SLHI June 23, 2008

Cassandra O’Neillwww.wholonomyconsulting.com

Implementation

Discuss in Pairs

1. What is it? 2. How is it important?

3. What are we working on thatInvolves the implementation

of something?

Small Groups

Write on flip chart paper:

What do we know about successful implementation?

What do we want to know?

How might the National Implementation Research Network Inform us?

How I learned about this

What I learned

The majority of implementation attempts are NOT successful

Implementation Attempts

• In business, change initiatives that are heavily dependent on people (reengineering, TQM, culture change) fail 80-90% of the time

R. W. Rogers, 2002

Implementation Attempts – slide 2

About 10% of what is taught in training gets transferred to the jobR. W. Rogers, 2002

Implementation Attempts – part 3

"Up to 70% of the failures in business are not due to poor strategy or a lack of good ideas, but to flawed execution." R. W. Rogers, 2002

What Does Not Work

Things that alone – are not enough for successful implementation:

Dissemination of information by itself does not lead to successful implementation (research literature, mailings, promulgation of practice guidelines)

What Does Not Work

Things that alone – are not enough for successful implementation:

Training alone, no matter how well done, does not lead to successful implementation

Why do we keep doing things that don’t work and expecting them to work?

The personal is structural and systemic

What level learning is going on?First OrderSecond OrderThird Order

First Order Change or Learning

Adaptive learning, taking place within accepted boundaries that leaves basic values unexamined and unchanged

Second Order Change or Learning

Reflective learning that examines the assumptions of first order learning

AHA

Third order change or learning

Transformative learning happens when we see things differently and involves a deep awareness of alternate world views and ways of doing things

Paradigm Shift

Implementation

What Does Work?

Implement Innovations

Effective intervention practices+Effective implementation practices=Good outcomes for consumers

Broader Application

Good idea + good design and planning +Good implementation

= Good Outcome

INTEGRATED & COMPENSATORY

CONSULTATION & COACHING

STAFF PERFORMANCE EVALUATION

FACILITATIVE ADMINISTRATIVE

SUPPORTS

RECRUITMENT AND SELECTION

PRESERVICE TRAINING

SYSTEMSINTERVENTIONS

What Does Work? Implementation Drivers

DECISION SUPPORT DATA SYSTEMS

  OUTCOMES

(% of Participants who Demonstrate Knowledge, Demonstrate new Skills in a Training Setting, and Use new Skills in the Classroom)

TRAININGCOMPONENTS

Knowledge SkillDemonstration

Use in the Classroom

Theory and Discussion

 

10% 

5% 0%

..+Demonstration in Training

30% 20% 0%

…+ Practice & Feedback in Training

60% 60% 5%

…+ Coaching in Classroom

95% 95% 95%  

Joyce and Showers, 2002

Challenges with new learning

Doing something new is difficult

Asking someone to stop doing something they are proficient in – (even if the results aren’t good)

And asking them to do something they are not proficient in – they are just learning

Challenges with newly-learned behavior pg 44

Newly-learned behavior is: crude compared to performance by a

master practitioner,fragile and needs to be supported in the face

of reactions from consumers and others in the service setting

Incomplete and will need to be shaped to be most functional in a service setting

Stages of Implementation

• Exploration• Installation• Initial Implementation• Full Implementation• Innovation• Sustainability

Implementation occurs in stages:

Fixsen, Naoom, Blase, Friedman, & Wallace, 2005

2 – 4 Years

Degrees of Implementation pg 6

Paper Implementation

Process Implementation

Performance Implementation

What Does Design have to do with it?

Who determines the design?

Difference between Intent and Result

Installation – the process of introducing a new solution, attention is focused on logistics, announcing new program or process

Realization – outcomes are realized when organizations go beyond installation to actions that produce intended outcomes

Kentucky ROCKS!

Applied the 7 drivers by developing a tool

Which included questions to explore for each of the 7 drivers!

How might this information inform us?

What questions related to these drivers might be useful to us in our work?

A few thoughts before we explore these questions…

21st Century Solutions lie within the intersection of

and interaction between

Sufficiency Paradigm

Dynamical Human SystemsNon linear

Brain/Neuroscience findings

Strengths and ResiliencyBuilding

21st Century Solutions DO NOT Lie within the intersection of

Scarcity Paradigm

Linear and Mechanistic SystemsDeficit Approach

Community Readiness Model developed by Edwards, Jumper-Thurman, Plested, Oetting & Swanson (2000)

No Awareness

Denial

Vague Awareness

Initiation Stabilization

Preparation

Preplanning

Creating Demand2 ways

1. Data which shows something isn’t working

Vs2. Belief that a better future is possible

Myths

External Feedback promotes growth and development

Burning Platform Theory

How can we apply

what we’ve learned about keys to successIn implementation?