The document outlines a quality improvement program aimed at enhancing the use of evidence in practice for looked-after children in Scotland. It details the implementation stages and various challenges faced in utilizing evidence effectively, such as competing priorities and a lack of relevant skills. Additionally, it emphasizes the need for collaborative discussions and innovative practices to promote better outcomes while highlighting the importance of measuring improvements and creating a shared understanding across the system.

1. Improving the use of
evidence using Quality
Improvement
Name
Job Title / Organisation
Dominique Harvey
04 November 2015Organisation
www.celcis.org
www.celcis.org

2. www.celcis.org
CELCIS Permanence and
Care Team (PaCT)
• Aim – to develop and deliver a
permanence improvement programme for
Scotland
• Vision - to secure sustainable
improvements for looked after children,
achieved through systemic, strategic and
practice changes
• Delivery of Permanence and Care
Excellence (PACE) programme

3. www.celcis.org
Aims of today’s session
1. Applying the Quality Improvement (QI)
model to improving use of evidence in
practice
2. What is different about QI?
3. Learning from the use of QI

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Challenges to using
evidence to improve
practice
1. Competing priorities
2. Lack of skills, knowledge and training
3. Differentiating between good quality
and less rigorous research
4. Lack of fit between research and
practice
5. Need for continuous practice
development and supervision
See Wike, Bledsoe, Manuel et al. (2014)

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Improving the use of
evidence in practice in
Argyll and Bute
Stage 1: Aim setting
Stage 2: Identifying barriers and enablers
Stage 3: Develop change theory
Stage 4: Testing
Stage 5: Implementation

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Improving the use of
evidence in practice in
Argyll and Bute
Aim
By XXX, the number of practitioners using
evidence to improve their practice will
increase by XXX%

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Force field analysis
By XX, the
number of
practitioners
using evidence
to improve
their practice
will increase by
XX%
Creativity and confidence
Scope to include evidence in reports
Assessment not restrictive
People’s interest – some workers will be interested
and motivated
PDR system is good for identifying areas staff want
to build on and helps them to take responsibility
Good links with other agencies
Quite a lot of staff get the opportunity to develop
and join strategic groups so practitioners feel
energised to take developmental opportunities
Accessibility (perhaps this should not be a barrier
but is perhaps more difficult for people who are
longer out of university)
Time constraints/ competing demands
Applying relevance to a task (e.g. incorporating the
research into a Hearing or CP report)
Ongoing debate re format of assessment (this has
changed a number of times in one year). Format
may be a barrier to creatively incorporating
evidence as some practitioners use it prescriptively
Systems do not always promote innovation
Forces for Forces against
Good team-working – having discussions and
looking at topics more analytically helps to inform
assessment and creates good environment for
healthy discussion
Condensing information for people
Information is easily accessible
From an organisational perspective, the service is
based on a corporate business model, and therefore
some people are not always encouraged unless
there is a dynamic management culture.

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Force field analysis
By XX, the
number of
practitioners
using evidence
to improve
their practice
will increase by
XX%
Ongoing debate re format of assessment (this has
changed a number of times in one year). Format
may be a barrier to creatively incorporating
evidence as some practitioners use it prescriptively
Forces for Forces against
Good team-working – having discussions and
looking at topics more analytically helps to inform
assessment and creates good environment for
healthy discussion

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Driver Diagram

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What is different about QI?
• Aim setting – creating shared
understanding across whole-system
• Clear understanding of current
performance
• Measurement of improvement
• Building up evidence base before moving
to implementation

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:
… I wouldn’t have understood
methodology, I wouldn’t have
understood the need to do the
PDSA’s et cetera et cetera, so
there was the education
element of it
… to challenge entrenched views of how
things have to be done and allows those
involved the freedom to try new ways of
working and think about what will actually
improve outcomes for children rather than
sticking rigidly to processes
… a new way of thinking… the
most important part is that it
allows you to test changes that
may seem quite radical in a
safe and informed
environment
… understanding that we
could do small things to effect
change, that we didn’t have to,
you know, go away and spend
months and months and
months talking about what
we wanted to do

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:
Questions?