building capacity to improve outcomes · 2018. 5. 7. · frank porter graham child development...
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Barbara Sims
barbara.sims@unc.edu
National Implementation Research Network Frank Porter Graham Child Development Institute
University of North Carolina at Chapel Hill
Building Capacity to Improve Outcomes Building
Capacity
Institute
Charlotte NC
May 3, 2016
The Opportunity
What’s the Way Forward?
Socially
Significant
Outcomes
Effective
Interventions
Effective
Implementation
Enabling
Contexts
Formula for Success
WHY
Socially
Significant
Outcomes
WHAT
Effective
Interventions
HOW & WHO
Effective
Implementation
WHERE
Enabling
Contexts
Formula for Success
Systems Alignment for Outcomes
Student
School
District/Local VR
Regional Program/Community
State Policymakers
Federal Policymakers
What Does It Take?
It Takes Time
It Takes Teams
It Takes Supports
It Takes Communication
Implementation Stages
Exploration Installation Initial
Implementation
Full Implementation
2-4 Years
• Assess needs
• Examine fit and
feasibility
• Form Team
• Develop
communication
protocols
• Identify
infrastructure
elements
• Acquire
Resources
• Assess gaps
• Initiate feedback
loops
• Develop
infrastructure to
support practice
& organizational
change
• Initiate new
practices
• Use data for
continuous
improvement
• Strengthen
infrastructure to
support practice
& organizational
change
• Use
improvement
cycles
• Assess fidelity
and outcomes
• Maintain skillful
practice
• Produce more
efficient and
effective
infrastructure
What Does It Take?
It Takes Time
It Takes Teams
It Takes Supports
It Takes Communication
Making It Happen
Letting “it” happen
Helping “it” happen
Making “it” happen
Based on Hall & Hord (1987); Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou (2004); Fixsen, Blase, Duda, Naoom, & Van Dyke (2010)
Implementation Teams
PrProgram occurs without
direction or intervention
Making It Happen
Letting “it” happen
Helping “it” happen
Making “it” happen
Based on Hall & Hord (1987); Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou (2004); Fixsen, Blase, Duda, Naoom, & Van Dyke (2010)
Implementation Teams
Interested schools or employers
figure it out on their own
Making It Happen
Letting “it” happen
Helping “it” happen
Making “it” happen
Based on Hall & Hord (1987); Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou (2004); Fixsen, Blase, Duda, Naoom, & Van Dyke (2010)
Implementation Teams
• Active use of strategies to support the adoption of
the program or practice
• Active installation of supports for implementation
of the program or practice
• Implementation teams are accountable for change
and progress
Implementation Team No Implementation
Team
80%
3 Years
14%
17
Years
To “Making it Happen” From “Letting it Happen”
Sources: Fixsen, Blase, Timbers, & Wolf, 2001 Balas & Boren, 2000 Green & Seifert, 2005 Saldana & Chamberlain, 2012
Improvement in Intervention Outcomes
Implementation Teams
Implementation Teams provide an accountable and sustainable structure to move a practice through stages of implementation with fidelity.
Implementation Teams
Ensuring Support
Engaging the Community
Creating enabling context
Effective Practices
Implementation Infrastructure
Improvement Cycles
System Change
Linked Implementation Teams
Student
School
District/Local VR
Regional Program/Community
State Policymakers
Federal Policymakers
What Does It Take?
It Takes Time
It Takes Teams
It Takes Supports
It Takes Communication
Example
Student
School
District/Local VR
Regional Program/Community
State Policymakers
Federal Policymakers
What does Janet need to support
her work?
Competency Supports
Organizational Supports
Leadership Supports
]
Competency Supports
Selection Training
Coaching Fidelity Assessment
]
Organizational Supports
Decision Support Data System Facilitative Administration Systems Intervention
Implementation Drivers
© Fixsen & Blase, 2008
Leadership
Improved Outcomes
Help to develop,
improve, and
sustain educators’
competence and
confidence to
implement
effective
innovations
Consistent and Competent Use of
Educational Innovations
Help ensure
sustainability and
improvement at
the organization
and system
levels
Help guide leaders to use the right leadership strategies for the situation
Integrated &
Compensatory
What Does It Take?
It Takes Time
It Takes Teams
It Takes Supports
It Takes Communication
Who Should Be Communicating?
Your team
Vertical team connections
Horizontal team connections
27
Team
Team
Team
Team
Team Team
How Often Should You Communicate?
Regularly scheduled
Formal Process
Dedicated appointment
Opportunities to make changes
Quarterly
Monthly
Weekly
What Should We Talk About?
What’s working?
What’s not working?
What’s getting in our way?
How do we know?
Using Data and Information
What data are we looking at? Outcome Process Fidelity
How might we need to adjust based
on this data?
How will we know if these adjustments worked?
Who will be responsible for these adjustments? Timeline?
Look
Think
Act
Citation and Copyright
This document is based on the work of the National Implementation Research
Network (NIRN).
© 2013-2016 Allison Metz, Leah Bartley, Jonathan Green, Laura Louison, Sandy
Naoom, Barbara Sims, and Caryn Ward
This 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.edu
web: http://nirn.fpg.unc.edu
The 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.
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