Barbara Sims, Co-Director National SISEP Center FPG Child Development Center University of North Carolina at Chapel Hill Greensboro.NC March 20, 2013 Implementation Teams: Getting the Work Done NC SIP Spring Networking Meeting

IMPLEMENTATION TEAMS Organized, expert assistance to develop and sustain an accountable and effective structure

Impl. TeamNO Impl. Team Effective Making it Happen IMPLEMENTATION INTERVENTION 80%, 3 Yrs 14%, 17 Yrs Balas & Boren, 2000 Green & Seifert, 2005 Fixsen, Blase, Timbers, & Wolf, 2001 Letting it Happen Helping it Happen Implementation Teams

Who Makes Change Happen? Invest in the development of implementation capacity and expanded, diversified leadership  Vendors vs. Implementation Teams  Linked Teaming Structures  Adaptive Problem Solving Units Implementation Teams

“We tend to focus on snapshots of isolated parts of the system and wonder why our deepest problems never seem to get solved.” —Senge, 1990 Linked Team Structures Implementation Teams School-based Implementation Team School-based Implementation Team District-based Implementation Team District-based Implementation Team Regionally-based Implementation Team State-based Implementation Team State-based Implementation Team

Provide Implementation Support  Focus is on  Quality, integration, sustainability of Drivers  Data-based decision-making  Problem-solving and analytical engagement  Purposeful adaptation and planned supports  Alignment and Sustainability  Provide accountable structure to move intervention through stages of implementation for any initiative Implementation Teams

Essential Functions Team Structure Intervention Implementation Improvement Cycles System Change Implementation Teams Implementation Teams know and apply:

Building Capacity to Lead Building capacity requires more than just forming Implementation Teams…There needs to a be new way of…  Organizing to address complex problems  Talking about issues  Making decisions  Relating to one another Implementation Teams

Forming the Team Selection Criteria Stakeholders vs. Implementation Team Interviews Existing staff working intentionally Moving from “hand picked” to specific criteria Frustration as a motivator Requisite variety Duplication of skill sets Implementation Teams

Initial Team Functioning Clear understanding of the mission (or reason) for the work  Important enough to warrant the effort required to develop effective and sustainable implementation infrastructure Clear relationship between the identified intervention and overall mission Clear definition of the critical components and operationalization of the intervention Implementation Teams

Intervention Training Develop Intervention Training Plan  Implementation team members as initial trainers  If outside experts are used you need to assess »Innovation Fluency »Use of Training Best Practices »Data from people they have ‘trained’ Implementation Teams

Intervention Training Plan Aspects requiring new knowledge Description Purpose Supporting data Examples Critical components Key behaviors Implementation Teams

Intervention Training Plan Identify what will be taught by whom Duration of each topic Aspects requiring new skills  Behavior rehearsals  Identify and prepare behavior rehearsal leaders and confederates Implementation Teams

Intervention Training Plan Prioritize training topics Develop order of training and assessment Identify (or develop) fidelity measures  Direct observation  Interviews/surveys  Records reviews Implementation Teams

Fidelity Assessment Immediately after initial training Usability testing approach  Rapid cycle problem solving  Designed to build skills of team members »Assessment process »Training »Intervention Implementation Teams

Coaching Plan Initial coaching may be done by Implementation Team members  Team members who know the innovation  Team members who know how to coach Initial topics result from:  Debriefing  Weekly observations  Usability testing Implementation Teams

Coaching Plan Weekly Implementation Team meetings Develop selection criteria for coaches Coaches as pivot point  PDSA to identify »Skill deficiencies »Time and opportunity barriers »Systems issues Implementation Teams

Indicators of Success Indicators Essential Functions Representative, Accountable Terms of Reference, Communication Protocols Develop Team Structure Demonstrate fluency in strategy Operationalize Interventions when needed Know and apply the Intervention Develop infrastructure Conduct Stage-appropriate work Know and apply Implementation Institutionalize communication cycles Use data for decision making, problem solving and communication cycles Know and apply Improvement Cycles Demonstrate knowledge of system components and skills for system building Know and apply Systems Change Implementation Teams

Build capacity to do what? Essential Functions Representative, Accountable MOU, Communication Protocols Develop Team Structure Demonstrate fluency in strategy Operationalize Interventions when needed Know and apply the Intervention Develop infrastructure Conduct Stage-appropriate Work Know and apply Implementation Institutionalize feedback loops Use data for decision making, problem solving and feedback loops Know and apply Improvement Cycles Demonstrate knowledge of system components and skills for system building Know and apply Systems Change Implementation Teams RESULTS …can effect change throughout the system and make decisions …can promote implementation of core components, adaptations, and infrastructure …can guide implementation and build capacity throughout the organization and system …can address challenges and do action planning …can improve access, reach or scale, connection, and influence decision-making

©Copyright Dean Fixsen and Karen Blase This 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 or transform this work. Any of the above conditions can be waived if you get permission from the copyright holder.

Get Connected! For more on Implementation Science