1. FACING REALITY: WHAT IT TAKES TO IMPLEMENT SYSTEMS CHANGE National Webinar May 16, 2011

2. Overview of Webinar Marketa Garner Gautreau Western and Pacific Child Welfare Implementation Center

3. Webinar Overview  Webinar goals  Plans for webinar series  Introduction to Implementation Centers  Basic understanding of Implementation Science  Reflections on lessons learned in systems change and implications for states  Your participation is critical! Send us your questions and answer polling questions

4. Introduction to the Implementation Centers Michelle Graef Midwest Child Welfare Implementation Center

5. Implementation Centers and National Resource Centers  Improve child welfare administration and practice  Meet Federal performance standards and implement effective programs  Pursue sustainable and positive systems change  Improve outcomes for children, youth & families Funded by the Children’s Bureau to provide States and Territories, Tribes, and Tribal Consortia individualized training and technical assistance (T/TA) to:

6.  States and Tribes are sometimes without the resources necessary to implement comprehensive strategic plans  National Resource Centers have limited resources to provide intensive, long-term TA  Implementation Centers provide in-depth and long-term consultation and peer networking opportunities to States and Tribes Implementation Centers: Filling the Gap

7. Project Partner Roles Building Capacity to Implement Sustainable Systems Change Implementation CenterChild Welfare Agency Conduct organizational and readiness assessment to identify potential barriers to implementation Develop and implement strategies to address organizational barriers and improve readiness for implementation Guide planning processDevelop project plan Provide and coordinate technical assistance resources to support organizational change and facilitate implementation Provide and coordinate organizational/ human resources to manage change and support implementation Provide technical assistance to promote best practices in organizational and child welfare systems change Utilize best practices to align people, process, structure, measurement/rewards, and technology around the desired systems change Facilitate implementationImplement plan Develop methodology (e.g. benchmarks, tools) to monitor implementation progress Collect project data; use data reports to monitor implementation and inform /refine implementation strategies Evaluate project outcomesUse findings and lessons learned to inform future implementation efforts

9. Who are the Implementation Centers? Implementation CenterOrganization Northeast & Caribbean Implementation Center (NCIC) University of Southern Maine, Muskie School of Public Service Atlantic Coast Child Welfare Implementation Center (ACCWIC) University of Maryland School of Social Work Midwest Child Welfare Implementation Center (MCWIC) University of Nebraska-Lincoln, Center on Children, Families & the Law Mountains & Plains Child Welfare Implementation Center (MPCWIC) University of Texas at Arlington, Center for Child Welfare partnering with the University of Denver, Butler Institute and The Native American Training Institute (NATI) Western & Pacific Child Welfare Implementation Center (WPIC) American Institutes for Research, partnering with National Indian Child Welfare Association, Center for the Study of Social Policy, National Technical Assistance Center for Children’s Mental Health at Georgetown University, and the Florida Mental Health Institute at the University of South Florida

10. Learn More Implementation CentersWebsite Northeast & Caribbean Implementation Center (NCIC) http://ncic.muskie.usm.maine.edu Atlantic Coast Child Welfare Implementation Center (ACCWIC) www.accwic.org Midwest Child Welfare Implementation Center (MCWIC) www.mcwic.org Mountains & Plains Child Welfare Implementation Center (MPCWIC) www.mpcwic.org Western & Pacific Child Welfare Implementation Center (WPIC) www.wpicenter.org

11. Understanding Implementation Science Cathy Fisher Atlantic Coast Child Welfare Implementation Center

12. Implementation is Complex I

13. THERE IS SCIENCE TO GUIDE US  There is a body of research on effective implementation  Most has focused on research/evidenced based practices  Child welfare systems have been slow to explore the science  Well-defined and developed child welfare models are foundational to sound implementation  Application of implementation science may improve child welfare outcomes  Implementation is both an art and a science.

14. THERE IS SCIENCE TO GUIDE US  There is a body of research on effective implementation  Most has focused on research/evidenced based practices  Child welfare systems have been slow to explore the science  Well-defined and developed child welfare models are foundational to sound implementation  Application of implementation science may improve child welfare outcomes  Implementation is both an art and a science.

