Transcript How to implement EBPs

Building
Implementation
Capacity
Barbara Sims, Co-Director
National SISEP Center
FPG Child Development Center
University of North Carolina at Chapel Hill
NC SIP Spring
Networking
Meeting
Greensboro.NC
March 20, 2013
Implementation Gap
Implementation is defined as a specified set of activities
designed to put into practice an activity or program of
known dimensions.
RESEARCH
PRACTICE
GAP
IMPLEMENTATION
Why Focus on Implementation?
“Students cannot benefit from
interventions they do not experience.”
Implementation Science
Business as Usual: Impact
Best data show these methods, when used alone
Do not Result in Implementation as Intended
 Diffusion/ Dissemination of information
 Training
 Passing laws/ mandates/ regulations
 Providing funding/ incentives
 Organization change/ reorganization
5 to 10% return on investment
NECESSARY BUT NOT SUFFICIENT
Formula for Success
Effective
Interventions
Effective
Implementation
Methods
Socially
Significant
Outcomes
Enabling
Contexts
Plan for Change
Students
Shifting Accountability
Educators
System
Active Implementation
Frameworks
Usable Interventions
Implementation Stages
Implementation Drivers
Improvement Cycles
Implementation Teams
Usable Interventions
•
An intervention needs to
be teachable, learnable,
doable, and be readily
assessed in practice.
Interventions
Implementation Stages
•
Purposeful matching of
critical implementation
activities to the appropriate
stage of the process
Stages
Implementation Drivers
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Help to develop, improve, and
sustain educators’ competence
and confidence to implement
effective educational practices
and supports.
Help ensure sustainability and
improvement at the organization
and systems level
Help guide leaders to use the right
leadership strategies for the
situation
Drivers
Improvement Cycles
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New Approaches Need New
Ways of Work
Transparent, protocol-driven
feedback loops and processes
Aligned policies, funding,
guidance to support new
ways of work
Cycles
Implementation Teams
Organized, expert assistance to
develop and sustain an accountable
and effective structure
Teams
USABLE INTERVENTIONS
Purposeful matching of critical implementation
activities to the stage of the process
Useable Interventions
Performance Assessment
Operational Definitions
Essential Functions
Description
• Philosophy, Values and
Principles
• Inclusion and Exclusion
Criteria
Useable Interventions
Description
Performance Assessment
Operational Definitions
Essential Functions
Clear description of the
features that must be present
to say that a program exists
in a given location
Useable Interventions
Essential Functions
Description
Performance Assessment
Operational Definitions
Describe each core
component in terms that can
be taught, learned, done in
practice, and assessed in
practice
Useable Interventions
Operational Definitions
Essential Functions
Description
Performance Assessment
Provides evidence that the
program is being used as
intended and is resulting in
the desired outcomes
Usable Interventions
Tools You Can Use
Hexagon Tool
Practice Profiles
The Hexagon
An EBP Exploration Tool
The “Hexagon” can be used as a
planning tool to evaluate evidencebased programs and practices during
the Exploration Stage of
Implementation.
Download available at:
www.scalingup.org/tools-and-resources
Need in school, district, state
• Academic & socially significant Issues
• Parent & community perceptions of need
• Data indicating need
Capacity to Implement
•
•
Staff meet minimum qualifications
Able to sustain Imp Drivers
• Financially
• Structurally
Buy-in process operationalized
• Practitioners
• Families
•
NEED
Fit with current Initiatives
• School, district , state priorities
• Organizational structures
Community values
CAPACITY
FIT
EBP:
5 Point Rating Scale:
High = 5; Medium = 3; Low = 1.
Midpoints can be used and scored as a 2 or 4.
High
Med
Low
READINESS
Fit
Resources and supports for:
Readiness for Replication
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Need
RESOURCES
Qualified purveyor
Expert or TA available
Mature sites to observe
Several replications
How well is it operationalized?
Are Imp Drivers operationalized?
EVIDENCE
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Curricula & Classroom
Technology supports (IT dept.)
Staffing
Training
Data Systems
Coaching & Supervision
Administration & system
Resource Availability
Evidence
Evidence
Readiness for
Replication
Capacity to
Implement
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Outcomes – Is it worth it?
