9/21/2012. Implementation Science: It Could Be Happening to You. Overview and Objectives. Oregon Scaling Up Goals

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1 Oregon Implementation Science: It Could Be Happening to You S P E C I A L T H A N K S T O S I S E P / N I R N Overview and Objectives 1. Oregon Scaling Up - History of Implementation Science in Oregon, o How does EBISS fit with Oregon Scaling Up? o What Will Be Coming to Your District and When, Resources? 2. Participants will gain a better understanding of the core elements Oregon is focused on in Scaling Up evidence based practices. Oregon Scaling Up Goals The purpose of Oregon s Scaling-Up work is to promote student academic achievement and behavioral health by supporting Oregon s school districts to effectively implement selected evidence-based practices. This will be accomplished by establishing adequate state, regional, and district capacity to carry out effective implementation, organizational change, and systems transformation strategies. Goal 1: Create an Oregon-specific implementation framework (using NIRN/SISEP framework model). Goal 2: Utilize Oregon s Implementation Framework, across multiple teaming structures, to fully implement and sustain selected EBPs state-wide. 1

2 History of Oregon Scaling Up Early 2008 ODE selected as one of three states to receive intense technical assistance from SISEP, a federal technical assistance center ODE began to meet with monthly with SISEP and engage in activities designed to build ODE capacity to implement and Scale Up selected evidence-based practices Two STSs hired A regional team organized, and trained by SISEP, to begin to design Oregon Scaling Up activities Readied participant districts for Scaling Activities History of Oregon Scaling Up Late 2010 SISEP, ODE, STS, and 8 school districts began district Exploration activities Mutual selection with two districts to engage in further Exploration and Installation activities with ODE, STSs, and SISEP EBISS II grant accepted in which funding will go to support districts activities for fully implementing selected EBP EBISS II - Four Overarching Objectives 1. Increase capacity of state-level providers of professional development to convey interconnectedness of initiatives and provide districts with relevant materials for tiered decision-making (SPDG Contractors). 2. Increase district capacity to expand and sustain a tiered model of behavior and academic support (EBISS II districts). 3. Increase the number of districts who make use of implementation science to begin the process of implementing tiered decision-making models for academics and behavior (new districts). 4. Increase the number of special educators in Oregon (Speech Pathologists). 2

3 Summary of Link Between EBISS II & Oregon Scaling Up EBISS I districts have developed a system for Building Team Capacity at the district and school levels. EBISS II is moving forward to strengthen district capacity with new knowledge gained from Oregon Scaling Up (with assistance from SISEP/NIRN). EBISS II allows districts to focus on more specific interventions based on a district identified need. Oregon Scaling UP will support EBISS II activities at the district level while simultaneously working to build regional and state capacity for the implementation and sustainability of EBPs. EBISS II Service Delivery and Support Three live trainings Four, one-hour webinar trainings Technical Assistance via phone, and other correspondence Access to web-based resources EBISS II: PURPOSE This is a five year grant from the US Department of Education, Office of Special Education Programs, intended to promote effective professional development within local educational agencies. 3

4 EBISS II: GRANT BENEFITS Districts receive: Funding to support some of the efforts in the grant. Upon request, distance collaboration from experts to support the work. Face to face interactions three times per year Webinars available 24/7 to all district staff on various strands of focus. Ability to select from the strands an area or more of focus. Resources to further the understanding of Scaling Up (assessment tools, etc.). Opportunity to participate in state level feedback sessions. EBISS II: GRANT EXPECTATIONS District requirements: Include district leadership participation in the three face to face meetings each year of the grant Submit data on the outcomes as required under the grant and for the strands of focus selected Feedback on the Scaling Up efforts and ways to enhance this work statewide Participate in the webinars for the areas of focus selected (live or archived) Willingness to learn and practice the critical elements of Scaling Up Willingness to alert leaders at ODE if the project goes off course Six Strands from EBISS II Grant RTI: For districts interested in refining their work in tiered decision-systems for academics. RTI LD: For districts interested in learning more about using RTI to determine LD eligibility. Implementation Science and Drivers: For learning more about the systems and drivers. Target Populations: For districts interested in focusing on a specific population to assure improvement and to address gaps in achievement or behavioral expectations. Secondary Literacy: For districts interested in outcomes specific to middle and high school. PBIS: For districts interested in refining their work in tiered decision-systems for behavior. 4

