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SLHI June 23, 2008
Cassandra O’Neillwww.wholonomyconsulting.com
Implementation
Discuss in Pairs
1. What is it? 2. How is it important?
3. What are we working on thatInvolves the implementation
of something?
Small Groups
Write on flip chart paper:
What do we know about successful implementation?
What do we want to know?
How might the National Implementation Research Network Inform us?
How I learned about this
What I learned
The majority of implementation attempts are NOT successful
Implementation Attempts
• In business, change initiatives that are heavily dependent on people (reengineering, TQM, culture change) fail 80-90% of the time
R. W. Rogers, 2002
Implementation Attempts – slide 2
About 10% of what is taught in training gets transferred to the jobR. W. Rogers, 2002
Implementation Attempts – part 3
"Up to 70% of the failures in business are not due to poor strategy or a lack of good ideas, but to flawed execution." R. W. Rogers, 2002
What Does Not Work
Things that alone – are not enough for successful implementation:
Dissemination of information by itself does not lead to successful implementation (research literature, mailings, promulgation of practice guidelines)
What Does Not Work
Things that alone – are not enough for successful implementation:
Training alone, no matter how well done, does not lead to successful implementation
Why do we keep doing things that don’t work and expecting them to work?
The personal is structural and systemic
What level learning is going on?First OrderSecond OrderThird Order
First Order Change or Learning
Adaptive learning, taking place within accepted boundaries that leaves basic values unexamined and unchanged
Second Order Change or Learning
Reflective learning that examines the assumptions of first order learning
AHA
Third order change or learning
Transformative learning happens when we see things differently and involves a deep awareness of alternate world views and ways of doing things
Paradigm Shift
Implementation
What Does Work?
Implement Innovations
Effective intervention practices+Effective implementation practices=Good outcomes for consumers
Broader Application
Good idea + good design and planning +Good implementation
= Good Outcome
INTEGRATED & COMPENSATORY
CONSULTATION & COACHING
STAFF PERFORMANCE EVALUATION
FACILITATIVE ADMINISTRATIVE
SUPPORTS
RECRUITMENT AND SELECTION
PRESERVICE TRAINING
SYSTEMSINTERVENTIONS
What Does Work? Implementation Drivers
DECISION SUPPORT DATA SYSTEMS
OUTCOMES
(% of Participants who Demonstrate Knowledge, Demonstrate new Skills in a Training Setting, and Use new Skills in the Classroom)
TRAININGCOMPONENTS
Knowledge SkillDemonstration
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
Challenges with new learning
Doing something new is difficult
Asking someone to stop doing something they are proficient in – (even if the results aren’t good)
And asking them to do something they are not proficient in – they are just learning
Challenges with newly-learned behavior pg 44
Newly-learned behavior is: crude compared to performance by a
master practitioner,fragile and needs to be supported in the face
of reactions from consumers and others in the service setting
Incomplete and will need to be shaped to be most functional in a service setting
Stages of Implementation
• Exploration• Installation• Initial Implementation• Full Implementation• Innovation• Sustainability
Implementation occurs in stages:
Fixsen, Naoom, Blase, Friedman, & Wallace, 2005
2 – 4 Years
Degrees of Implementation pg 6
Paper Implementation
Process Implementation
Performance Implementation
What Does Design have to do with it?
Who determines the design?
Difference between Intent and Result
Installation – the process of introducing a new solution, attention is focused on logistics, announcing new program or process
Realization – outcomes are realized when organizations go beyond installation to actions that produce intended outcomes
Kentucky ROCKS!
Applied the 7 drivers by developing a tool
Which included questions to explore for each of the 7 drivers!
How might this information inform us?
What questions related to these drivers might be useful to us in our work?
A few thoughts before we explore these questions…
21st Century Solutions lie within the intersection of
and interaction between
Sufficiency Paradigm
Dynamical Human SystemsNon linear
Brain/Neuroscience findings
Strengths and ResiliencyBuilding
21st Century Solutions DO NOT Lie within the intersection of
Scarcity Paradigm
Linear and Mechanistic SystemsDeficit Approach
Community Readiness Model developed by Edwards, Jumper-Thurman, Plested, Oetting & Swanson (2000)
No Awareness
Denial
Vague Awareness
Initiation Stabilization
Preparation
Preplanning
Creating Demand2 ways
1. Data which shows something isn’t working
Vs2. Belief that a better future is possible
Myths
External Feedback promotes growth and development
Burning Platform Theory
How can we apply
what we’ve learned about keys to successIn implementation?