Planning & Program Implementation National Replication 9/30/2015
GOALS FOR THE PRESENTATION • Introduction of a framework to use when considering replication • Share web site resources • Share printed questionnaires to complete when doing your assessment • Introduce various work products to support replication • EBAssests • EBAnalytics • EBAccountability • Discuss success and challenges when implementing • Considerations when implementing
What Type of Cook are You? Do You Follow the Recipe? Do You Improvise or Substitute? Do You Need Pictures? Do You Measure?
Website Resources 1. NREPP (NATIONAL REGISTRY OF EVIDENCE BASED PROGRAMS AND PRACTICES) ex. IDENTIFIED PROBLEM IN COMMUNITY IS: DELINQUENCY AND CRIME AMONG YOUNG ADULTS http://www.nrepp.samhsa.gov/ > enter “crime” in the Find An Intervention box> 18 results, then narrow search by Age {select “18 ‐ 25”}; by Outcome Categories {select Crime/Delinquency}; by Geographic Locations {select Urban & Rural} , now narrowed to 2 models to research. 2. THE CALIFORNIA EVIDENCE ‐ BASED CLEARING FOR CHILD WELFARE ex. IDENTIFIED PROBLEM IN COMMUNITY IS: LACK OF SUPPORT FOR PARENTS http://www.cebc4cw.org/ > Select & Implement Programs>Topic Areas>Alpha Listing yields 5 top rated models to research. 3. BLUEPRINTS FOR HEALTHY YOUTH DEVELOPMENT ex. IDENTIFIED PROBLEM IN COMMUNITY IS: BULLYING http://www.blueprintsprograms.com/ > Program Search>Search All Criteria at Once>Problem Behavior>now narrow search by Program Outcomes {select “Bullying”}; and by Target Population {select Late Childhood & Early Adolescence}, now narrowed to 3 models to research. 4. SAMHSA (SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION) ex. IDENTIFIED PROBLEM IN COMMUNITY IS: SUBSTANCE ABUSE http://www.samhsa.gov/ >Programs & Campaigns>EBP Webguide>Mental Health Treatment>Effective Child Therapy:Evidence ‐ based Mental Health Treatment for Children & Adolescents>>Effective Child Therapy>Professionals and Educators>About Specific Treatments>Specific Evidence ‐ based Treatment Programs>Substance Abuse yields 6 programs, 5 with Internet links.
WHAT OTHER RESOURCES ARE THERE Identifying and Selecting Evidence ‐ Based Programs and Practices: Questions To Consider • Outcome Identification • EBP Identification • Evidence for Effectiveness • Organizational and Community Fit • Capacity and Resources • Monitoring and Sustainability
1 plus Research Design : At least 1 RCT 2 ; both with positive another rigorous study findings Replication : Replicated with positive findings ; and Exemplary Sustainability : Outcomes are sustained for at 2 ; Research Design : At least 1 rigorous study (Evidence ‐ Based) least a 1 year with positive findings Replication : Replicated with positive findings ; Effective or Sustainability : Outcomes are sustained for at 2 ; Research Design : At least 1 rigorous study least a 1 year with positive findings Promising Replication : Not Replicated ; and Sustainability : Outcomes are not sustained for 1 year Research Design : Pre ‐ Post study or Post study; with positive findings Emerging Replication : Not Replicated ; and Sustainability : Outcomes are notsustained for 1 year Based in theory , collecting quality Innovative Practice data, has logic model , and monitoring fidelity with positive findings . Cannot Rate k 1 RCT – Randomized Controlled Trial 2 Rigorous Study – Randomized Controlled Trial or Quasi ‐ Experimental Study
Questions To Ask as You Explore the Possible Use of an Intervention • Implementations • Adaptations • Staffing • Quality Assurance Mechanisms • Training and Technical Assistance • Costs
Organizational and Assessment Implementation System Readiness
Organizational and Assessment Implementation System Readiness Administrative Oversight Service Provider Oversight Referral/Utilization Management Stakeholder Management Model Fidelity Promotion Data Collection and Evaluation Funding and Sustainability Guidance