15. Models to support Implementation  Implementation Science  National Implementation Research Network (NIRN)  Phases of Change  John Kotter, Harvard Business School  Managing Change  ADKAR Model – Prosci (Awareness, Desire, Knowledge, Ability and Reinforcement)

16. Key Elements of Systems Change

17. Getting from here to there… Stages of Implementation

18. SustainabilityInnovationFull OperationInitial ImplementationInstallationExploration

19. Stages of Implementation Core Activities Exploration Conduct organizational assessment Garner leadership and stakeholder support Review literature Solicit multiple perspectives on needs and opportunities Establish baseline performance Develop intervention model Design/Installation Develop plans: Implementation Communication Change management Define goals and benchmarks Engage stakeholders Conduct readiness assessment Align organization systems/supports Initial Implementation Build staff competency Communicate project status Monitor fidelity of implementation Monitor implementation climate Identify and address barriers to implementation Provide performance feedback to staff, management, and stakeholders Adapted from Implementation Research: A Synthesis of the Literature (2008) The National Implementation Research Network

20. Stages/Activities Full Implementation Apply lessons learned from initial implementation to full operation Track fidelity through quality assurance and performance evaluation data Solicit feedback from multiple stakeholders and consumers Evaluate impact on child and family outcomes Innovation Adapt or adjust intervention model to reflect lessons learned from stakeholder feedback, tracking, evaluation Communicate changes and rationale Re-build competency around modified model Sustainability Establish long term funding sources Align ongoing quality assurance and performance measurement with model Promote visibility of new practice and successful outcomes Adapted from Implementation Research: A Synthesis of the Literature (2008) The National Implementation Research Network

21. Selection Training Coaching Performance Assessment (Fidelity) Systems Intervention LEADERSHIP Decision Support Data System Integrated & Compensatory COMPETENCY ORGANIZATION Facilitative Administration © Fixsen & Blase, 2008 National Implementation Research Network: Implementation Drivers

22. Project Management Change Management A structured approach to managing tasks, resources and budget to achieve a desired outcome A set of processes and tools to manage the people engaged in the project to achieve the desired outcome Project vs. Change Management * Implementation requires managing the project and managing the change

23. Process for Implementing Change

24.  Leaders:  Make the case for change  Guide the organization through change  Keep the focus, stay engaged and reinforce change  Perception of change based on position in the organization  Individuals change at different rates  All change is individual- It’s all about me! Changing the Organization

25. ADKAR - Change Management Model  Awareness of the need for change  Desire to participate and support the change  Knowledge of how to change  Ability to implement the required skills/behaviors  Reinforcement to sustain the change Hiatt, J. (2006) ADKAR: a Model for Change in Business, Government and our Community : How to Implement Successful Change in our Personal Lives and Professional Careers. Change Management Learning Center, Prosci, CO.

26. Engaging in Change  Establish readiness for change  Build trusting relationships  Develop champions  Balance flexibility vs. staying the course  Allocate time and resources  Take regular organization temperature  Communicate, before, during and after  Clarify the impact of the change at the individual level

27. Maria Scannapieco Mountains and Plains Child Welfare Implementation Center Lessons Learned

28. Successful, sustained implementation isn’t easy!  Implementation Science teaches the need for a purposeful, somewhat resource heavy approach to change  Burdened child welfare systems may struggle with this level of infrastructure commitment

29. Implementation Centers have found the following to be key:  Leadership  Trusting relationships  Clarifying who owns the plan  Flexibility versus staying the course

30. Lessons Learned  Time and resources  Communication, communication, communication  Defining roles and responsibilities  Readiness and reality

31. Lessons Learned  Champions  Measures of success  Capacity building

32. Lessons Learned with Tribes  Different issues of trust  Understanding of implementation science  Building capacity and access to technology  Each Tribe has unique identity with different languages, customs and traditions  Layers of complexity  Rural insular communities  Tribal politics

33. What are your experiences around implementation of systems change?  What strategies have been most successful as your organization prepared for child welfare reform?  How were staff prepared to take on a new systems change effort in the organization?  What role have staff and stakeholders played in leading change efforts?

34. Topics for Future Implementation Center Webinars  What is your preference?  Developing, implementing, and enhancing practice models  Increasing engagement/collaboration with stakeholders  Using data for effective program management

35. For Further Reading  National Implementation Research Network - www.fpg.unc.edu/~nirn  ADKAR - www.change-management.com  John Kotter - www.kotterinternational.com

36. We want to hear from you…. Send us your questions and comments:  Marketa Gautreau - mgautreau@air.org  Michelle Graef – mgraef@unlnotes.unl.edu  Cathy Fisher – cfisher@umaryland.edu  Maria Scannapieco - mscannapieco@uta.edu