COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...
COSIG CONFERENCE BROCHURE.pdf - Drexel University College ... COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...
COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 What we know about EBPs… • Practice interventions • Supported by evidence that they are effective • We all want to do what is known to work best for the consumers with whom we work • EBP implementation – easier said than done? Promoting Recovery-Oriented Programs & Practices …moving EBPs into routine care is more challenging than inventing them! It is one thing to say with the prophet Amos, “Let justice roll down like mighty waters,” and quite another to work out the irrigation system. Promoting Recovery-Oriented Programs & Practices William Sloane Coffin What we know so far about implementation science • Fixsen, et al. synthesis of literature (2005) – Searched 9 academic databases for “implementation” since 1970 – Across multiple domains (e.g. agriculture, business, child welfare, engineering, health, juvenile justice, manufacturing, medicine, mental health, nursing, and social services) – Reviewed 1,054 – Cut to 734 deemed “significant” – Only 22 reported results of studies or meta analyses of implementation variables Promoting Recovery-Oriented Programs & Practices What’s Common? Despite tremendous variability in content and context, across domains: • They have similar implementation problems • They showed similar implementation solutions Promoting Recovery-Oriented Programs & Practices “Problem” themes • No clear pathways to implementation yet • What is implemented – is often not used with high fidelity and good effect – disappears with time and staff turnover • “Usability” has little to do with the weight of the evidence re: program outcomes – Evidence on effectiveness helps us select what we want to implement – Evidence on outcomes does not help us implement the program Promoting Recovery-Oriented Programs & Practices “Solutions” themes (Facilitators to implementation) • “Buy-in” and champions • Adequate time for “exploration” • Perceived benefit & manageable risk • Reduction of systems and policy barriers • Right resources at the right time • Implementation teams with clear change leadership • Organizational change Promoting Recovery-Oriented Programs & Practices 2
COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 “Solutions” themes (Facilitators to implementation) • Effective strategies to change adult behavior (e.g. front line staff, supervisors) • Effective strategies to change program operations (e.g. H.R., scheduling) • Access to knowledgeable people (“purveyors”) • Trusting relationship with purveyors • Fidelity and outcomes measures Promoting Recovery-Oriented Programs & Practices How do we know an implementation is successful? • Intervention Outcomes • Implementation Outcomes Promoting Recovery-Oriented Programs & Practices How do we know an implementation is successful? • Intervention Outcomes –The “Evidence” in EBPs –Collection of intervention outcomes in every application • Implementation Outcomes Promoting Recovery-Oriented Programs & Practices How do we know an implementation is successful? • Intervention Outcomes – The “Evidence” in EBPs – Collection of intervention outcomes -every application • Implementation Outcomes – Fidelity scales measure the success of the implementation effort – Presence or absence of key elements – Scores allow us to attribute changes in intervention outcomes (consumer, etc.) to the EBP Promoting Recovery-Oriented Programs & Practices The research on EBPs tells us: Effective intervention practices + Effective implementation practices Good outcomes for consumers No other combination of factors reliably produces desired outcomes for consumers. Promoting Recovery-Oriented Programs & Practices What have we found in Ohio? • Numerous factors appear to influence the success of IDDT implementation • These factors and strategies can be described so can begin to measure their presence or absence • Observations support some themes in the literature about core implementation components Promoting Recovery-Oriented Programs & Practices 3
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<strong>COSIG</strong> Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006<br />
“Solutions” themes<br />
(Facilitators to implementation)<br />
• Effective strategies to change adult<br />
behavior (e.g. front line staff, supervisors)<br />
• Effective strategies to change program<br />
operations (e.g. H.R., scheduling)<br />
• Access to knowledgeable people<br />
(“purveyors”)<br />
• Trusting relationship with purveyors<br />
• Fidelity and outcomes measures<br />
Promoting Recovery-Oriented<br />
Programs & Practices<br />
How do we know an<br />
implementation is successful?<br />
• Intervention Outcomes<br />
• Implementation<br />
Outcomes<br />
Promoting Recovery-Oriented<br />
Programs & Practices<br />
How do we know an<br />
implementation is successful?<br />
• Intervention Outcomes<br />
–The “Evidence” in EBPs<br />
–Collection of intervention outcomes<br />
in every application<br />
• Implementation Outcomes<br />
Promoting Recovery-Oriented<br />
Programs & Practices<br />
How do we know an<br />
implementation is successful?<br />
• Intervention Outcomes<br />
– The “Evidence” in EBPs<br />
– Collection of intervention outcomes -every<br />
application<br />
• Implementation Outcomes<br />
– Fidelity scales measure the success of the<br />
implementation effort<br />
– Presence or absence of key elements<br />
– Scores allow us to attribute changes in<br />
intervention outcomes (consumer, etc.) to the<br />
EBP<br />
Promoting Recovery-Oriented<br />
Programs & Practices<br />
The research on EBPs tells us:<br />
Effective intervention practices<br />
+ Effective implementation<br />
practices<br />
Good outcomes for consumers<br />
No other combination of factors reliably<br />
produces desired outcomes for consumers.<br />
Promoting Recovery-Oriented<br />
Programs & Practices<br />
What have we found in Ohio?<br />
• Numerous factors appear to influence the<br />
success of IDDT implementation<br />
• These factors and strategies can be<br />
described<br />
so can begin to measure their presence or<br />
absence<br />
• Observations support some themes in the<br />
literature about core implementation<br />
components<br />
Promoting Recovery-Oriented<br />
Programs & Practices<br />
3
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