Implementation of Safety Practice Model in Child Welfare

Report
Atlantic Coast Child Welfare Implementation Center
Partners for Change
A member of the National Training and Technical Assistance Network, a service of the Children’s Bureau, U.S. Dept. Health and Human Services
Implementation of a Safety Model in
Child Welfare
Cathy Fisher, Project Director, ACCWIC
Susan Richards, Director of Training, SAMS Project Director, West Virginia
DHHR/Bureau for Children &Families
Toby Lester, CPS Policy Specialist, West Virginia DHHR/Bureau for Children
&Families
Kathy Simms, National Resource for Child Protective Services
February 22, 2013
Implementation Framework
Performance Assessment (Fidelity)
Systems Intervention
Coaching
Facilitative Administration
Training
Staff
Selection
Integrated
& Compensatory
Decision Support Data
System
LEADERSHIP
© Fixsen & Blase, 2008
The Role of Leadership
 Align
the change with agency mission, vision, and values
 Provide clear, frequent communication making the case for
the change and supporting implementation
 Seek support and feedback from stakeholders
 Foster an organizational environment that is conducive to
change, learning and improvement
 Provide rationale for changes in policies, procedures,
structure, staffing, etc.
 Garner needed resources
 Ensure sustainability
Competency Drivers Are:
Mechanisms that help develop, improve and sustain
one’s ability to implement an intervention with fidelity
and benefits to children and families.
Staff Selection
 Training
 Coaching
 Performance Assessment

Organization Drivers Are:
Mechanisms to create and sustain hospitable
organizational and systems environments for
effective services.
Systems Intervention
 Facilitative Administration
 Decision Support Data System

West Virginia
SAMS Project Purpose
Purpose: To implement a new Child
Protective Services (CPS) safety
assessment and intervention system in
West Virginia that:
 Utilizes a change management approach to
fully implement the new system
 Permanently changes practice in West
Virginia
 Results in better outcomes for children and
families
SAMS Vision
A systematic and
effective continuum of
safety assessment and
intervention decisionmaking from receipt of
referral to case closure
SAMS Implementation Goals






DHHR/BCF staff awareness, understanding, and
commitment
External stakeholder and provider awareness,
understanding, and commitment
Comprehensive and supportive structures (i.e.,
policy, computer systems, quality assurance)
Consistent and consultative supervision
Competent and capable staff
Implementation with fidelity
SAMS Implementation




Implementation of SAMS began 2009
SAMS was the priority initiative and resources were
secured to support the implementation
Consistent engagement of key state and field
leadership contributed to SAMS success
Engagement of several key Implementation Drivers
contributed to successful practice change
Driver-Systems Intervention
Performance Assessment (Fidelity)
Systems Intervention
Coaching
Facilitative Administration
Training
Staff
Selection
Integrated
& Compensatory
Decision Support Data
System
LEADERSHIP
© Fixsen & Blase, 2008
Communication and Engagement
Internal
CPS Social Workers
and Supervisors
Upper Management
Legal
State Office
External
Judicial/Legal
Providers
Key Leaders in
Child Welfare
Communication and Engagement
Internal





Newsletters
“Talking Points”
Documents
Memos
Training
Q & A Processes
External




“Round Table”
discussions
Trainings
Redesigned WebPages
Brochures
What we quickly learned





Slow Down!
Determine baselines regarding knowledge and skill;
plan accordingly
Engage Early and Often
Subject Matter Experts at all discussions and
trainings
Misinformation travels fast!
2nd Attempt

Surveyed DHHR Staff, Providers, Judges, CASA,
Caregiver’s Attorneys, Guardian Ad Litems, and
other key stakeholders to measure their
 Agreement
with the need to change
 Knowledge of key SAMS practice concepts
 Level of agreement regarding changes
 Effect of past strategies
Results




Identified problematic attitude and/or practice
issues
Identified strengths and replicated successes
Able to strategically communicate and engage
internal and external partners
A better understanding by Internal and External
Stakeholders of the decision making model, the
necessity for practice change and how families can
be positively impacted
Drivers-Training and Coaching
Performance Assessment (Fidelity)
Systems Intervention
Coaching
Facilitative Administration
Training
Staff
Selection
Integrated
& Compensatory
Decision Support Data
System
LEADERSHIP
© Fixsen & Blase, 2008
Coaching
Training and Coaching




