Implementat ion Science 101 Vestena Robbins, PhD Kentucky Dept for Behavioral Health, Developmental and Intellectual Disabilities
Dec 29, 2015
Implementation Science
101Vestena Robbins, PhD
Kentucky Dept for Behavioral Health, Developmental and
Intellectual Disabilities
LESSON #1
Individuals cannot benefit from good
interventions… if they don’t experience them!Nor do they benefit… even with the best of
intentions.
Funding for Innovation
US Federal Government spends $95+ billion a year to fund research on new interventions
and over $1.6 trillion to support services to
citizens but these do not result in intended
benefits or outcomes to consumers and communities.
SCIENCE TO SERVICE GAP
SCIENCE
SERVICE
?
IMPLEMENTATION GAP
SCIENCE
SERVICE
IMPLEMENTATION
“The bridge from science to service must be built, repaired, maintained, and improved.” -—NIRN Brief, January 2009
Implementation Defined
Putting a program or specific set of activities to work in a real setting, such as a school, hospital, or community, to bring benefits to the population you want to serve.
LESSON #2
Evidence Usability
“Evidence” on effectiveness helps you select what to implement for whom and under what circumstances
“Evidence” on effectiveness does not help you implement
LESSON #3
Interventiona
Implementation
Effective Not Effective
Effective Actual Benefits
Inconsistent; Not Sustainable; Poor OUtcomes
Not Effective
Poor Outcomes
Poor Outcomes; Sometimes harmful
Institute of Medicine, 2000; 2001; 2009; New Freedom Commission on Mental Health, 2003; National Commission on Excellence in Education, 1993; Department for Health and Human Services, 1999)
“The use of effective interventions without
implementation strategies is like serum without a
syringe; the cure is available but the delivery system is
not.”
~Fixsen, Blase, Duda, Naoom, & Van Dyke, 2010
LESSON #4
Successfully implementing a program that fits your organization’s needs is a process—not a single event—that occurs in multiple stages of planning, purposeful action, and evaluating.
Implementation Research: A Synthesis of the LiteratureFixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005)
Stages of ImplementationExploration: Getting
StartedInstallation: launchingInitial Implementation:
Expect the UnexpectedFull Implementation:
Practice is in PlaceProgram
Sustainability: Maintaining Success
LESSON #5
Successful implementation is based on a framework of integrated and compensatory core components or “drivers”
Adapted from © Fixsen & Blase, 2008
Consumer Benefits
Technical
Integrated & Compensatory
Participant Assessment
Coaching
Preparation & Training
Participant Recruitment & Selection
System Intervention (External Supports)
Facilitative Administration (Internal Supports)
Data to Support Decision Making
Competency Organization
Leadership
Adaptive
Implementation Drivers Framework
Integrated and Compensatory(% of Participants who Demonstrate Knowledge, Demonstrate New Skills in a Training Setting, and Use New Skills in the Classroom)
TRAININGCOMPONENTS
Knowledge Skill Demonstration
Use in 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
Homework Assignment: Review the Monograph
Download the monograph at:http://www.fpg.unc.edu/~nirn/resources/publications/Monograph
Homework Assignment: Join A WebinarThe National Center for Child
Traumatic Stress will host a live webinar with Dean Fixsen, Ph.D. on Establishing a Framework for the Implementation of Evidence-Based Programs
Wednesday, May 25th at 12:00pm EST/9:00am PST
http://learn.nctsn.org/file.php/1/pdf/NCTSN_Implementing_and_Sustaining_Evidence-Based_Practice_Speaker_Series.pdf
Homework Assignment: Attend the GIC
Homework Assignment:Contact DBHDIDVestena (Tena) RobbinsKari CollinsOutcome Transformation
and Education BranchKDBHDID502/[email protected]