Assessment (Month 1) Administrative • SWOT Analysis • How will the Project be Managed Oversight • Understand how the Target Population will get linked to the service • Procure for the service delivery requesting provider proposals Service Provider • Develop organizational readiness checklist for the selected provider Oversight • Identify current referral stream for selected provider and cross check for target population Referral/Utilization • Identify outcome targets for # served, length of treatment & utilization • Meet with primary referral source and share referral process Management Stakeholder • Identity each key stakeholder and determine support for the service while assess knowledge of the evidence based intervention Management Model Fidelity • Meet with selected service provider and assess experience and capacity with EBP’s including quality assurance, data collection, evaluation, program improvement plans, staff retention and Promotion incentives, hiring/correction action/firing practices Data Collection and • Set benchmarks for outcomes • Identify sources for obtaining outcome data Evaluation • Determine need for outside evaluation • Meet with funder to identify current funding amounts, restrictions, review reimbursement Funding & procedures and insure all costs are covered including training, licensing, travel etc. Sustainability • Determine if Federal funds or other funds could be used in the future for the intervention Guidance
Organizational & System Readiness (Months 2 ‐ 4) Administrative Oversight • Finalize /Order referral, reporting and information forms that will need to collected for the target population • Draft initial policy and procedure manual Service Provider Oversight • Contract for services from funder drafted along with securing supporting documentation (i.e. background screening, insurance certificates etc.) • Assist with hiring • Complete review of EBP readiness checklist • Set up Monthly check in calls with administration for progress • Identify POC for referral agencies Referral/Utilization • Train referral agencies on referral procedures Management Stakeholder Management • Train stakeholders on the model, expectations and benefits • Establish outcome reporting process and content Model Fidelity Promotion • Schedule initial model training • Establish benchmarks for fidelity & potential monetary incentives • Establish supervision procedures • Establish monthly calls with model experts Data Collection & Evaluation • Formalize data collection, benchmarks and reporting format Funding and Sustainability • Finalize budgets and look for cost savings if able to bundle service costs • Develop long term sustainability funding for the EBP Guidance
Implementation (Month 5 and on) Administrative Oversight • Ensure Provider is complying with Policy and Procedure Manual • Revise Manual as needed Service Provider • Monitor model compliance by randomly attending supervision and file review • Meet monthly with Program Director and Agency administration to review Oversight implementation of EBP • Track staff turnover • Larger rollouts convene monthly Provider calls Referral/Utilization • Monitor referral, appropriateness and utilization numbers monthly • Meet with referral sources as needed Management Stakeholder • Share outcome data as agreed upon frequency and content • Participate in Community Meetings dealing with the relevant service delivery needs Management • Review and monitor fidelity reports and treatment pacing information Model Fidelity Promotion • Facilitate monthly calls with model experts • Review monthly accuracy of data reported from demographics to dates of service Data Collection and • Report on identified outcomes Evaluation • Meet with outside evaluator to ensure data set quarterly Funding and • Monitor expense and make recommendations for overages or under utilization • Pursue long term funding as needed Sustainability Guidance
• Importance of hiring right (the first time) PROBLEM: > 50% turnover and average 85 day vacancy rate identified in 2010 WHAT WE DID : • Turnover analysis of every contracted agency for last 4 years (2007 ‐ 2010) • HR assessment of each agency’s recruitment, hiring & retention practices Researched model requirements for staff competencies • WHAT WE FOUND: • Many therapists seemed unprepared for the EBP realities such as in ‐ home therapy, intense oversight & scrutiny, and being held accountable for outcomes • Models had very specific requirements and expectations SOLUTIONS: • In collaboration with the model experts and with the EBP program managers and team supervisors, we created a list of EBP Core Competencies based on the Alaskan Core Competencies as identified in a survey done by the Annapolis Coalition in 2010. We added several descriptors to each Core Competency • In collaboration with the model experts and the agencies, we wrote a comprehensive model specific Hiring Manual Paradigm of screening in is flipped to screening out…Initial Screening is designed to screen out o Structured Interviewing with scoring is stressed o RESULTS: 27% turnover and average 45 day vacancy rate achieved by the end of 2011
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