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“What It Takes” for Implementation:“What It Takes” for Implementation:“What It Takes” for Implementation:“What It Takes” for Implementation:Aligning Structures and Processes for Aligning Structures and Processes for Aligning Structures and Processes for Aligning Structures and Processes for

Strengthening SystemsStrengthening SystemsStrengthening SystemsStrengthening Systems

Renée I. Boothroyd, Renée I. Boothroyd, Renée I. Boothroyd, Renée I. Boothroyd, Ph.D., M.A., M.P.H.Ph.D., M.A., M.P.H.Ph.D., M.A., M.P.H.Ph.D., M.A., M.P.H.With Directors Institute Faculty Anita Barbee, Danna Fabella,

Mark Lapiz, Karen Lofts-Jarboe, Crystal Luffberry, Linda Martinez,

and Gary Taylor

March 22, 2017March 22, 2017March 22, 2017March 22, 2017

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Evidence-Based Strategies and Getting to Social Impact

Evidence-Based, Effective

Strategies

Improved safety, permanency &

wellbeing for children, families, communities

33

“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation

1. A focus on People matters.

2. A focus on the Organization

matters just as much if not more.

3. Leadership for change lives at multiple levels.

4. Supporting use of the practice model is a deliberate, ongoing Process.

4

4

A Focus on People Matters . . . A Focus on People Matters . . . A Focus on People Matters . . . A Focus on People Matters . . .

Not Just “Train and Hope”Not Just “Train and Hope”Not Just “Train and Hope”Not Just “Train and Hope”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% 60% 5%

…+ Coaching in Classroom

95% 95% 95%

—Joyce and Showers, 2002

EvidenceEvidenceEvidenceEvidence----Based Strategies: Based Strategies: Based Strategies: Based Strategies: Getting to Social Impact?Getting to Social Impact?Getting to Social Impact?Getting to Social Impact?

Effective Interventions

Actual SupportsYears 1-3

Outcomes Years 4-5

Every Worker Trained

Fewer than 50% of the workers received

some training

Fewer than 10% of the agencies used the

model as intended

Every Worker

Continually

Supported

Fewer than 25% of

those workers

received support

Vast majority of children & families do not benefit

66

“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation

1. A focus on People matters.

2. A focus on the Organizationmatters just as much if not more.

3. Leadership for change lives at multiple levels.

4. Supporting use of the practice model is a deliberate, ongoing Process.

7

70102030405060708090

100

Practitioner Development Organization Development

Op

era

tin

g 6

+ Y

rs.

N = 84

N = 219

Fixsen, Blase, Timbers, & Wolf (2001)

Group Homes adopting Evidence Based Strategies:

Where are they spending their resources?

Focus on People Matters . . . Focus on People Matters . . . Focus on People Matters . . . Focus on People Matters . . . Focus on Organization Matters Just as Much!Focus on Organization Matters Just as Much!Focus on Organization Matters Just as Much!Focus on Organization Matters Just as Much!

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Focus on People Matters . . . Focus on People Matters . . . Focus on People Matters . . . Focus on People Matters . . . Focus on Organization Matters Just as Much!Focus on Organization Matters Just as Much!Focus on Organization Matters Just as Much!Focus on Organization Matters Just as Much!

Welfare of Children

o Individual focus

o Accountability for

outcomes achieved

Child Welfare

o System focus

o Accountability for

services delivered

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9

Organization as “We are in this Together:”Organization as “We are in this Together:”Organization as “We are in this Together:”Organization as “We are in this Together:”Implementation Structures and Processes that:Implementation Structures and Processes that:Implementation Structures and Processes that:Implementation Structures and Processes that:

Use data

for

improve-

ment

Engage

leadership at

multiple levels

Meaningfully

involve

community

partners

Gather and share

feedback from

staff at all levels

about strengths

and challenges

Manage

addressing

how to

improve

policies and

practices

Create and

nurture change

HOST

1010

“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation

1. A focus on People matters.

2. A focus on the Organizationmatters just as much if not more.

3. Leadership for change lives at multiple levels.

4. Supporting use of the practice model is a deliberate, ongoing Process.

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Leadership for Change:Leadership for Change:Leadership for Change:Leadership for Change:

Most important and most changeable factor

associated with effective implementation!

