Designing and Implementing
Effective Services
Crosscare Teen Counselling Conference
Nuala Doherty - Director, Centre for E...
Overview

1. Designing effective
services

2. Implementing
effective services

What is evidence?

The Implementation Gap

...
Introduction to CES
A small organisation
with charity status

Established in 2008
(5 year grant)

A multi-disciplinary
sta...
CES Mission

Better Outcomes for Children, Young
People, Families and Communities

Effective

Efficient

Policy

Good Prac...
1. What do we mean by Evidence?
Evidence-based
A programme, service or intervention that has consistently
been shown to pr...
Types of evidence

Consultation

Research
Practice
Wisdom

Policy
What Works?

•
•
•
•
•

For whom
In what circumstances
At what point in time
Using which approach
Under what conditions
Developing a shared understanding of the evidence
journey
• Good Practice - A community of judgement of what works
• Promi...
What are the Benefits of Using Evidence?

It can
improve
outcomes for
children,
families and
communities

It is Ethical –
...
What are the Challenges of Using Evidence?
• Be able to select, weigh and interpret evidence
• Contested definitions of ev...
Evidence Needs a Context to be Useful
•

Assess how ‘workable’ this approach will be for your area

•

Understand the qual...
Outcomes
•

Outcomes are the changes for service users or other targets of change that happen as a result
of an interventi...
Logic Models
A Logic model is key in the design phase in ensuring your
services or intervention is outcomes focused, and h...
More specifically….
Monitoring and evaluation

INPUTS
Program
commitments

What we
invest

OUTPUTS

OUTCOMES

Activities

...
2. Implementing Effective Services
The “Implementation Gap”

15
Understanding Implementation
At its simplest, implementation can be described as the carrying
out of a plan for doing some...
Bridging the Gap
Science to Service

Best Evidence

Gap

Service

IMPLEMENTATION

Source: Implementation Masterclass, Dubl...
What Works?
Implementing properly matters!
Fidelity is important.
Fidelity is the degree to which the activities undertake...
Implementation Drivers
Improved Fidelity and Outcomes

Staff capacity to
support clients
with the selected
practices

Orga...
Implementation Drivers: Improved Fidelity &
Outcomes

Selection
Training
Coaching

Staff capacity to
support clients with ...
Implementation Drivers: Organisational support
Improved Fidelity and Outcomes
Systems Intervention
Facilitative Administra...
Implementation Drivers: Leadership
Improved Fidelity and Outcomes
• Adaptive challenges
cannot be solved by
existing syste...
Practitioners and Implementation

Need support

Need to feel
their work
and
contributions
are valued

Need to feel
involve...
How CES Promotes Evidence in Practice

Prevention and
Early Intervention
Projects

Practice Seminars
e.g. Sourcing
Useable...
Evidence Route Map for Youth Work
To Conclude…..
•

In the Design phase, factors to consider are:
o The Evidence
o Local context and need
o Logic Models to ...
Evidence + Implementation = Better Outcomes for Children

Effective
Interventions
The “WHAT”

Designing

Effective
Impleme...
If you are interested in ‘evidence based/informed practice’

•
•
•
•
•

www.effectiveservices.org
www.iriss.org.uk
www.cen...
Nuala Doherty
Director, Centre for Effective Services

ndoherty@effectiveservices.org
www.effectiveservices.org
Upcoming SlideShare
Loading in …5
×

Centre for effective services nuala doherty

376 views
203 views

Published on

Teen Counselling 2013 Conference

Published in: Health & Medicine, Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
376
On SlideShare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Centre for effective services nuala doherty

