Scottish Learning Festival

The Early Years Collaborative and the Model for Improvement

24th September 2014

The earliest years of child’s life represent the single greatest

chance to make a lasting impact on a child’s future

Joining the Dots (Professor Susan Deacon, 2011)

Chief Medical Officer’s Report

(CMO, 2007)

Early Intervention (Graham Allen,

2010)

Early Years Framework (2008)

‘Getting it Right for Every Child’ (GIRFEC,

2004)

Neuroscience and Brain

Development Research (Dr Bruce

Perry)

Scottish Government

Economic Modelling (2010)

The Evidence

Base

Scotland needs to work to bring

together the many people involved in

young children’s lives

To ensure that all children have appropriate,

positive experiences

Let’s provide a strong

foundation for future learning, behaviour and

health

Context National Outcome 2007

Our children have the best start in life and are ready to succeed

Early Years Framework 2008 10 key elements

Early Years Taskforce 2011 In partnership with local government, the NHS,

the police and the Third Sector

How?

Our Ambition

To make Scotland the best place in the world to grow up in by improving outcomes, and

reducing inequalities, for all babies, children, mothers, fathers and families across Scotland to ensure that all children have the best start

in life and are ready to succeed

Workstreams

Conception to 1 year

1 year to 30 months

30 months to

start of Primary School

Start of Primary

School to end of

Primary 4

Leadership

Scotland – the best

place in the world to grow up

Key Changes

The Big Ticket Items for Scotland

Informed by Early Years Collaborative testing across Scotland and experts in early years

Early support for Pregnancy and Beyond

Attachment and Child Development beyond Maternity Services

Continuity of Care in Transitions between Services

27-30 month Child Health Review

Developing Parenting Skills

Family Engagement to Support Early Learning

Addressing Child Poverty (inc. Income Maximisation)

Raising Attainment for All Twelve education departments

1-2 secondary schools and their cluster of primaries per local authority

 

Regional Learning Sessions

in September and December 2014

 

Full scale Learning Session will take place March 2015

MarshmallowChallenge

The

+ +

18 minutes

Rules1. It must be a free STANDING structure

2. You cannot be touching or holding on to thestructure after 18 minutes

3. Use as much or as little of the kit as you want

4. The entire marshmallow must be on top. Donot eat the marshmallow or cut it into pieces.

5. No phones allowed – no YouTube!

MarshmallowChallenge

The

Typical Progress

Start 18minutes

Typical Progress

Start 18minutes

Orient

Typical Progress

Start 18minutes

Orient Plan

Typical Progress

Start 18minutes

Orient Plan Build

Typical Progress

Start 18minutes

Orient Plan Build Ta-Da!

Typical Progress

Start 18minutes

Orient Plan Build Oh-No!

PoorPerformance?

What type of teamconsistently shows

Recent Graduates of Business School

GreatPerformance?

What type of teamconsistently shows

Nursery children!

Why?

Fail Win

Start18

minutes

Start18

minutes

• Find the best plan & execute• Focus on the structure

• Focus on the marshmallow• Play, prototype, experiment

DESIGN DESIGN DESIGN DESIGN APPROVE

Conference Room

Real World

The Typical Approach…

IMPLEMENT

DESIGN

TEST & MODIFY

TEST & MODIFY

APPROVEIF

NECESSARY

Conference Room

Real WorldTEST & MODIFY

The Quality Improvement Approach

START TO IMPLEMENT

Tests of Change?

https://www.youtube.com/watch?v=w0ffwDYo00Q

Special Thanks:

We are grateful to Tom Wujec for making his original Marshmallow Challengematerials available to the world!

Learn more at:

marshmallowchallenge.com

What do you want to improve for the children and families you work with?

The Model for Improvement

The Model for Improvement

A tool to achieve positive outcomes for children and families in Scotland

Why change?

