Post on 07-May-2020
September 8, 2017
Allison Metz, Ph.D. Director and Senior Scientist
Implementing Evidence to Achieve Child Welfare Outcomes
New Jersey Task Force on Child Abuse and Neglect2017 Biennial Conference
Implementation Science
Effective Practices
Effective Implementation
Enabling Context
Improved Outcomes
Implementation Defined. (n.d.). Retrieved November 22, 2016, from
http://nirn.fpg.unc.edu/learn-implementation/implementation-defined
Intervention Selection
Intervention Selection
NEED
FIT
RESOURCES
EVIDENCE
CAPACITY
USABILITY
Fit with current Initiatives• Community, regional, state
priorities• Organizational structures
Community values
Need in community, region, state• Socially significant Issues• Parent & community perceptions of
need• Data indicating need
Resources and supports for:• Interventions• Technology supports
(IT dept.)• Staffing• Training• Data Systems• Coaching &
Supervision• Administration &
systemEvidence•Outcomes – Is it worth it?•Fidelity data•Cost – effectiveness data•Number of studies•Population similarities•Diverse cultural groups•Efficacy or Effectiveness
Capacity to Implement• Staff meet minimum
qualifications• Able to sustain Imp Drivers
• Financially • Structurally
• Buy-in process operationalized
• Practitioners • Families
Usability for Replication• Qualified purveyor• Expert or TA available• Mature sites to observe• Several replications• How well is it operationalized?• Are Imp Drivers
operationalized?
Need - Data demonstrating the needs of the population and the EBP/EIP
Fit - Alignment of EBP/EIP approach with local and state priorities and initiatives
Resources - Resources & supports available for developing organizational and systems readiness, engaging key stakeholders in the system, and decision-support data systems
Evidence- Expected outcomes when EBP/EIP is implemented as intended
Usability- Extent to which EBP/EIP approach is well-defined
Capacity - Required staffing and administrative practices, and capacity for data input and analysis, and fidelity and outcome assessments
IS for Improved Outcomes
Effective Practices
Effective Implementation
Enabling Context
Improved Outcomes
Implementation Defined. (n.d.). Retrieved November 22, 2016, from
http://nirn.fpg.unc.edu/learn-implementation/implementation-defined
Drivers
]
• Competency Supports
Selection Process
Training Process
Coaching Process
Fidelity Assessment
Decision SupportData Systems
FacilitativeAdministration
SystemsIntervention
• Organizational Supports• Leadership Supports
Fidelity
Coaching
Training
Selection
Integrated & Compensatory
Systems Intervention
FacilitativeAdministration
Decision SupportData System
AdaptiveLeadership Drivers
Consistent Use of EBP/EIP
Positive Child and Family Outcomes
Integrated & Compensatory
Technical
Implementation Drivers
IS for Improved Outcomes
Effective Practices
Effective Implementation
Enabling Context
Improved Outcomes
Implementation Defined. (n.d.). Retrieved November 22, 2016, from
http://nirn.fpg.unc.edu/learn-implementation/implementation-defined
Teams
Data & Communication
Collaboration leads to:• Practices that are more implementable• Infrastructure that brings practice and implementation closer together• Attention to local needs and increased relevance and impact of implementation
activity• Enhanced capacity and capability of implementation
Teams and Stakeholder Engagement
• Working in complex systems requires the engagement and influence of multiple stakeholders.
• This requires a different kind of leadership- moving from solo heroes to collaboration and teamwork.
11
(Rycroft Malone and colleagues, 2013
Core Practice
Infrastructure
Improvement Cycles
Systems
Operationalize core practices of the EBP/EIP
Develop guiding processes for building staff competency and organizational capacity to support the implementation of EBP/EIP
Identify metrics to assess and improve implementation of practices; develop communication protocols
Build cross-sector collaboration and buy-in for the EBP/EIP model and garner support and buy-in from key stakeholders, including families
Team Functions
Using Data for Improvement
• Continuous Quality Improvement involve developing a process for identifying, collecting, and analyzing data that are useful to make decisions on improvement. This process should be ongoing.
• The process should provide timely, reliable data for decision-making.
CQI Best Practices:
• Clear accountability for CQI
• Support for those accountable for CQI
• CQI activities built into regular practice routines
• CQI used to support data-driven decision-making for the purpose of improvement
Implementation Team
ProgramManagement Team
Direct Service StaffSu
stai
nabi
lity
Prac
tice
Info
rms
Polic
yPolicy Enables
Practice
Communication & Learning
Frank Porter Graham Child Development InstituteUniversity of North Carolina
Chapel Hill, NC
http://nirn.fpg.unc.edu/www.scalingup.org
www.implementationconference.org
Allison MetzAllison.metz@unc.edu
Citation and CopyrightThis document is based on the work of the National Implementation Research Network (NIRN).© 2013-2016 Allison Metz & Leah BartleyThis content is licensed under Creative Commons license CC BY-NC-ND, Attribution-NonCommercial-NoDerivs . You are free to share, copy, distribute and transmit the work under the following conditions: Attribution — You must attribute the work in the manner specified by the author or licensor (but not in any way that suggests that they endorse you or your use of the work); Noncommercial — You may not use this work for commercial purposes; No Derivative Works — You may not alter, transform, or build upon this work. Any of the above conditions can be waived if you get permission from the copyright holder.
email: nirn@unc.eduweb: http://nirn.fpg.unc.eduThe mission of the National Implementation Research Network (NIRN) is to contribute to the best practices and science of implementation, organization change, and system reinvention to improve outcomes across the spectrum of human services.