Transcript Document

Working Smarter:
The implementation journey to
improve student outcomes
Michelle A. Duda, Ph.D., BCBA,
Dean L. Fixsen, Ph.D.
&
Karen A. Blase Ph.D.,
Melissa Van Dyke, LCSW
Frank Porter Graham Child Development Institute
University of North Carolina – Chapel Hill
A Framework for Implementation
(Stages of Implementation)
Part 3
Who does the work?
• Implementation Teams
• Develop effective, flexible,
adaptable capacity to initiate and
manage continual change
o
Requires new roles, functions, and skill
sets that do not exist currently
Implementation Team
• Policy members
o
change policy, barrier busters, facilitators
• Practice members
o
do the innovation, test policies, feedback
• Families and stakeholders
• Management members
o
establish and define roles and functions
• Others?
Implementation Team
• A group that knows your states ESD
initiative very well (formal and practice
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)
Implementation Team
Implementation Team
Simultaneous, Multi-Level Interventions
Teacher
School
Management (leadership, policy)
Administration (HR, structure)
Supervision (nature, content)
District/Division
State and Community Context
Implementation Team Functions
Prepare
Communities
Prepare Districts
Prepare schools
faculty, staff
Implementation
Team
Work with
Researchers
Assure
Student
Benefits
Assure
Implementation
Implementation Team
Terms of Reference
• Scope, Objectives, and Expected Outcomes
• Term (Time or Outcome-Based)
• Membership (inclusive of family members, youth,
system partners, providers, with attention to cultural
diversity)
• Leadership, Roles, and Functions
• Boundaries and Limitations (what is not authorized)
• Authority, Accountability and Reporting Requirements
• Decision-making Processes (e.g. Majority,
Consensus)
• Values and way of work that are to be evident during
the term of work (e.g. no meetings without family
members and youth present)
Implementation Team
• Change the behavior of adult education
professionals
o
“Systems don’t change, people do”
o
Change organizational structures,
cultures, and climates
o
Change the thinking of system directors
and policy makers
Implementation Team
Overarching Roles and Responsibilities:
• Moving the project through the stages of
implementation
• Ensuring that the implementation drivers needed
for fidelity and sustainability are integrated and
successfully embedded in the overall effort
• Identify barriers and find solutions
• Identify facilitators and institutionalize them
Stages of Implementation
• Implementation is not an event
• A mission-oriented process
involving multiple decisions, actions,
and corrections
Stages of Implementation
Implementation occurs in stages:
•
•
•
•
•
•
Exploration
Installation
Initial Implementation
Full Implementation
Innovation
Sustainability
Fixsen, Naoom, Blase, Friedman, & Wallace, 2005
2 – 4 Years
Implementation Components
• What do we need to know about
successful implementation methods?
• Stages of Implementation
• Drivers (Implementation Components)
• Multilevel Influences (Systems, organizations)
The Exploration “Stage”:
Consensus Building
“Many implementation efforts fail
because someone underestimated the
scope or importance preparation. Indeed,
the organizational hills are full of
managers who believe that an
innovation’s technical superiority and
strategic importance will guarantee
acceptance.”

 Leonard-Barton & Kraus,
Harvard Business Review, 1985
Exploration Stage Goals
Consensus Building
• Forming an Implementation Team (Oversight
Team)
• Assessing community needs and current
performance and outcomes related to that
need
• Studying and assessing “fit”
Exploration:
Making the Adoption Decision (or not)
Overall Goals:
• Examine degree to which the EBP, best practice, or
policy meets the needs of the District, school, &
community
• Determine whether adoption and implementation is
desirable and feasible
• Create readiness for change
Time of Interaction and Assessment:
•
•
•
•
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With Schools, Teachers, and Teachers
With Broad Range of Stakeholder
With Providers and Funders
With Content Experts or TA Resources
With Other Implementing States, Districts, Schools
Exploration:
Making the Adoption Decision (or not)
What happens during Exploration to develop
readiness for change?
• Assess capacity, resources, “fit” and “buy-in”
• Awareness, garnering support (parents, teachers,
stakeholders, leaders, champions)
• Describe risk and help partners manage risk
• Identify schools or classrooms comfortable with
their ability to manage risk
• Assess the accessibility of knowledge experts –
who knows the innovation
Key Stakeholders Include;
• Consumers
• Family Members
• Broad Members from the community
• Providers
• Funders
• Other Implementation sites
• Others???
What happens during Exploration?