  1. 1. Designing and Implementing Effective Services Crosscare Teen Counselling Conference Nuala Doherty - Director, Centre for Effective Services Sarah Rochford - Intern 27th September 2013 © The Centre for Effective Services 2013
  2. 2. Overview 1. Designing effective services 2. Implementing effective services What is evidence? The Implementation Gap Sourcing and Using evidence: Challenges and Benefits Implementation Drivers Putting Evidence in Context Outcomes Logic Models How CES Supports evidence into practice
  3. 3. Introduction to CES A small organisation with charity status Established in 2008 (5 year grant) A multi-disciplinary staff team Jointly funded by All Island organisation Government Belfast • Dept. Environment, Community and Local Government • Dept. Children and Youth Affairs Dublin Atlantic Philanthropies 3
  4. 4. CES Mission Better Outcomes for Children, Young People, Families and Communities Effective Efficient Policy Good Practice Systems Evidence to Implementation All-Island Partnerships & Collaborations The Centre for Effective Services works with others to connect and support the implementation of effective policy, efficient systems and good practice, using the best available evidence, so that children, families and communities thrive.
  5. 5. 1. What do we mean by Evidence? Evidence-based A programme, service or intervention that has consistently been shown to produce positive results by independent research studies that have been conducted to a particular degree of scientific quality. Evidence-informed Practice based on the integration of experience, judgement and expertise with the best available external evidence from systematic research. 5
  6. 6. Types of evidence Consultation Research Practice Wisdom Policy
  7. 7. What Works? • • • • • For whom In what circumstances At what point in time Using which approach Under what conditions
  8. 8. Developing a shared understanding of the evidence journey • Good Practice - A community of judgement of what works • Promising Approaches - Some positive findings but findings are not consistent or rigorous enough to be sure • Research Based - Based on sound theory informed by a growing body of empirical research • Evidence Based - rigorously evaluated with consistent results Evidence must be fit for purpose and take account of the complex nature of service delivery and social needs. It helps us to assess and make decisions on interventions with an ‘evidence lens’
  9. 9. What are the Benefits of Using Evidence? It can improve outcomes for children, families and communities It is Ethical – do no harm. It can help us to understand how and why it worked and for whom, so it we can develop service delivery for the future It can increase chances of future funding & sustainability for organisations Relating costs to benefits can inform the debate about policy priorities and resource allocation Establishing what is not known helps to identify risks, limitations and grey areas for new services.
  10. 10. What are the Challenges of Using Evidence? • Be able to select, weigh and interpret evidence • Contested definitions of evidence • Limits to the evidence - Findings from different studies can sometimes be contradictory • Dearth of research in some areas and can be incomplete • Take into account the complexity and systemic nature of social problems and their underpinning issues • The best evidence in the world will not result in better outcomes if poorly implemented
  11. 11. Evidence Needs a Context to be Useful • Assess how ‘workable’ this approach will be for your area • Understand the qualitative local experiences, needs and strengths in your area • Look carefully at the service delivery mechanism most likely to work for your client group • Attempts to distil out the ‘active ingredients’ of effective programmes to identify effective practice and mainstream. • Resources are important - think about sustainability from the start • This will let you make an informed choice
  12. 12. Outcomes • Outcomes are the changes for service users or other targets of change that happen as a result of an intervention or service being provided. • There are levels of outcomes, i.e. individuals, families, specific groups, communities or organisations themselves. • Outcomes can be conceptualised in various ways: • • • soft outcomes - changes in feelings, thinking and perceptions. Hard outcomes - changes in behaviours, attainment or status which can be measured. Short-term outcomes, medium or long-term. • Being outcomes as opposed to outputs focused allows for the development of indicators of success and provides a common end for stakeholders. • It provides a more direct, focused approach to service provision.
  13. 13. Logic Models A Logic model is key in the design phase in ensuring your services or intervention is outcomes focused, and helps us to be accountable. It is a depiction of a programme/intervention showing what it will do and what it is to accomplish. A series of “if-then” relationships that, if implemented as intended, lead to the desired outcomes. Research shows logic models can improve communication, clarify programme purpose, improve service delivery, provide coherence across complex tasks and diverse environments, and help us do better evaluation (what variables to measure).
  14. 14. More specifically…. Monitoring and evaluation INPUTS Program commitments What we invest OUTPUTS OUTCOMES Activities Participation What we do Who we reach Short Medium Longterm What results Evidence 14 © Centre for Effective Services 2013
  15. 15. 2. Implementing Effective Services The “Implementation Gap” 15
  16. 16. Understanding Implementation At its simplest, implementation can be described as the carrying out of a plan for doing something. It focuses on operationalising the plan – the How , rather than the What Implementation involves — a specified set of purposeful activities — at the practice, programme and systems levels — putting into practice a programme, intervention or service with established and recognisable processes that are necessary to achieve desired outcomes. 16
  17. 17. Bridging the Gap Science to Service Best Evidence Gap Service IMPLEMENTATION Source: Implementation Masterclass, Dublin, May 2011, K. Blase and D. Fixsen 17
  18. 18. What Works? Implementing properly matters! Fidelity is important. Fidelity is the degree to which the activities undertaken in a programme are true to the design of the original programme on which it is based. Higher Fidelity is correlated with better outcomes across a wide range of programmes and practices
  19. 19. Implementation Drivers Improved Fidelity and Outcomes Staff capacity to support clients with the selected practices Organisational capacity to support staff in implementing practices with fidelity Leadership Capacity to provide direction, vision, & the “right” leadership approach Source: Adapted from Implementation Masterclass, Dublin, May 2011, K. Blase and D. 19 Fixsen
  20. 20. Implementation Drivers: Improved Fidelity & Outcomes Selection Training Coaching Staff capacity to support clients with the selected practices 20
  21. 21. Implementation Drivers: Organisational support Improved Fidelity and Outcomes Systems Intervention Facilitative Administration Organisational capacity to support staff in implementing practices with fidelity Decision Support Data System 21
  22. 22. Implementation Drivers: Leadership Improved Fidelity and Outcomes • Adaptive challenges cannot be solved by existing systems. • Adaptive leadership involves finding solutions that are new and break away from normal approaches. This involves convening staff, developing plans & reaching a consensus. Adaptive Capacity to provide direction, vision, & the “right” leadership approach Leadership • Technical challenges are those which can be solved by existing organisational systems. • Technical leadership involves managing these challenges by knowing what needs to be done and doing it. Technical 22
  23. 23. Practitioners and Implementation Need support Need to feel their work and contributions are valued Need to feel involved and that their opinions are heard Need to be empowered to use their skills and wisdom
  24. 24. How CES Promotes Evidence in Practice Prevention and Early Intervention Projects Practice Seminars e.g. Sourcing Useable Evidence Strategic Advice and Support The What Works Process CES Library Online Resource for Youth Workers
  25. 25. Evidence Route Map for Youth Work
  26. 26. To Conclude….. • In the Design phase, factors to consider are: o The Evidence o Local context and need o Logic Models to focus outcomes and accompanying indicators • During Implementation, key ingredients are: o Building staff competency o Organisational Readiness o Leadership to match the challenge and Championing of the new approach
  27. 27. Evidence + Implementation = Better Outcomes for Children Effective Interventions The “WHAT” Designing Effective Implementation The “HOW” Implementing Positive Outcomes for Children Effective Services Source: Implementation Masterclass, Dublin, May 2011, K. Blase and D. Fixsen
  28. 28. If you are interested in ‘evidence based/informed practice’ • • • • • www.effectiveservices.org www.iriss.org.uk www.ceni.org www.scie.org www.cssp.org
  29. 29. Nuala Doherty Director, Centre for Effective Services ndoherty@effectiveservices.org www.effectiveservices.org

×