Training by itself is an ineffective approach to implementation.
Functional components of staff training: knowledge of the
program and practices, demonstrations of key skills, and
practice to criterion of key skills.
Core coaching components: teaching and reinforcing skill
development, adaptations of skills to fit the personal styles of
practitioners (changing form, not function).
Coaches need to be trained and coached to provide
specialized coaching functions.
Implementation Background


Worker training was delivered immediately following supervisor
training and supervisors had not yet had a reasonable opportunity to
develop their competency in the PCFA.
The lack of opportunity for supervisors to develop foundational
competency of the PCFA prior to workers attending training resulted
in supervisors lacking knowledge, skill and confidence to support the
worker training experience.
Implementation Change


Supervisors made the primary target audience for implementation
activities delivered by ACTION, NRCCPS and SAM Special Forces.
Fundamental purpose for implementation activities modified to
develop supervisors so they could take charge in leading the
implementation effort with their workers.
Objectives for the Changed Focus
1.
2.
3.
4.
5.
Increase knowledge regarding PCFA necessary for providing
case practice consultation.
Understanding how the principles for intervention are
important for achieving practice objectives.
Develop interpersonal skills necessary for coaching and
modeling the PCFA intervention stages.
Build supervisor confidence for working with staff to develop
their knowledge and skill and/or influence their professional
mentality.
Establish the expectation that supervisors are fundamentally
responsible for developing the competency of their worker for
completing the PCFA.
New Implementation Strategy



Intensive learning program for supervisors to develop knowledge
related to the intervention concepts, criteria, processes, and principles
for PCFA and CPE. Activities conducted to develop their capacity to
supervise the intervention process.
At the conclusion, a Supervisor Proficiency Assessment conducted to
assess the supervisors’ ability to effectively manage and support the
implementation of the intervention model with workers.
After the Proficiency Assessment, Special Forces and supervisors to
work together to develop worker competencies related to the PCFA
and CPE process., involving supervisors actively participating in
training, practicum, and consultation/coaching experiences.
Supervisor Proficiency Assessment
Supervisor Consultation Process

Expert guided discussions that correspond
with each of the PCFA intervention stages;
providing standardized, systematic practice
and promoting effective caseworkercaregiver relationships that result in
caregiver self-awareness and mutually
identified goals that identify what must
change while ensuring client selfdetermination.
Supervisor Consultation Guide



Provides an organized structure for
consulting with casework staff related to
PCFA practice issues and decisionmaking requirements .
Emphasizes specific supervisor
consultation expectations as a case
proceeds through each intervention
stage of the PCFA process.
Emphasizes supervisor-caseworker
consultation as the essential method for
directing practice.
Where We Are Now



PCFA supervisor proficiency process completed for all
supervisors.
Developing a supervisor proficiency process for the IA and
FFA.
Rolling out Coaching training for all supervisors to reinforce
concepts.
Lessons Learned
Lessons Learned



Pay attention to supervisory competency development
from the beginning.
Allow adequate time for supervisors to learn and
become comfortable with the new practice model so
they can reinforce it with their staff.
Pay attention to the relationship between supervisor
proficiency and fidelity – without supervisor
proficiency the chances of fidelity to the model are
greatly diminished.
Closing Comments
Outcome: WV has achieved 70% fidelity rate.
 Focus on salient implementation drivers
contributed to an increase in practitioner
performance
 Planning and implementing a sustainability
plan anchors the practice change in the system
 Leadership owns the responsibility for
sustaining the change.
References
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman,
R. M. & Wallace, F. (2005). Implementation
Research: A Synthesis of the Literature. Tampa,
FL: University of South Florida, Louis de la
Parte Florida Mental Health Institute, The
National Implementation Research Network
(FMHI Publication #231).
Presenters’ Contact Information
Cathy Fisher: [email protected]
Toby Lester: [email protected]
Susan Richards: [email protected]
Kathy Simms: [email protected]

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