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Dean L. Fixsen, Karen A. Blase, Michelle A. Duda, Sandra F. Naoom, Melissa Van Dyke National Implementation Research Network Implementation and System.

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Presentation on theme: "Dean L. Fixsen, Karen A. Blase, Michelle A. Duda, Sandra F. Naoom, Melissa Van Dyke National Implementation Research Network Implementation and System."— Presentation transcript:

1 Dean L. Fixsen, Karen A. Blase, Michelle A. Duda, Sandra F. Naoom, Melissa Van Dyke National Implementation Research Network Implementation and System Change NHSC 2008

2 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 NCLB Act & IDEA 2004 Implementation of scientifically based research Ensure that school personnel have the skills and knowledge necessary to improve the academic achievement and functional performance of children, including the use of scientifically based instructional practices, to the maximum extent possible;

3 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 High School Education 15 million high school students 1.2 million high school teachers 20,000 high schools 3,143 counties 60 states & U.S. jurisdictions

4 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Research to Practice RESEARCH PRACTICE GAP IMPLEMENTATION Improved Student Outcomes Improved Education Systems

5 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 “In theory there is no difference between theory and practice; in practice, there is.” Yogi Berra Thanks to Joanne Cashman, The National Association of State Directors of Special Education

6 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Research to Practice Research to Practice Gap What is known is not what is adopted to help students, families, and communities Implementation Gap What is adopted is not used with fidelity and good outcomes for students. What is used with fidelity is not sustained for a useful period of time. What is sustained is not used on a scale sufficient to impact all high school students.

7 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 0 100 200 300 400 500 600 700 800 900 ≤197219741976197819801982 0 50 100 150 200 250 300 Cumulative Couples Cumulative Homes Fixsen, Blase, Timbers, & Wolf (2001) Teaching–Family Model

8 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Reviews Human service prevention and treatment program literature (e.g. substance abuse, MH, justice, education, health) Literature re: advanced manufacturing technologies, business, management, agriculture, engineering Successful practices on a national scale (e.g. SW-PBS, SFA, MST, FFT, NFP, SE, IDDT, DBT, MI, PMTO, Incredible Years)

9 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Insufficient Methods Implementation What Works Clearinghouse Pretty small Implementation What Does Not Work Clearinghouse Very large

10 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Insufficient Methods Excellent experimental evidence for what does not work Diffusion/dissemination of information by itself does not lead to successful implementation (research literature, mailings, promulgation of practice guidelines) Training alone, no matter how well done, does not lead to successful implementation.

11 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Insufficient Methods Excellent evidence for what does not work Implementation by edict/ accountability by itself does not work Implementation by “following the money” by itself does not work Implementation without changing supporting roles and functions does not work Paul Nutt (2002). Why Decisions Fail

12 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 What Works Effective intervention practices + Effective implementation practices = Good outcomes for students

13 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implement Innovations EffectiveNOT Effective Effective NOT Effective IMPLEMENTATION INTERVENTION Student Benefits

14 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation An effective intervention is one thing Implementation of an effective intervention is a very different thing

15 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Letting it happen Recipients are accountable Helping it happen Recipients are accountable Making it happen Purposeful use of implementation practices and science Implementation teams are accountable Based on Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou, 2004

16 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Sustainable Benefits: Goal Start with the end in mind What will it take to: make statewide use of high school innovations that produce increasingly effective outcomes for the next 50 years?

17 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Sustainable Benefits: What Rigorous curriculum and instruction Assessment and accountability Teacher quality/ PD Student and family supports Stakeholder engagement Leadership and governance Organization and structure Resources for sustainability

18 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Sustainable Benefits: How Choosing an innovation Implementation drivers Implementation stages Implementation teams System improvement

19 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Choosing an Innovation Core intervention components Clearly described (who/what) Fully operationalized (do/say) Practical measure of fidelity ** Field tested (recursive revision) Contextualized (org./systems fit) Effective (worth all the effort)

20 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Sustainable Benefits Choosing an innovation Implementation drivers Implementation stages Implementation teams System improvement

21 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Drivers Reliably produce predictable outcomes for students, families, and communities

22 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 INTEGRATED & COMPENSATORY CONSULTATION & COACHING STAFF PERFORMANCE EVALUATION STAFF PERFORMANCE EVALUATION FACILITATIVE ADMINISTRATIVE SUPPORTS RECRUITMENT AND SELECTION PRESERVICE TRAINING SYSTEMS INTERVENTIONS SYSTEMS INTERVENTIONS Implementation Drivers DECISION SUPPORT DATA SYSTEMS