WHO & HOWWHO & HOWWHO & HOWWHO & HOW

Integrate same functions

into leadership and

implementation team

structures and processes

Leadership & Management

Executive

• Demonstrate commitment to practice model and

partnerships

• Create and nurture opportunities for change

Aldridge, Boothroyd, Fleming, Lofts-Jarboe,

Morrow, Ritchie, & Sebian (2016)

Leadership as “We are in this Together:”Leadership as “We are in this Together:”Leadership as “We are in this Together:”Leadership as “We are in this Together:”

Role, Structures, & Processes at Role, Structures, & Processes at Role, Structures, & Processes at Role, Structures, & Processes at MMMMultiple Levelsultiple Levelsultiple Levelsultiple Levels

Cross-

Agency

• Align initiatives, manage conflicts, ensure usability

• Recommend policy and practice solutions to

address needs

• Communicate changes and successes

Vision and decision-making

authority, yet action and

follow-up may get dropped

Day-to-

Day

• Ensure buy-in and readiness for stage-based work

• Organize, align, sustain implementation

infrastructure

• Actively use data and other information for

continuous improvement

Get going, make progress, but

stall when faced with issues

outside scope of authority

Lots of things to do that

may not appear to fit

together - confusion,

frustration, “drift”

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Leadership for Change: MultiLeadership for Change: MultiLeadership for Change: MultiLeadership for Change: Multi----LeveLeveLeveLevellll

“Ensuring the ladder is against the right wall”

Facilitates

individual staff

Creates organizational

culture of best practices

among Teams/Groups

Ensures structures,

processes, policies, and

resources in the organization

to support use of the

practice model

Child and family

outcomes

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“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation

1. A focus on People matters.

2. A focus on the Organizationmatters just as much if not more.

3. Leadership for change lives at multiple levels of the organization.

4. Supporting use of the practice model is a deliberate, ongoing Process.

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Implementation is a Process:Implementation is a Process:Implementation is a Process:Implementation is a Process:Strengthening Systems for Social Impact

Evidence-Based, Effective Strategies

Local Capacity & Practices for Active Implementation &

Scale-Up

Supportive and Efficient Child & Family

Service Systems

Improved safety, permanency &

wellbeing for children, families, communities

Implementation Capacity and Performance

(people, processes, using data, partnership)

COMP LEX , S H I F T I NG CON TEX T

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Implementation Capacity & Performance

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“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation1. A focus on people matters.

� Workforce Development (Training, Ongoing Coaching for all staff)

2. A focus on the organization matters just as much if not more AND

3. Leadership for change lives at multiple levels.

�Organizational Readiness Building (Linked Leadership and

Implementation Teams)

�Engagement, Relationships, and Partnership

4. Supporting use of the practice model is a deliberate, ongoing process.

�Quality, Outcome, and System Improvement

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ACTIVITYHANDOUT

Common Project Management Structure:

Curious Questions

19

In your experience, how has this kind of

teaming structure worked in your

organization?

Where it is working well, what benefits do you and

your organization experience?

Where it is frustrating or troublesome, what

problems do you and your organization experience?

What may be missing?

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Functional Leadership and Implementation Teams

• “Initiative fatigue” - competing priorities, “program shift”

• Lost focus on what trying to do (“program drift”)

• Communication, feed-forward & feed-back loops

• Role confusion/clarity (“my role”)

• Differentiated responsibility (“our role”)

• Shared accountability and improvement

• Work together to actualize things in practice and move outcomes

(not convene around projects)

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“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation1. A focus on people matters.

