Barbara Sims, Co-Director

National SISEP Center

FPG Child Development Center

University of North Carolina at Chapel Hill

Greensboro.NCMarch 20, 2013

Implementation Teams: Getting the Work Done

NC SIP Spring Networking Meeting

IMPLEMENTATION TEAMS

Organized, expert assistance to develop and sustain an accountable and effective structure

Impl. Team NO Impl. Team

Effective

Making it Happen

IMPLEMENTATION

INT

ER

VE

NT

ION

80%, 3 Yrs 14%, 17 Yrs

Balas & Boren, 2000 Green & Seifert, 2005

Fixsen, Blase, Timbers, & Wolf, 2001

Letting it Happen Helping it Happen

Implementation Teams

Who Makes Change Happen?

Invest in the development of implementation capacity and expanded, diversified leadership

Vendors vs. Implementation Teams

Linked Teaming Structures

Adaptive Problem Solving Units

Implementation Teams

“We tend to focus on snapshots of isolated parts of the system and wonder why our deepest problems never seem to get solved.”

—Senge, 1990

Linked Team StructuresImplementation Teams

School-basedImplementation Team

School-basedImplementation Team

District-basedImplementation Team

District-basedImplementation Team

Regionally-basedImplementation Team

State-basedImplementation Team

State-basedImplementation Team

Provide Implementation Support

Focus is on Quality, integration, sustainability of Drivers Data-based decision-making Problem-solving and analytical engagement Purposeful adaptation and planned supports Alignment and Sustainability

Provide accountable structure to move intervention through stages of implementation for any initiative

Implementation Teams

Essential Functions

Team Structure

Intervention

Implementation

Improvement Cycles

System Change

Implementation TeamsImplementation Teams know and apply:

Building Capacity to Lead

Building capacity requires more than just forming Implementation Teams…There needs to a be new way of…Organizing to address complex problems Talking about issuesMaking decisionsRelating to one another

Implementation Teams

Forming the Team

Selection Criteria

• Stakeholders vs. Implementation Team

• Interviews

• Existing staff working intentionally

• Moving from “hand picked” to specific criteria

• Frustration as a motivator

• Requisite variety

• Duplication of skill sets

Implementation Teams

Initial Team Functioning

• Clear understanding of the mission (or reason) for the work Important enough to warrant the

effort required to develop effective and sustainable implementation infrastructure

• Clear relationship between the identified intervention and overall mission

• Clear definition of the critical components and operationalization of the intervention

Implementation Teams

Intervention Training

• Develop Intervention Training Plan Implementation team members as

initial trainers If outside experts are used you need

to assess » Innovation Fluency» Use of Training Best Practices» Data from people they have ‘trained’

Implementation Teams

Intervention Training Plan

Aspects requiring new knowledge

• Description

• Purpose

• Supporting data

• Examples

• Critical components

• Key behaviors

Implementation Teams

Intervention Training Plan

• Identify what will be taught by whom

• Duration of each topic

• Aspects requiring new skills Behavior rehearsals Identify and prepare behavior

rehearsal leaders and confederates

Implementation Teams

Intervention Training Plan

• Prioritize training topics

• Develop order of training and assessment

• Identify (or develop) fidelity measures Direct observation Interviews/surveys Records reviews

Implementation Teams

Fidelity Assessment

• Immediately after initial training

• Usability testing approach Rapid cycle problem solving Designed to build skills of team

members» Assessment process» Training» Intervention

Implementation Teams

Coaching Plan

• Initial coaching may be done by Implementation Team members Team members who know the

innovation Team members who know how to

coach

• Initial topics result from: Debriefing Weekly observations Usability testing

Implementation Teams

Coaching Plan

• Weekly Implementation Team meetings

• Develop selection criteria for coaches

• Coaches as pivot point PDSA to identify

» Skill deficiencies» Time and opportunity barriers» Systems issues

Implementation Teams

Indicators of Success

• IndicatorsEssential Functions

• Representative, Accountable• Terms of Reference, Communication ProtocolsDevelop Team Structure

• Demonstrate fluency in strategy• Operationalize Interventions when needed

Know and apply the Intervention

• Develop infrastructure• Conduct Stage-appropriate work

Know and apply Implementation

• Institutionalize communication cycles• Use data for decision making, problem solving and

communication cycles

Know and apply Improvement Cycles

• Demonstrate knowledge of system components and skills for system building

Know and apply Systems Change

Implementation Teams

Build capacity to do what?

Essential Functions

• Representative, Accountable• MOU, Communication ProtocolsDevelop Team Structure

• Demonstrate fluency in strategy• Operationalize Interventions when needed

Know and apply the Intervention

• Develop infrastructure• Conduct Stage-appropriate Work

Know and apply Implementation

• Institutionalize feedback loops• Use data for decision making, problem solving and

feedback loops

Know and apply Improvement Cycles

• Demonstrate knowledge of system components and skills for system building

Know and apply Systems Change

Implementation Teams

RESULTS…can effect change throughout the system and make

decisions

…can promote implementation of core components, adaptations, and infrastructure

…can guide implementation and build capacity throughout the organization and system

…can address challenges and do action planning

…can improve access, reach or scale, connection, and influence decision-making

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