23 OUTCOMES (% of Participants who Demonstrate Knowledge, Demonstrate new Skills in a Training Setting, and Use new Skills in the Classroom) TRAINING COMPONENTS Knowledge Skill Demonstration Use in the Classroom Theory and Discussion 10% 5%0%..+Demonstration in Training 30% 20% 0% …+ Practice & Feedback in Training 60% 5% …+ Coaching in Classroom 95% Joyce and Showers, 2002 Integrated & Compensatory

24 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Sustainable Benefits Choosing an innovation Implementation drivers Implementation stages Implementation teams System improvement

25 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Stages of Implementation Exploration Installation Initial Implementation Full Implementation Innovation Sustainability Implementation occurs in stages: Fixsen, Naoom, Blase, Friedman, & Wallace, 2005 2 – 4 Years

26 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Stages of Implementation Exploration Installation Initial Implementation Full Implementation Innovation Sustainability Implementation occurs in stages: Fixsen, Naoom, Blase, Friedman, & Wallace, 2005 2 – 4 Years Intervention Outcomes 0% 100% Implementation Outcomes

27 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Sustainable Benefits Choosing an innovation Implementation drivers Implementation stages Implementation teams System improvement

28 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Letting it happen Recipients are accountable Helping it happen Recipients are accountable Making it happen Purposeful use of implementation practices and science Implementation teams are accountable Based on Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou, 2004

29 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Team A group that knows the innovation very well (formal and craft knowledge) A group that knows how to implement that innovation with fidelity and good effect A group that accumulates data & experiential knowledge -- more effective and efficient over time (information economics, K. Arrow)

30 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Team School Management (leadership, policy) Administration (HR, structure) Supervision (nature, content) Teachers & Staff State and Community Context District Implementation Team Simultaneous, Multi-Level Interventions

31 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Team Prepare Communities Prepare schools faculty, staff Work with Researchers Assure Implementation Prepare Districts Assure Student Benefits

32 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Sustainable Benefits Choosing an innovation Implementation drivers Implementation stages Implementation teams System improvement

33 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 A Sobering Observation "All organizations [and systems] are designed, intentionally or unwittingly, to achieve precisely the results they get." R. Spencer Darling Business Expert

34 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 System Change To scale up interventions we must first scale up implementation capacity Building implementation capacity is essential to maximizing the use of EBPs and other innovations Large scale, real time change

35 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 System Change Implement Innovations Sustainable Infrastructure Initiate & Manage Change

36 Management Group Implementation Team #1 (Up to 50 Schools) Policy Enabled Practice (PEP) Practice Informed Policy (PIP) System Change State Transformation Team (STT)

37 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 System Change Transformation Zones Focus on one thing – do it well Amend the usual rules Establish the first operating example of an innovation & system change Manage change, reduce risks A zone may be a region, a school, a part of a system Depends on where you choose to start

38 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Transformation Zone Management Group and Practice Group meet monthly in order to bring about system change (urgent, real time) –The first Implementation Team begins the implementation process in 5 – 10 schools (Transformation Zone) –Repeat the process in subsequent sets of 5 – 10 schools –CAPACITY DEVELOPMENT GOAL: Maximize opportunities for Implementation Team members to learn

39 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Cost

40 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Systems Change State Department Districts Schools Teachers/ Staff Effective Practices ALIGNMENT Federal Departments Implementation Teams FORM SUPPORTS FUNCTION

41 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Scale Up Website New OSEP Center (Fixsen, Blase, Horner, Sugai) State Implementation and Scaling up of Evidence-based Practices (SISEP) www.scalingup.org

42 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Thank You We thank the following for their support Annie E. Casey Foundation (EBPs and cultural competence) William T. Grant Foundation (implementation literature review) Substance Abuse and Mental Health Services Administration (implementation strategies grants; NREPP reviews; SOC analyses of implementation; national implementation awards) Centers for Disease Control & Prevention (implementation research contract) National Institute of Mental Health (research and training grants) Juvenile Justice and Delinquency Prevention (program development and evaluation grants Agency for Children and Families (child welfare leadership development contract) Office of Special Education Programs (implementation capacity development center contract)

43 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 For More Information Dean L. Fixsen 813-974-4446 dfixsen@fmhi.usf.edu Karen A. Blase 813-974-4463 kblase@fmhi.usf.edu National Implementation Research Network At the Louis de la Parte Florida Mental Health Institute University of South Florida http://nirn.fmhi.usf.edu

44 Copyright © Dean L. Fixsen and Karen A. Blase, 2008 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: http://nirn.fmhi.usf.edu/resources/publications/Monograph/index.cfm Implementation Research: A Synthesis of the Literature


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