� Workforce Development (Training, Ongoing Coaching for all staff)

2. A focus on the organization matters just as much if not more AND

3. Leadership for change lives at multiple levels.

�Organizational Readiness Building

(Linked Leadership and Implementation Teams)

�Engagement, Relationships, and Partnership

4. Supporting use of the practice model is a deliberate, ongoing process.

�Quality, Outcome, and System Improvement

HOST

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As in nature, a successful adaptation allows an

organization or community to take the best from its traditions,

identity, and history into the future.

Heifetz, Grashow, & Linsky (2009, p.23)

Starting from StrengthsStarting from StrengthsStarting from StrengthsStarting from Strengths

24

BREAK (15 mins)

25

25

My Role in Leading My Role in Leading My Role in Leading My Role in Leading Practice Model Implementation Practice Model Implementation Practice Model Implementation Practice Model Implementation

and System Changeand System Changeand System Changeand System Change

Renée I. Boothroyd, Renée I. Boothroyd, Renée I. Boothroyd, Renée I. Boothroyd, Ph.D., M.A., M.P.H.Ph.D., M.A., M.P.H.Ph.D., M.A., M.P.H.Ph.D., M.A., M.P.H.With Directors Institute Faculty Anita Barbee, Danna Fabella, Mark

Lapiz, Karen Lofts-Jarboe, Crystal Luffberry, Linda Martinez, and

Gary Taylor

March 22, 2017March 22, 2017March 22, 2017March 22, 2017

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“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation“What it Takes” for Implementation1. A focus on people matters.

� Workforce Development (Training, Ongoing Coaching for all staff)

2. A focus on the organization matters just as much if not more AND

3. Leadership for change lives at multiple levels.

�Organizational Readiness Building

(Linked Leadership and Implementation Teams)

�Engagement, Relationships, and Partnership

4. Supporting use of the practice model is a deliberate, ongoing process.

�Quality, Outcome, and System Improvement

HOST

27

27

Organization as “We are in this Together:”Organization as “We are in this Together:”Organization as “We are in this Together:”Organization as “We are in this Together:”Implementation Structures and Processes that:Implementation Structures and Processes that:Implementation Structures and Processes that:Implementation Structures and Processes that:

HOSTUse data

for

improve-

ment

Engage

leadership at

multiple levels

Meaningfully

involve

community

partners

Gather and share

feedback from

staff at all levels

about strengths

and challenges

Manage

addressing

how to

improve

policies and

practices

Create and

nurture change

28

ACTIVITY- HANDOUT -

Leadership and Teaming

Structures and Processes

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Leadership is about me as an individual (my own

actions and behaviors to lead people). It is also about

the practices, procedures, and policies that I ensure

so that the broader organization enables and

supports use of the practice model (leading the

organization). I can use functional structures and

strategic processes to develop a “culture and climate”

in this organization that facilitate implementation of

the practice model and integrated initiatives.

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ACTIVITYFramed by Scenario A or Scenario B and your

own County experience:

Begin by discussing items as a group, then

each person completes the Assessment

Form individually.

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POLLS

32

Functional Leadership and Implementation Teams

Connect across multiple levels of the

organization (people and processes)

“Function

Over

Form”

• Areas of strength

• Areas for development

• New roles of existing teams

• New teams, team members

• New linkages, communications,

strategic roles

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Development CirclesDevelopment CirclesDevelopment CirclesDevelopment Circles1. A focus on people matters.

� Workforce Development (Training, Ongoing Coaching for all staff)

2. A focus on the organization matters just as much if not more AND

3. Leadership for change lives at multiple levels.

�Organizational Readiness Building

(Linked Leadership and Implementation Teams)

�Engagement, Relationships, and Partnership

4. Supporting use of the practice model is a deliberate, ongoing process.

�Quality, Outcome, and System Improvement

HOST