5 INNOVATION Why Effective Intervention Practice Effective Implementation Strategies Improved Outcomes Implementation Science IMPLEMENTATION Effective NOT Effective Effective NOT Effective Student Benefits Poor outcomes Inconsistent; Not Sustainable; Poor outcomes Poor outcomes; Sometimes harmful (Institute of Medicine, 2000; 2001; 2009; New Freedom Commission on Mental Health, 2003; National Commission on Excellence in Education,1983; Department of Health and Human Services, 1999) What For Oregon: Academic and Behavior Support Systems focusing on Prevention Screening Progress Monitoring Multi-tiered Research-based Instruction Data based decision-making 5

6 When Stages of Implementation Exploration Installation Initial Implementation Full Implementation 2 4 Years Exploration Goals: Examine degree to which the Evidence Based Practice, best practice, systems change meets the needs in the settings identified Determine whether moving ahead with the initiative and implementation is desirable and feasible Create readiness for change at many levels Goal: Installation To make the structural and instrumental changes necessary to initiate services 6

7 State Transformation Specialists Initial Implementation Goals: Survive the awkward stage! o Learn from mistakes o Continue buy-in efforts o Manage expectations Goals: Full Implementation Maintaining and improving skills and activities throughout the system Components integrated, fully functioning Skillful practices by front line staff, supervisors, administrators Changes in policy that are reflected in practice at all levels Ready to be evaluated for expected outcomes State Management Team Who Implementation Teams State Transformation Team Regional Implementation Team Regional Implementation Team Regional Implementation Team Regional Implementation Team N = Schools N = Schools N = Schools N = Schools 7

8 State Management Team Activities Convene monthly meetings with the State Transformation Team. Regularly communicate, problem solve, and analyze data. Establish communication linkages with implementation teams to analyze facilitators, barriers, and resolutions. Support the integration of implementation activities across a variety of initiatives. Ensure meaningful family and stakeholder communication and partnerships. Create and update action plans annually with specifications of measurable outcomes. State Transformation Team Activities Regularly communicate and problem solve with the State Management and Regional Implementation Teams. Create, guide, and improve implementation support capacity of the Regional Implementation Teams. Promote the blending of implementation functions across initiatives. Promote meaningful stakeholder engagement. Identify gaps in infrastructure and problemsolve at a systems level to close those gaps. Promote aligned data collection systems used to inform data-based decisions. Regional Implementation Team Activities Develop District and Building Leadership and Implementation Teams. Review current strengths, needs, and initiatives at the District and School levels. Provide implementation training, coaching and consultation based on the needs of the districts. Initiate and actively engage in continuous quality improvement cycles. Help Districts with a gap analysis related to critical implementation features. 8

9 District Leadership and Implementation Team Activities Assess the impact and implementation of current evidence based practices on student outcomes. Organize change at the building and district level to support effective implementation. Communicate with the Regional Implementation Team so that information and data can be fed back to the State to resolve systems barriers. Development District Action Plan as part of the District Improvement Process and alignment of individual School improvement plans. How - Improvement Cycles PDSA Cycle Policy to Practice Feedback Loops Usability Testing Transformation Zones Plan Do Study Act Definition: An improvement process is the use of a specified set of procedures to initiate or improve a procedure, process, or product by Behaviorally defining the issue or intervention and developing a plan (Plan), Executing the plan as intended (Do), Studying the data obtained during and after the execution of the Plan (Study), Making subsequent adjustments to either the Intervention process or the Implementation process (Act) Go again if need be! Shorthand term: PDSA 9

10 External System Change Support Practice Informed Policy (PIP) Feedback Policy Enabled Practices (PEP) How Policy to Practice Feedback Loops Policy (Plan) Study - Act Practice (Do) Usability Testing Usability testing is an efficient and effective method for operationalizing a program and for establishing the necessary implementation supports in practice. The usability testing approach also allows for repeated use of PDSA Cycles to quickly adjust the program with each iteration so each step is testing a new and, hopefully, improved version. Transformation Zones Make use of an innovation in practice (operationalize, fidelity, outcomes) Establish implementation supports (contextualize Drivers and Stages) Engage leaders in the PEP-PIP improvement cycle to align system components and functions Create capacity and momentum for larger scale changes 10

