connecting evidence to outcomes: practioner development programme
TRANSCRIPT
Connecting Evidence to Outcomes: Practitioner Development Programme
Finding and Using the evidence you need for confident decision making and planning Dr Stella Owens - Centre for Effective Services
9th BASPCAN International Congress12th – 15th April 2015University of Edinburgh
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Background
CES a small organisation with
charity status
Established in 2008
Jointly funded by
Government • Dept Children and
Youth Affairs
The Atlantic Philanthropies
All Island organisation
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Purpose of CES
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A Multi-disciplinary Team
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Main areas of work
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DHSSPS: A Framework for Social Work Practice in Northern Ireland
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A Strategy for Social Work in Northern Ireland 2012-2022
Strategic Priorities• Strengthening the capacity of the workforce• Improving Social Work Services• Building leadership and trust
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A Strategy for Social Work in Northern Ireland 2012-2022
• Social work practice must be based on evidence of ‘What Works’.• Social workers must be equipped with the knowledge, skills and
expertise to deliver effective social work interventions and partnership approaches in service planning, commissioning and provision
• All social work practitioners need access to up-to-date research and evidence to inform their practice decisions
• It is imperative that their judgements are based on professional standards and values, are informed by knowledge and experience, reflect best practice guidance and comply with legal requirements.
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Social Work Strategy Innovation Fund
Two collaborative bids:
1. Partnership with Western Health and Social Care Trust - evidence informed social work practice
2. Partnership with Children's Service Improvement Board – supporting better decision making with independent chairs
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Real World Pressures
‘ Busy practitioners need easy access to clear and succinctly presented practical research which is amenable to application in their work.’
Child Abuse Review Jan-Feb 2014
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What are the barriers you experience in using evidence?
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Aim - Evidence Informed Practitioner Programme
To increase the quality of social work practitioner analysis and decision making by equipping participants with skills in sourcing and utilising evidence and knowledge and integrating it into their day to day practice.
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Evidence Informed Practitioner Programme Objectives
1. To develop skills in sourcing, critically appraising and applying evidence to practice and service improvement
2. Integrating evidence into reports and decision making
3. Integrating evidence into supervisory and practice/service development role
4. The development of knowledge translation and transfer skills across teams and between practitioners
5. Build confidence of the workforce in their expertise and a learning and improvement culture
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Programme Outcomes1. Reduced length of reports but increased quality through use of evidence and
research knowledge to support analysis and decisions
2. Increased compliance with quality assurance criteria and positive feedback from chairs and governance leads
3. Better decisions which are implemented successfully
4. Reduced usage of expert witnesses and reduced costs as social workers capacity increases
5. Reduced time in meetings spent discussing information without reaching clear decisions in the absence of authoritative evidence or knowledge
6. Self reported increase in confidence from social work practitioners
7. Culture of continuous improvement and practice.
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What do we mean by evidence?
Evidence-based
A programme, service or intervention that has consistently been shown to produce positive results by independent research studies that have been
conducted to a particular degree of scientific quality.
Evidence-informed Practice based on the integration of experience, judgement and expertise
with the best available external evidence from systematic research.
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Methodology
Social workers
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Process
Induction Three Training Modules
Ongoing Mentoring
Celebration PQ Submission Presentations
Evaluation
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Participants
17 social workers and senior social workers• Child and family• Adult mental health• CAMHS
11 mentors and 4 Tutors• From Training (mentors)• From Senior Management (mentors)• WHSCT (tutor)• CES (tutors)
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Expectations at the beginning of the course- High Hopes
“I'm looking forward to how my practice will evolve following participation in the programme”
“Excited to take part in the process”
“Feeling very enthusiastic”“Looking forward to the challenges of the course and a bit daunted’
“Looking forward to learning about my practice and what works”
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Induction Day: ‘What was most useful?’
“Informative, overwhelming but exciting and challenging!”
“Just to have content and process explained so well “
“I am excited in using this learning to improve my work with a group I have recently set up “
“The discussion around the differences between evidence informed and evidence based practice. I hope that I can use this pilot experience as a way of influencing future planning of services”
“Being able to talk to mentor about expectations”
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Day 1- March- What was most useful?
“The workshop discussing case studies and how to apply an outcomes approach to practice, and the need for me to reflect more on outcomes before writing any of my future assessments ”
“Will feel more confident about accessing research/evidence material – HONNI etc”
“Learning to search. Discussion on outcomes. Preparation of profile for the day’s training. Time to reflect and review guidance on case”
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As a result of the course..(feedback from Day 3)
“I will use evidence to help me be more confident in decision making”
“I will use evidence more to inform my practice”
“I will discuss in team meeting and use evidence to make links to risk and protective indicators to my future practice”
“It encourages me to continue with research and applying to current cases”
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Case management reviews
An overview of learning arising from Case Management Reviews in Northern Ireland 2003-2008(Dr John Devaney, Dr Lisa Bunting, Dr David Hayes and Dr Anne Lazenbatt, QUB January 2013)
Based on 24 Case Management Reviews undertaken on 45 children
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The Report and Recommendations
• ‘An overly descriptive tone ...... provided little analysis of what may have contributed to events or what learning could be extrapolated’.
• ‘significant gaps in information about family history and or professional involvement’
• ‘A mismatch between issues identified in the report and recommendations arising from the review
• ‘Recommendations that were aspirational and lacked focus’• ‘reports with too many recommendations’
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The Report and Recommendations
• ‘Decision making was often based on triggering events rather than cumulative knowledge’.
• ‘lack of comprehensive oversight and clarity as to the direction of the work contributed to less effective decision making’.
• ‘deficits in professional knowledge about the indicators of risk and abuse......played a role’.
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Aim – Chairs programme
• To increase the consistency and quality of decision making of Case Conferences and LAC Care Reviews across N. Ireland through supporting Chairs to source and apply relevant knowledge and evidence in the decision-making processes which they facilitate
• 28 independent and operational Chairs across all five Trusts in N. Ireland
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Learning Objectives
i. To explore an evidence informed and outcomes approach to decision making at case reviews and case conferences in line with the recommendations of Early Authoritative Intervention
ii. To equip Chairs with skills in sourcing and critically appraising relevant knowledge and evidence to support decision-making.
iii. To increase the level of participation and evidence from users’ experience in decision making processes
iv. To provide Chairs with practical quality assurance mechanisms for critiquing social work reports and assessments.
v. To develop an evidence informed decision making framework system for Chairs to use with practitioners to create consistency in decision making processes and continuous improvement in the quality of social work assessments
vi. To use peer action learning to support the application of learning to the work setting.
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Pre-programme questionnaire
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Pre-programme questionnaire
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Pre-programme questionnaire
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Modules
Module 1: Decision Making and Early Authoritative Intervention • Using a line of enquiry approach and a panel of expert witnesses
Module 2: Decision Making Using Evidence from Experience and Creating an Enabling Environment •Explore ways in which Chairs utilise practice wisdom and participative methods to enable the voice of children and young people to be heard in the decision making process
Module 3: Decision Making: Quality and Consistency •Working from real-life case conference and review reports this module will focuses on quality and consistency - the evidence which informs decision making
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Benefits of the programme(s)
• Easy to replicate• Builds capacity of workforce development• Increases practitioner confidence• Better decisions – Better outcomes for children
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Reclaiming social work……?
