Workstream 5 Breakout Session

Understanding your Workstream and Priority Tests of Change

Early Years Collaborative Learning Session Three – Day 2

We’ve been building will & generating ideas for a while Dr Bruce Perry – neuroscience and brain development EPPE Study –- 2004 GIRFEC - 2004 CMO’s report - 2007 Early Years Framework - 2008 The Foundation Years - Frank Field – 2010 Early Intervention - Graham Allen – 2010 Scottish Government economic modelling (Nov 2010) Joining the Dots – Report from Professor Susan Deacon

(March 2011)

Components of a Learning System 1. System level measures2. Explicit theory or rationale for system changes3. Segmentation of the population4. Learn by testing changes sequentially5. Use informative cases: “Act for the individual learn for the

population” 6. Learning during scale-up and spread with a production plan

to go to scale7. Periodic review8. People to manage and oversee the learning system

From Tom Nolan PhD, IHI

Breakout Objectives

• Build a common understanding of the current theory of what drives the overall aim for this Workstream;

• Identify where on the Driver Diagram your work is having an impact.

• Identify and prioritize drivers by areas of highest impact at a local level

• Reflect on the assets within your community that can help you achieve greater impact in prioritised areas

• Develop a proposal for Tests of Change to be shared with your CPP.

How we will spend our time ……

• Refresh on Driver Diagram theory and presentation of current theory for Workstream 5

• Review and Reflect on Workstream 5 Driver Diagram

• Identification of which Drivers you have the biggest impact on

• Development of a proposed Test of Change to share with CPP.

Conceptual Driver DiagramOutcome 1⁰ driver 2⁰ driver

Specific Change Ideas

Aim or Outcome

1⁰ driver 1

1⁰ driver 2

2⁰ driver 3

2⁰ driver 2

2⁰ driver 1

2⁰ driver 4

2⁰ driver 5

Ideas:123456789......NOutcome

Measure(s)Process Measure(s)

Local Process Measure(s)

8

Understanding Our Theory: Early Years Workstream Diagrams

Reduce infant mortality

Social Issues

Post-birth actions

Pre-birth maternal health

Maternal smoking

Improved sharing of information

Improved management of care

Increase referrals

Improved identification

Aim 1⁰ 2⁰

Theory of what actions will reduce infant mortality

Detailed Aim:

To reduce by 15% the rates of stillbirth & infant mortality by 2015

Maternal drinking

Maternal misuse of drugs

Health

Increase rate of breastfed babies

Quicker diagnoses of Neonatal Abstinence Syndrome

Poverty

Housing

Domestic Abuse & Violence

Maternal Obesity

Maternal mental health

Attachment

Improved stability / permanence for LAC

Improved uptake of benefits

Improved planning

Improved family centred response

Improved leadership & culture

Improved teamwork, communication and collaboration

Parenting skills

Identification & reasons for current resilience

WORKSTREAM 1 (conception to 1 year)

Theory of what drivers infant mortality

Children have all the developmental skills and abilities expected of a 27-30 month year old

Social Issues

Child’s physical and mental activity

Maternal health and skills

Mother’s level of education

Improved sharing of information

Improved management of care

Increase referrals

Improved identification

Detailed Aim:

85% of all children within each CPP have reached all of the expected developmental milestones at the time of the child’s 27-30 month child health review by end-2016

Parental misuse of drugs

Health

Increase child’s dental health

Improving child nutrition

Poverty

Housing

Domestic Abuse & Violence

Parental obesity

Maternal mental health

Attachment

Improved stability / permanence for LAC

Improved uptake of benefits

Improved planning

Improved family centred response

Improved leadership & culture

Improved teamwork, communication and collaboration

Improving brain stimulation and physical play

Parental misuse of drinking

Parenting skills

WORKSTREAM 2 (1 year to 30 months)

Identification & reasons for current resilience

Aim 1⁰ 2⁰

Theory of what drivers developmental milestonesTheory of what actions will

ensure developmental milestones are reached

Children have all the developmental skills and abilities expected at the start of primary school

Social Issues

Child’s physical and mental activity

Maternal health and skills

Mother’s level of education

Improved sharing of information

Improved management of care

Increase referrals

Improved identification

Detailed Aim:

90% of all children within each CPP have reached all of the expected developmental milestones at the time the child starts primary school, by end-2017