• Buy-in and consensus building DO NOT end
• You will never “finish” getting buy-in from
stakeholders
• Assessing how much help is available for
implementation
• Assessing capacity, resources, and “buy-in”
• Re-Assessing Feasibility
• Deciding to move ahead/or not
The Installation “Stage”:
Setting the Stage for Infrastructure
“Managers may view technology as more of
a problem than a solution”
Robert Haavind, Editor, New Technology, 1985
“The paradox of non-evidence
implementation of evidence-based
programs”.
Robert Drake, Paul Gorman, Will Torrery, 2002
Installation Stage Goals
• Setting the Stage for infrastructure
• To create structural and instrumental
changes necessary to initiate the
innovation
• Active participation
Installation
• Structural and instrumental changes
necessary to initiate the innovation
• Creating space for the new program Establishing referral flow
• Staff Recruitment & Hiring
• Training
o
o
Administration/Staff
Teachers
Installation (continued)
• Infrastructure Development
• Initiating EBP infrastructure by planning
for:
o Ongoing Training
o Coaching and Supervision
o Staff & Fidelity Evaluation
o Outcome evaluation
o Identifying Administrative Issues
o Identifying Broader Systems Issues
o Troubleshooting (PDSA cycles)
Student Benefits
• Performance Assessment
(Fidelity)
Systems
Intervention
Coaching
Competency
Training
Adaptive
Integrated &
Compensatory
Selection
Technical
Leadership
Organization
Facilitative
Administration
Decision Support
Data System
Installation Stage Challenges
• Resources consumed but no new
services provided for children
• Start up may add 10-20% to first year costs
• Status Quo gets challenged
• Creating new realities
o
“Oh, I didn’t understand that this would mean……”
Overcoming “Challenges”
•
•
•
•
Anticipatory guidance for champions
High level “protection” and support
Rapid-cycle problem solving
Reduced expectations (initially) and
ability to tolerate higher costs during
start up
• Focus on evolving organizational
supports
• Conversations to help establish new
community and organizational climates
and cultures
The Initial Implementation “Stage”
Initial Implementation Stage Goals
• Survive the awkward!!!!!
• Learn from mistakes
• Continue “buy-in” efforts
• Manage expectations
Initial Implementation Activities
•
•
•
•
Change practices
Provide services
Put components in place
Change organizational and community
structures & culture
• Manage change process
• Overcome fear & inertia
The Full Implementation “Stage”
Full Implementation Stage Goals
• Maintenance and Improvement
o Services
o Linkages
o Support
o Infrastructure
o Data Collection Systems
What is Full Implementation?
• Components integrated, fully functioning
• Skillful Service
• Purposeful Service
• Ready to be evaluated
o
o
o
Outcomes
Implementation
process
Well-developed Fidelity Measures
• Can discriminate between the EBP
and other practices
• Are correlated with better outcomes
• Help in interpreting research findings
• Help in interpreting program outcomes
and guiding implementation
ACTIVITY TWO
Reflection Questions: See handout
20 min
• Step 1: Meet your “new” team
• Step 2: Check to make sure you have
chart paper and markers
• Step 3: Elect a recorder for the chart
paper
• Step 4: Decide who will share back
• Step 5: Begin activity on handout
The Innovation “Stage”
Innovation Stage Goals
• First do it Right (high fidelity)..
• …Then do it better!
• Check in with multiple people at
multiple levels
• Create feedback loops
When do we have an innovation?
• Consult with Purveyor
• Model the Master
o Institutionalize Innovations by Using
the Drivers
• Evaluate Impact
o
Discriminate drift from innovation
The Sustainability “Stage”
Sustainability Stage Goals
• Motivation and Momentum
• Ensure funding streams for service and
infrastructure
• Ensure high fidelity and positive
outcomes through infrastructure
improvement and maintenance
• Continued analysis and incorporation of
implementation drivers
Sustainability
Starts during exploration, never stops
Part of every stage
Information and trust
Achieve good outcomes,
Expand support base during all stages
Ability to retain function while changing form
given turnover, changing needs and context
Multilevel Influences
• Successful and sustainable implementation of
innovations always requires organizational
change at multiple levels.
o
Changing the behavior of adult human service
professionals
o
Changing organizational structures, cultures, and
climates
o
Changing the thinking of system directors and policy
makers
For More Information
Michelle A. Duda, Ph.D.
• 919-636-0843
• [email protected]
Dean L. Fixsen, Ph.D.
• 919-966-3892
• [email protected]
At the Frank Porter Graham Child Development Institute
University of North Carolina
Chapel Hill, NC
www.scalingup.org
http://nirn.fpg.unc.edu/
http://www.fpg.unc.edu/~nirn/resources/publications/Monograph/
For More Information
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://www.fpg.unc.edu/~nirn/resources/publications/
Monograph/
To order the monograph go to:
https://fmhi.pro-copy.com/