11 How Implementation Drivers Student Benefit Performance Assessment (Fidelity) Selection Training Coaching Integrated & Compensatory Systems Intervention Facilitative Administration Decision Support Data System Technical Leadership Adaptive Fixsen & Blase, 2007 How Implementation Drivers Student Benefit Performance Assessment (Fidelity) Coaching Training Selection Integrated & Compensatory Fixsen & Blase, 2007 Purpose: Selection Select for the unteachables Screen for pre-requisites Set expectations Allow for mutual selection Improve likelihood of retention after investment Improve likelihood that training, coaching, and supervision will result in implementation 11

12 Coaching Purpose: Ensures fidelity Ensures implementation Develops clinical and practice judgment Provides feedback to selection and training processes Grounded in Best Practices Training Purpose: Establish Buy-in Knowledge acquisition Skill Development Performance Assessment Purpose: Measure fidelity Ensure implementation Reinforce staff and build on strengths Feedback to agency on functioning of Recruitment and Selection Practices Training Programs (pre and in-service) Supervision and Coaching Systems Interpretation of Outcome Data 12

13 How Implementation Drivers Student Benefit Performance Assessment (Fidelity) Selection Training Coaching Integrated & Compensatory Systems Intervention Facilitative Administration Decision Support Data System Fixsen & Blase, 2007 Systems Intervention Purpose: Identify barriers and facilitators for the new way of work. Create an externally and internally hospitable environment for the new way of work. Contribute to cumulative learning in multisite projects. Facilitative Administration Purpose: Facilitates installation and implementation of the Drivers. Aligns policies and procedures. Takes the lead on Systems Interventions. Looks for ways to make work of practitioners and supervisors easier!! 13

14 Decision Support Data System Purpose: To make a difference for children. Provide information to assess effectiveness of evidence-based practices. Analyze the relationship of fidelity to outcomes. To guide further program development. Engage in continuous quality improvement Interaction with Core Implementation Components. Celebrate success. Be accountable to consumers and funders. How Implementation Drivers Student Benefit Performance Assessment (Fidelity) Selection Training Coaching Integrated & Compensatory Systems Intervention Facilitative Administration Decision Support Data System Leadership Technical Adaptive Fixsen & Blase, 2007 Leadership Different challenges call for different strategies. Technical Strategies Adaptive Strategies According to Ron Heifetz and his colleagues at Harvard s Kennedy School of Government, one of the biggest mistakes leaders make is to incorrectly identify the type of challenge they are facing. Using technical approaches for adaptive issues (and vice versa) 14

15 Technical Challenges Perspectives are aligned (views, values) Definition of the problem is clear Solution and implementation of the solution is relatively clear, although may be complicated There can be a primary locus of responsibility for organizing the work Technical Strategies Use established norms/ goals Define problems Provide solutions Clarify roles and responsibilities Assign tasks Manage conflict Maintain order Adaptive Challenges Legitimate, yet competing, perspectives emerge Definition of the problem is unclear There are different perspectives on the issue at hand Solution and implementation is unclear and requires learning Primary locus of responsibility is not a single entity or person Ron Heifetz, Leadership without Easy Answers,

16 ALIGNMENT Implementation Teams Adaptive Strategies Get on the Balcony Identify the Adaptive Challenge Regulate Distress Maintain Disciplined Attention Give the Work Back to the People Protect All Voices Ron Heifetz, Leadership without Easy Answers, 1996 Developing Feedback Loops and Continuous Improvement Cycles State Management Team Integrated & Compensatory Providing feedback and data on implementation efforts State Leadership Team Leadership Regional Implementation Team Integrated & Compensatory Leadership District Team Integrated & Compensatory Integrated & Compensatory Leadership Providing supports for effective practices implemented with fidelity Leadership System Alignment Nation-level Departments State-level Department Counties, Regions Districts Effective Practices for Students FORM SUPPORTS FUNCTION School 16

17 Summary Improving Outcomes through the Active Use of Effective Implementation Strategies -- Purposeful selection of an effective and feasible What. Conceptualize a change process so that effective interventions for the population of concern can become embedded and sustained in socially complex settings. stage-matched activities to guide the process implementation drivers to build the infrastructure Improvement processes are critical. The work is never done because the environment is in motion. Invest in the development of organized, expert implementation support. 17

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