Parental misuse of drugs

Health

Increase child’s dental health

Improving child nutrition

Poverty

Housing

Domestic Abuse & Violence

Parental obesity

Maternal mental health

Attachment

Improved stability / permanence for LAC

Improved uptake of benefits

Improved planning

Improved family centred response

Improved leadership & culture

Improved teamwork, communication and collaboration

Improving brain stimulation and physical play

Parental misuse of drinking

Early Learning

Parenting skills

WORKSTREAM 3 (30 months to start of primary school)

Identification & reasons for current resilience

Aim 1⁰ 2⁰

Theory of what drivers developmental milestones

Theory of what actions will ensure developmental

milestones are reached at the start of primary school

Aim

95% of children in each CPP area will have reached all of the expected developmental milestones and educational outcomes by the end of Primary 4 by 2021

Primary Driver

Societal Issues

Primary Driver

Child’s physical, cognitive, mental health & emotional development

(Individual child’s characteristics/profile)

Primary Driver

Carers’/Parents’ physical & mental health & skills

Primary Driver

Learning environment Achievement of Es and Os at relevant CfE levelStandards of delivery for meeting learners needs

Primary Driver

Community environment

Secondary Driver(s)

Poverty Home environment Domestic Abuse Impact of in

equalities Media Influences Access to wider opportunities

Employment /Workforce issues Accessibility and affordability of

childcare CYP implementation

Secondary Driver(s)

Safe & secure home Access to quality Early learning Play

Child’s & family aspirations Health Attachment Ability to form

relationships Participation in wider opportunities Workforce

knowledge, skills & understanding Cultural activities Disabilities

Child resilience

Secondary Driver(s)

Safe & secure home Family resilience Adequate income

Family aspirations Level of education Substance misuse

Disabilities & mental health Parenting skills & knowledge

Nutrition/physical disabilities Family relationships

Secondary Driver(s)

Home learning environment Parent’s engagement Parental

involvement with services School learning environment out of

school childcare, learning and play Support with homework

Secondary Driver(s)

Transport Access to wider opportunities Access to services Children

a key part of the community Parents on school councils/ committees

Children’s views sought and acted on in developing local resources

Space to play Use of schools and grounds community assets

WORKSTREAM 5

Review of DD and Reflection

Step One: Take a few minutes to review the driver diagram and discuss with the person next to you.

Step Two: Discuss the driver diagram with your table mates using the following prompts:1. Yes, I’m glad this was included ……2. I would add….3. I don’t understand …..

If you have a question while at your table…Raise your GREEN CARD for Improvement Science-related questionsRaise your YELLOW CARD for Early Years Content-related questionsRaise your BLUE CARD for logistics questions (e.g., Can we have a few more marker pens, please?)

All Worksheets will be collected after the session!

Don’t Forget!

Report Out to the Room

“What did you learn that came as a surprise to you?”

Prioritization and Inventory of Assets

CPP: Early Years Collaborative Learning Session 3 Inventory of Bright Spots and Creating Initial Tests of Change PART 1: PRIORITIZATION OF DRIVERS & CREATING CREATING TESTS OF CHANGE Prioritise the drivers with the highest impact for you, what specific interventions are you currently working on in this area? What community assets will be needed to help you achieve maximum impact? PART 2: What test(s) could you run that could make that work even better/more impactful? Describe your first test(s) of change: Person responsible When to be done Where to be done

Prioritization and Inventory of Assets

Step One: Using the worksheet and driver diagram identify which of the drivers you are currently working on and identify the top 3 where you feel you can have the most impact.

Step Two: For these areas of highest impact, reflect on the community assets that can help you have maximum impact.

You can work alone or team up with others on this exercise, however everyone need to complete the worksheet.

Creating a Test of Change

Using your number 1 area of highest impact, reflect on the tests you could run that could make that work even more impactful and record on the worksheet.

You can use this to share your proposed test of change with your CPP.

Report out to the Room

• What intervention are your currently working on, and what is your test of change?

• Keep all report-outs to a “twitter update” (1-2 sentences!)

Thanks for a great session!

Transition to CPP Planning Session (Coffee available to take with you!)

A NEW HEALTHIER ME!!

CALORIESIN

CALORIES OUT

Limit daily intake

Substitute low calorie

Limit alcohol

Exercise

Fidgeting

Driver diagram for a new healthier me!

Tests of changeSecondary driversPrimary driversAim

Track calories

Plan meals

Drink water not coke

Gym 5 x per week

Cycle to work

Chi balls