Fidelity data
Cost – effectiveness data
Number of studies
Population similarities
Diverse cultural groups
Efficacy or Effectiveness
Total Score
© National Implementation Research Network 2009-2012
Adapted from work by Laurel J. Kiser, Michelle Zabel, Albert A. Zachik, and Joan Smith at the University
IMPLEMENTATION STAGES
Purposeful matching of critical implementation
activities to the stage of the process
Implementation Stages
Exploration
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Assess needs
Examine
intervention
components
Consider
Implementation
Drivers
Assess Fit
Installation
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Acquire
Resources
Prepare
Organization
Prepare
Implementation
Drivers
Prepare Staff
Initial
Full
Implementation
Implementation
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2-4 Years
Adjust
Implementation
Drivers
Manage Change
Deploy Data
Systems
Initiate
Improvement
Cycles
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Monitor &
Manage
Implementation
Drivers
Achieve Fidelity
& Outcome
Benchmarks
Further Improve
Fidelity &
Outcomes
Implementation Stages
Tools You Can Use
District Initiative Inventory
Stages of Implementation Analysis
Implementation Action Plan
IMPLEMENTATION DRIVERS
Common features of successful supports to help
make full and effective use of a wide variety of
innovations
Implementation
Drivers
Competency Drivers
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Build competency and confidence
Develop, improve and sustain
competent & confident use of
innovations
Implementation Drivers
Performance Assessment
(Fidelity)
Coaching
Training
Selection
© Fixsen & Blase, 2008
Implementation
Drivers
Organization Drivers
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Change Organizations and Systems
Create and sustain hospitable
organizational and system environments
for effective services
Develop functional data systems that
can be used to inform decision-making
Implementation Drivers
Performance Assessment
(Fidelity)
Coaching
Training
Selection
Systems
Intervention
Facilitative
Administration
Decision Support
Data System
© Fixsen & Blase, 2008
Implementation
Drivers
Leadership Drivers
Purpose
Leadership Drivers
Identifying “wicked” problems and
applying effective strategies to
address those problems
Implementation Drivers
Performance Assessment
(Fidelity)
Coaching
Systems
Intervention
Training
Facilitative
Administration
Decision Support
Data System
Selection
Leadership
© Fixsen & Blase, 2008
Adaptive
Technical
Implementation Drivers
Tools You Can Use
Strategic Analysis of Implementation Drivers
Drivers Best Practices
ImpleMap Administration
IMPROVEMENT CYCLES
Changing on purpose to support the new way of
work
Improvement Cycles
Types of Improvement Cycles
Plan-Do-Study-Act Cycles
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Rapid cycle problem solving
•
Usability testing
•
Practice-policy communication
cycles
Improvement Cycles
Rapid Cycle Problem Solving
Act
Plan
Study
Do
Improvement Cycles
Usability Testing
Act
Plan
Act
Plan
Act
Plan
Study
Do
Study
Do
Study
Do
Practice-Policy Communication Cycle
Feedback
Practice Informs Policy
Policy Enables Practices
Plan
Study - Act
External Implementation Support
Policy
Do
Practice
FORM SUPPORTS FUNCTION
Policy
Structure
Procedure
Practice
Improvement Cycles
Tools You Can Use
Improvement Cycle Analysis Worksheet
Linking Communication Protocols
ImpleMap Administration
IMPLEMENTATION TEAMS
Organized, expert assistance to develop and sustain
an accountable and effective structure
Implementation Teams
IMPLEMENTATION
INTERVENTION
Impl. Team
Effective
NO Impl. Team
80%, 3 Yrs
14%, 17 Yrs
Making it Happen
Letting it Happen
Helping it Happen
Fixsen, Blase, Timbers, &
Wolf, 2001
Balas & Boren, 2000
Green & Seifert, 2005
Implementation
Teams
Linked Team Structures
“We tend to focus on
snapshots of isolated parts
of the system and wonder
why our deepest problems
never seem to get solved.”
—Senge, 1990
State-based
Implementation Team
Regionally-based
Implementation Team
District-based
Implementation Team
School-based
Implementation Team
Implementation Teams
Tools You Can Use
Implementation Team Checklist
©Copyright Dean Fixsen and Karen Blase
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August 19-21, 2013
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