The First Law of Improvement

“Every system is perfectly designed to achieve exactly

the results it gets.”Dr Paul Bataldan

The Primary Drivers of Improvement

Will

The Primary Drivers of Improvement

Ideas

The Primary Drivers of Improvement

Will

Ideas Implementation

Having the Will (desire) to change the current state to one that is better

Developing Ideas that will contribute to making processes and outcome better

Having the capacity to apply QI theory, tools & techniques that enable the Implementation of the ideas

QI

The Primary Drivers of Improvement

Implementation?

‘This model is not magic, but it is probably the most useful single framework I have encountered in

twenty years of my own work on quality improvement’

Dr Donald M. BerwickAdministrator of the Centres for Medicare & Medicaid Services

Professor of Paediatrics and Health Care Policy at the Harvard Medical School

The Model for Improvement

The Improvement Guide, 1996

The Thinking Part

The DoingPart

Developing an Aim Statement

What are we trying to accomplish?

Setting the Aim

Ambitious, unachievable by hard work

alone

Setting the Aim

Measurable

…..without measurement you

will never know if a change is an

improvement

Setting the Aim

Time specific

….. ensures focus

Setting the Aim

Specific

Define the group you are focusing

improvement efforts on

Setting aims: Characteristics

What?

Measurable (How good?)

Time specific (By when?)

Define target group (Who?)

Aim Statements

80% of children in Nessie Nursery will access outdoor play on a daily basis by October 2014

85% of pregnant mums in Prestwick will book with a midwife before 12 weeks of pregnancy by December 2014

90% of eligible children in Eaglesham will be registered with a

dentist by April 2015

Attendance rates at Speech and Language Therapy initial assessments in Dumfries will be 95% by end-July 2015

Got your aim?

Check!

How do we know that a change is an improvement?

Improvement is not just about measurement

However… without

measurement you will never be able to answer

the question

Improvement?

Judgment?Research?

Why are you collecting data?

70

35

0

10

20

30

40

50

60

70

80

Avg BeforeChange

Avg AfterChange

Cycl

e Ti

me

(min

.)Aggregated Data

Tells us very little about the

improvement journey

Median = 9

62

Tips for effective measures• Plot data over time

• Seek useful not perfection

• Use sampling

• Integrate measurement into daily routine

• Use qualitative and quantitative data

% receiving a story

% of stories read at bedtime

% of parents reporting improved bedtime routine

% enjoying the bedtime story

% reporting increase in bedtime story reading

Types of measures

Got your measures?

Check!

How will you know your change is an improvement?

What are your change ideas?

What do you think will make a difference?

What changes can we make that will result in improvement?

Selecting Changes• Evidence base: use the literature and evidence to inform your practice

• Use your own experience as a practitioner: your own hunches and theories

• Be strategic: set priorities based on the aim, known problems and feasibility

• Steal shamelessly! Learn from others and their experiences, hunches and theories

68

A practical need often drives creativity!

CHECKPOINT

Answer the 3 questions associated with the thinking part of the model before you start

testing

70% of projects fail because they don’t answer these questions at the outset

What now?

Tests of Change

Why test changes?

• To increase the belief that this particular change works and will result in improvement for your clients

• To learn how to adapt the change to conditions in your setting

• To evaluate the costs and “side-effects” of changes

• To minimise the resistance when spreading the change throughout the organisation

Plan Do Study Act Plan Do Study Act

“What will happen if we try something

different?”

“Let’s try it!”“Did it work?”

“What next? ”

Start small!

1 family

1 child

1 class

1 teacher

Three options after each test

Abandon (glad did small!)

Adopt (as tested)

Adapt (& test further)

Study

Act Plan

Do

Changes that will result in

improvement

Evidence, ideas, theories, hunches,

intuition,

Build confidence through testing

Think Big

Start Small

Scale Fast

This is new, so be brave!

@EYCollaborative

#bestplacetogrowup

EYCollaborative@scotland.gsi.gov.uk

www.scotland.gov.uk/earlyyears