what’s in a name? what out-of-home care managers think ‘evidence-based practice’ really means!
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What’s in a Name? What out-of-home care managers think ‘evidence-based practice’ really means!. Deirdre Cheers ACWA Conference - 2nd September 2002. Senior Managers and Team Leaders thoughts and ideas about evidence-based practice. - PowerPoint PPT PresentationTRANSCRIPT
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What’s in a Name?
What out-of-home care managers think ‘evidence-based practice’ really means!
Deirdre Cheers ACWA Conference - 2nd September 2002
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• Senior Managers and Team Leaders thoughts and ideas about evidence-based practice
• How evidence-based practice impacts on direct work with children and young people in out-of-home care care
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Looking After Children (LAC)
• A case management system for children and young people in out-of-home care
• Developed in the early 1990’s by UK Department of Health
• Based on extensive research into outcomes for children and young people in care
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Out-of-Home Care: Past and Present
• Changes in how care is provided
• Emerging trends
• Impact of research
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“ there are considerable pressures on professionals to adopt evidence - based practice, that is, action which is grounded in sound knowledge of the needs of children & families and latest evidence about what works for whom, when and why”
(Little, 1997)
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The Research
An investigation into knowledge held by Senior Managers and Team Leaders, and barriers to implementation of evidence-based systems,
in three Australian States/Territories.
The UK Looking After Children system is used as a case example.
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The Research (cont.)
• 9 out-of-home care agencies(government and non government)
• 3 states/territories - NSW, ACT, WA
• 19 participants (10 Senior Managers and 9 Team Leaders)
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Research Aims
• Explore definitions of evidence- based practice
• Consider the influence of research
• Look at barriers to implementation of evidence- based systems
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Two Associated Areas Explored
• Comparison of government and non-government agencies
• Similarities and differences between agencies on a state/territory basis
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The Interviews: Senior Managers
• Understanding and definition of the terms “evidence-based practice” and “guided practice”
• Relationship between employed position and ability to undertake professional reading/training/updating of knowledge base
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The Interviews: Senior Managers (cont.)
• Knowledge of Looking After Children
• Individual reservations and agency barriers to the use of Looking After Children
• Decision making process in agency
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The Interviews: Team Leaders
Additional questions about the use of
LAC as a tool for supervision
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Senior Managers
• Eight Senior Managers reported active and conscientious use of research to inform practice
• Nine offered theoretical definitions of evidence-based practice
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Senior Managers (cont’d)
• Only one could not offer a definition of evidence-based practice
• Four talked about increased knowledge of outcomes for children and young people in care as a result of examining research-informed practice interventions
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Senior Managers (cont’d)
• One Senior Manager talked about the integration of theory with research and practice, forming a “feedback loop”
• Three felt the terminology “evidence-based practice” to be increasingly commonplace in social work literature and practice
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Team Leaders
• Only one of nine reported using research knowledge in day-to-day practice
• Two said evidence-based practice was a term that they had never heard of before
• No Team Leaders were able to give a theoretical definition of evidence-based practice
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Team Leaders (cont.)
• Three said research is important to increase knowledge of outcomes for children and young people in care
• Two said research is useful as a means of providing feedback and increasing accountability to clients
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General Findings
• Senior Managers had a better understanding of terminology and made links between research and practice
• Both groups found difficulty in conceptualising a link between care outcomes and guidance for practice
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Evidence-Based Practice, LAC and Out-of-Home Care
• Both Senior Managers and Team Leaders spoke of the benefits of evidence-based practice in bringing consistency of approach to collection of information when children and young people enter care
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Senior Managers were more likely than
Team Leaders to be open to
implementation of evidence-based
systems such as LAC
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Expressed Reservations About the Use of Evidence-Based Practice
• Restriction on professional autonomy
• Reduction of worker independence
• Impediment to practice creativity
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• Political and bureaucratic “hidden agendas” -
fear of reduction of resources, and avoidance
by governments of fiscal responsibility for
children and young people in care
Expressed Reservations About the Use of Evidence-Based Practice cont’d
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CHILD PROTECTION
Messages from Research(the “ blue book”)
UK Department of Health, HMSO, 1995
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• Overview of 20 research studies
• brought together findings & themes from a range of reports and worked them into strong clear messages
• aimed to get professionals to evaluate their own practice and attitudes, not just to increase their knowledge
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• High profile ministerial launch
• Extensive circulation of free copies
• Series of regional day conferences
• High profile at national events
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Improving the Spread of “Evidence”
(Weyts, Morpeth, Bullock in Child and Family Social Work, Vol 5, Issue 3, August 2000)
•Publicity
•Training
•Guidance on implementation of the findings
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Guided Practice
Practice tools that assist
professionals to deliver evidence-
based services and provide
effective case work and case
management
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“ To be successful such tools should also have the capacity to convey ideas as well as information and in doing so should reinvigorate the original research.”
(Weyts, Morpeth and Bullock, 2000)
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Evidence-Based Practice is Guided Practice?
Closely related concepts
but not interchangeable terms
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Evidence-Based Practice is Guided Practice?
Evidence-based practice:
Practice shaped and informed
by research
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Evidence-Based Practice is Guided Practice?
Guided practice:
Prescribed tasks and recommended processes contained
within a practice framework
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The Looking After Children (LAC)
a case management system that is
evidence-based, guided practice
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Evidence-Based Practice in out-of-home care
Grounded in good knowledge about: • The needs of children and families
• The latest research findings about what works for which groups of children, when, and why
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• Takes into account the known costs and benefits of interventions
• places evidence in a wider context of related concerns eg legal, community, consumer
• provides a common conceptual framework into which new ideas, new research and new projects can be fitted
Evidence-Based Practice in out-of-home care
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LAC - Guiding the Journey Through Care