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

What does Prena need to support her practice?

]

• 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.