The challenges of successful implementation


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What has been done and the experiences of implementing “Child Talks” in General Psychiatric Clinics for adults at UNN, Tromsø, Norway to ensure that children of mentally ill and substance abusing parents are identified, and that they get the support to which they are entitled by Psychologist Charlotte Reedtz/
Educationalist Camilla Lauritzen/
PhD Karin van Doesum
The conference Developing Strength and Resilience in Children 1-2 Nov. 2010 in Oslo

Published in: Education, Health & Medicine
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The challenges of successful implementation

  1. 1. The challenges of successful implementation Implementing change of practice in mental health care for adults in Northern Norway Charlotte Reedtz and Camilla Lauritzen, November 2010
  2. 2. Children of mentally ill parents • Changes in existing legislation January 2010 • The changed Health Personnel Act (§ 10 a) states that health professionals should help to meet the needs for information and necessary follow-up for children under 18 years who have parents that receive health care for mental illnesses, substance abuse disorders or serious somatic illness or injury.
  3. 3. Guidelines (IS-5/2010) • The guidelines published by Norwegian authorities provide thorough descriptions of the expectations and the intention behind the legislation amendments • A somewhat overwhelming document, listing a number of new tasks and responsibilities that health care workers now have
  4. 4. How do we successfully implement the amended legislation? • Implementation of skills • Implementation of new practice Definition: Implementation is a specified set of activities designed to put into practice an activity or program of known dimensions (Fixsen et. Al 2005)
  5. 5. Project: Children of Mentally ill Parents – implementing and evaluating changes of practice within mental health care for adults • In this project RBUP North focuses on what changes of practice that will occur within mental health services for adults as a result of the amendments in legislation as of 2010; - Implementation of new routines and interventions - How to achieve systematic changes of practice that can be maintained over time
  6. 6. Our approach to implementation: • A perspective on innovation • A focus on the actions of those who convert innovation into practice • The essence of implementation is behavior change • Ideas behind innovations are not self-executive!
  7. 7. Implementation model : Phase 1: Initiate change; network planning/analysis and mobilize support and partnerships Phase 2: Adoption. Preparing the organization. Informing the total staff about the program and research. Develop schedules for executing change of practice. Phase 3: Effectuate change of practice Phase 4: Maintenance and consolidation (Barry & Jenkins, 2008)
  8. 8. Phase 1 - Initiate change; Project: Children of mentally ill in UNN A. Descriptive studies of what is needed within the organization, in this case The University Hospital of Northern Norway - UNN B. Description of the local context; Cooperation and dialogue with participants within UNN. C. Choose interventions and activities; E.g. check out the database Youngmind (Ungsinn) at D. Mobilize support, initiate and formalize cooperation. Contract. The contract based on the needs within the organization/UNN. Establish project group. Cooperation meetings. E. Establish project group and project management. Set aside personnel responsible for particular tasks within the project.
  9. 9. Phase 2 - Adoption. Preparing the organization. Project: Children of Mentally ill Parents in UNN A. Informing the total staff about the program and the research. Develop schedules for executing change of practice - regarding both research and intervention. Describe routines and responsibilities. B. The intervention ”Child Talks” - Training/education
  10. 10. Phase 3 - Effectuate change of practice. Project: Children of Mentally ill Parents in UNN A. Implementation of registration form B. Implementation of Child Talks C. Monitoring the implementation and practice of Child Talks and registration form. Logbook. D. Evaluation of training, peer coaching and coaching via program owner (VFB).
  11. 11. Phase 4 - Maintenance and consolidation. Project: Children of Mentally ill Parents in UNN A. Evaluation of change of practice within the organization. B. Evaluation of maintenance of the new practice.
  12. 12. The next decade…. • Implementing change of practice is the greatest challenge of them all (Hollin & McMurran, 2001). • Innovation takes time! • Researchers and health care workers need to join forces in order to prevent health problems in children who have mentally ill parents.