT)
Management
Group
System Change
Transformation Zones
Focus on one thing – do it well
Amend the usual rules
Establish the first operating example
of an innovation & system change
Manage change, reduce risks
A zone may be a region, a school, a
part of a system
Depends on where you choose to
start
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Transformation Zone
Management Group and Practice Group
meet monthly in order to bring about
system change (urgent, real time)
– The first Implementation Team begins the
implementation process in 5 – 10 schools
(Transformation Zone)
– Repeat the process in subsequent sets of
5 – 10 schools
– CAPACITY DEVELOPMENT GOAL:
Maximize opportunities for
Implementation Team members to learn
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Implementation Cost
Change in Budget (Percent)
Implementation Costs & Savings
(Inflation Adjusted)
120
110
100
90
80
70
60
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
1 Yr Pre
During
Post
Year 1
Post
Year 2
Post
Year 3
Federal
Departments
ALIGNMENT
State
Department
Districts
Schools
Teachers/ Staff
Effective Practices
FORM SUPPORTS FUNCTION
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Implementation Teams
Systems Change
Scale Up Website
New OSEP Center (Fixsen, Blase,
Horner, Sugai)
State Implementation and Scaling
up of Evidence-based Practices
(SISEP)
www.scalingup.org
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
Thank You
We thank the following for their support
Annie E. Casey Foundation (EBPs and cultural
competence)
William T. Grant Foundation (implementation literature
review)
Substance Abuse and Mental Health Services
Administration (implementation strategies grants; NREPP
reviews; SOC analyses of implementation; national
implementation awards)
Centers for Disease Control & Prevention (implementation
research contract)
National Institute of Mental Health (research and training
grants)
Juvenile Justice and Delinquency Prevention (program
development and evaluation grants
Agency for Children and Families (child welfare leadership
development contract)
Office of Special Education Programs (implementation
capacity development center contract)
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
For More Information
Karen A. Blase
Dean L. Fixsen
813-974-4463
813-974-4446
[email protected]
[email protected]
National Implementation Research Network
At the Louis de la Parte Florida Mental Health Institute
University of South Florida
http://nirn.fmhi.usf.edu
Copyright © Dean L. Fixsen and Karen A. Blase, 2008
For More Information
Implementation
Research:
A Synthesis of the
Literature
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F.
(2005). Implementation Research: A Synthesis of the Literature. Tampa,
FL: University of South Florida, Louis de la Parte Florida Mental Health
Institute, The National Implementation Research Network (FMHI
Publication #231).
Download all or part of the monograph at:
http://nirn.fmhi.usf.edu/resources/publications/Monograph/index.cfm
Copyright © Dean L. Fixsen and Karen A. Blase, 2008