Michelle A. Duda, Ph.D., BCBA, Dean L. Fixsen, Ph.D. & Karen A. Blase Ph.D., Melissa Van Dyke, LCSW Frank Porter Graham Child Development Institute University of North Carolina – Chapel Hill Working Smarter: The implementation journey to improve student outcomes

Continuous Improvement Cycles Part 5

Changing on Purpose New practices do not fare well in existing organizational structures and systems For Example: Transformation is not like plug and play devices for a computer, it is more like changing operating systems while downloading delicate files.

Innovations and Systems EXISTING SYSTEM EFFECTIVE INNOVATIONS ARE CHANGED TO FIT THE SYSTEM EXISTING SYSTEM IS CHANGED TO SUPPORT THE EFFECTIVENESS OF THE INNOVATION EFFECTIVE INNOVATION

AN ETERNAL STRUGGLE THE YIN & YANG OF CHANGE Innovations and Systems EXISTING SYSTEM EFFECTIVE INNOVATIONS ARE CHANGED TO FIT THE SYSTEM EXISTING SYSTEM IS CHANGED TO SUPPORT THE EFFECTIVENESS OF THE INNOVATION EFFECTIVE INNOVATION

Changing on Purpose People, organizations, and systems… Cannot change everything at once (too big; too complex; too many of them and too few of us) Cannot stop and re-tool (have to create the new in the midst of the existing) Cannot know what to do at every step (we will know it when we get there) Many outcomes are not predictable (who knew!?)

Improvement Cycles PDSA (plan, do, study, act) Cycle Rapid – Cycle o Problem Solving o Practice Improvement Transformation Zones PEP-PIP Cycle (policy enabled practice – practice informed policy) Usability testing

Shewhart (1924); Deming & Juran (1948); Six-Sigma (1990) Plan – Decide what to do Do – Do it (be sure) Study – Look at the results Act – Make adjustments Cycle – Do over and over again until the intended benefits are realized PDSA Cycles: Trial & Learning

Plan – Find a way for kids to clean the stove routinely Do – Say, “clean the stove please” Study – See what parts they clean well and what parts they miss Act – Develop a card with a few cleaning hints Cycle – Continue until there are enough hints to routinely have a clean stove Clean the Stove

Actual Program Ideal Program To Narrow the Variation of the Actual from the Ideal PDSA Cycles: Trial & Learning David Thomas, 1985

Plan – Innovation core components Do – Selection, training, coaching Study – Fidelity, outcomes Act – Make adjustments Cycle – Do over and over again until fidelity is reached in a reasonable period of time PDSA Cycles: Trial & Learning

PLAN DO STUDY ACT P D S A P D S A P D S A P D S A Innovation Training Coaching Fidelity Administration

Plan – Coaching methods Do – Frequency, intensity, duration Study – Time to reach fidelity for the past 20 teachers/ staff Act – Revise coaching methods to shore up weak areas Cycle – do over and over again as conditions and people change forever more PDSA Cycle - Eternal

PDSA Cycles Shewhart (1924); Deming (1948); Six-Sigma (1990) Plan – Develop specific things to do Do – Do them (make sure) Study – See what happens Act – Make adjustments Cycle – Do over and over again until the goal is reached (again)

PEP-PIP Cycle Policy enabled practice (PEP) Practice informed policy (PIP) The PDSA cycle in slow motion Monthly instead of hourly, daily cycles Bigger issues where agreement (issues, solutions) and certainty (if this, then that) are not apparent

PEP-PIP Cycle Policy Enabled Practice (PEP) Practice Informed Policy (PIP) Management Team Implementation Teams System Change “External” Leadership

Policy Practice Feedback Loops Policy (Plan) Practice (Do) Structure Procedure Policy Practice Form Supports Function at every level (National, State, County, Municipal, Agency) Feedback Study - Act “External” System Change Support

System Alignment State Department Regions Agencies Practitioners/ Staff Effective Practices ALIGNMENT Federal Departments Implementation Teams FORM SUPPORTS FUNCTION

Summary Implementation is hard work Information by training by itself will NOT lead to changes in practitioner skills and abilities Implementation occurs in stages and getting to Full Implementation can take 2-4 years Each stage of implementation has it’s own set of activities and challenges Successful implementation occurs when the innovation (i.e. ESD) is embedded within the schools culture Successful implementation requires behavior change o Research related to implementation is still in it’s infancy o Policy enables new practice but practice needs to inform policy

"All organizations [and systems] are designed, intentionally or unwittingly, to achieve precisely the results they get." R. Spencer Darling Business Expert

Our Journey Continues

Next Steps on Our Journey On your journey of implementing this research into practice, continue your partnership with your regional T/TAC Instructor(s)

For More Information Dean L. Fixsen, Ph.D Michelle A. Duda, Ph.D At the Frank Porter Graham Child Development Institute University of North Carolina Chapel Hill, NC

For More Information Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005). Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231). Download all or part of the monograph at: Monograph/ Monograph/ To order the monograph go to: