Workstream breakouts Format for Workstreams sessions • Introductions at your table • Improvement Bootcamp overview and other improvement journeys • Components of a learning system – how does our work stack up? • Workstream presentations – 30 mins each including Q&A • Table top reflection on own learning and application of improvement methodology The Bootcamp Experience : from this….. The Bootcamp Experience : to this…… Components of a Learning System 1. 2. 3. 4. 5. 6. 7. 8. System level measures Explicit theory or rationale for system changes Segmentation of the population Learn by testing changes sequentially Use informative cases: “Act for the individual learn for the population” Learning during scale-up and spread with a production plan to go to scale Periodic review People to manage and oversee the learning system From Tom Nolan PhD, IHI Scottish Borders SOA- Reducing Inequalities (Early Years strategy 12-15, Children and Young Peoples Service Plan 12-15, Healthy Living programme, PASPE strategy 2011) 65.4 Our children have the best start in life and are ready to succeed % of S4 pupils with 5 awards at SCQF at level 5 or above- 40.5 National average 36.6 12.8 Least deprived areas Scottish Borders Most deprived areas Aim: To establish an assessment that enables the CPP to accurately record and plan for the developmental milestones of children on entrance into P1 by August 2014 Early Years Collaborative Aim- to establish and implement an appropriate measure for Workstream : Lead- Amanda Cronin Workstream 3 by December 2014 Primary Drivers Secondary Drivers Local Actions Suitability of assessment Education Based Health Based Other Authority Develop own Test using SOGS Test Using PIPs Review tests and combine Various tests to establish the most appropriate age Establish process Establish appropriate assessment for P1 entrants Purpose of assessment Age of Child Profession of Assessor Criteria for P1 assessment Quality assure 27-30 planning Establish appropriate plan for P1 Establish tests that look who should be assessed at P1 Conduct tests using various professionals to conduct the assessment, HV, NN (Health) NN (Education) Staff Nurse, Nursery Teacher Conduct tests to review effectiveness of the 24 month plans Conduct tests that allow nursery teachers and partner agencies to support children in transition to school Aim: To establish an assessment that enables the CPP to accurately record and plan for the developmental milestones of children on entrance into P1 by August 2014 Measures Cycle 1e:???????????? A P S D Cycle 1d:???????????? Cycle 1c:???????????????? A P S D Cycle 1b: Ask the same HV to test a different child at the same age using SOGS who had a 24 month assessment Cycle 1a: Ask one HV to test one child aged 50 months using the SOGS tool who had a 24 month assessment Process Change: Implement a measure for children upon entrance into P1 We have built relationships Start together Plans for next 3-6 months • Review data from 24 & 27-30 month assessment • Review driver diagram with all testers to ensure we have all elements covered • Continue cycle of testing What needs to be done? - Identify test and appropriate testers Establish a robust system to measure Secure support for implementation Involve everyone in the design collection and understanding of the data East Dunbartonshire East Dunbartonshire CPP and community Life Expectancy: Males 79.4 Females 82.7 Highest in Scotland Residents in Owner Occupied Housing: 85% Scotland: 65% Average gross weekly earnings: £549.60 3rd highest in Scotland Hillhead: Amongst the 5% most deprived areas in Scotland Our aim Working together to achieve the best with the people of East Dunbartonshire. We will strive for the best possible outcomes for children, young people and their families and support the Scottish Government’s aim to make Scotland the best place in the world to grow up. Culture change Systems change Practice change Getting It Right for Every Child Key wins for Workstream 3: driver diagram • Societal Issues • Aim Children have all the developmental skills and abilities expected at the start of primary school 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 Access To Services • • • • Child’s physical & mental health and emotional development Carer’s physical & mental health and skills Early Learning & Play • • • Additional Support • • • • Parenting skills & knowledge • • Agree a protocol for sharing the 27/30 month assessment with education and consent issues with parents. Review and develop early years provision within EDC to meet aim of 600 hours for every pre-school child. Ensure clear referral pathways. Improve the quality of provision in local authority and partner providers Implement GIRFEC policy and procedures in all early years establishments. Provide Stay and Play (for parents with their children) within a local authority nursery. Improve the knowledge and skills of early years workforce on child development. Develop a transition programme with parents, health and education for children starting nursery. Develop and implement common assessment of developmental milestones at the end of early years Develop and implement support for children with ASN in all EDC early years providers. Improve identification and support for children who require support. Provide additional family information via the Play Talk Read Bus. Provide BookBug sessions within a local authority nursery. Families in need of parenting support within one of the local authority nurseries. Provide parenting Provide drop in, surgery and taster sessions (based on Triple P) Key wins in Child Development training programme Wellbeing Consistent analysis structures Staged interventions Emotional health & wellbeing Experiential play Self management skills Thinking and involvement Creating memories Communication Language rich environments Key wins in the area of measurement Made strategy personal Embedded methodology Increased sharing of ideas & knowledge Diverse tests of change Child focused: Ferre Laevers Development focused: writing, reading, nutrition Population wide: improving attendance Lessons learned in the area of measurement Assistance, reassurance and updates for all staff Framing tests of change in familiar language Examples with identified measurements Practical and relevant ideas Positive focus not just ‘threat of homework’ - though sometimes a deadline provides the impetus required Key wins in frontline testing Staff feedback from initial tests of change “The fact that it makes you think of the things you do daily to support children in small ways – or how you develop certain areas to accommodate individual needs …take that a step further – involving parents more questioning etc. which we will most definitely do!” “Continue to make adaptions and changes slowly and gradually, to benefit children’s and staff learning and experiences.” “Picked up lots of good ideas for encouraging home links as test of change.” “The course has made us think about our practice and how relevant it is.” “It will encourage me to look for missed opportunities in learning in my centres, particularly in interaction with children, ensuring they are challenged appropriately.” Lessons learned in frontline testing Everyone assumed they were ‘doing it wrong’ Healthy competition ‘On the spot’ conversations New concepts can worry people Ideas spark change and build momentum Key wins in our place approach Through a mix of formal and informal services the provision of the ‘family room’ and ‘parent room’ in the school and nursery aims to increase the security, education and welfare of children and parents in the Hillhead community to significantly improve the lives of families Relocating staff to where they are most needed Building resilience through fun activities Changing the way we work for increased efficiency e.g. A Support for All Group Key wins for Workstream 3: Strengths & Difficulties Aim: The questionnaire is intended to identify children’s readiness for learning prior to transferring to school. Measures: Total difficulties score Changes: Common assessment tool (SDQ) implemented at a standard time across East Dunbartonshire Plan Act Do Study Key wins for Workstream 3: Strengths & Difficulties Strengths and Difficulties Questionnaire (June 2013 pilot) Total difficulties: Percentage of pre-school children without likely problems 98% 96% 94% 92% 90% 88% 86% 84% EDC Sample Female (n=29) EDC Sample Male (n=43) All EDC Sample (n=72) Glasgow (n=4142) Key wins for Workstream 3: Strengths & Difficulties Staff feedback from the pilot “It has made me stop and think about whether he is ready for school socially and emotionally I mean” The universal approach to carrying out the questionnaire “means that children who are ‘invisible’ won’t get missed” The collaborative approach taken to completing the pilot was noted as being particularly important in providing a richness of data – “different members of staff see children differently so this [completing the SDQ collaboratively] helps to get a picture of the whole child”. Plans for next 3-6 months Professional development driving methodology uptake Positive behavioural strategies Protocols - Looked after children Emotional Health & Wellbeing Acting on initial tests of change Healthy eating: Thumbs up / Thumbs down Outdoor play: Time out numbers Communication: Leuven Wellbeing scale Singing Time & Parental Involvement Writing Register: Identifying one’s name Implementing the Strengths and Difficulties Questionnaire & transition programme TABLE DISCUSSION • Who are individuals and/or teams currently working on in this area? Are they currently using Quality Improvement methods/PDSA cycles to guide their learning? • Reflecting on the emerging knowledge within this area, and today’s plenary session on scaling up your work, what are some considerations you need to plan for to get to scale for your project?