Moving Beyond Train and Hope: Building a Sustainable Service Delivery Model
Andye Criste & Bridget Walker, LSCI Master Trainers
Supporting children and youth with intensive social, emotional, behavior and/or mental health challenges has many difficulties. Multiple funding sources, shifting regulations, competing initiatives and staff turnover are only a few. Many agencies and districts turn to the LSCI Institute requesting training support for staff. Indeed, the LSCI Institute and its Senior and Master Trainers provide excellent training and content. However, LSCI can provide much more than training content. The LSCI Institute can help schools and agencies build a system delivery model to support sustainable, long term program improvement and staff development. This paper provides an overview of how LSCI Trainers can support your school, district or agency in creating a customized implementation and service delivery plan.
The Science to Service Gap
“What is known is not what is adopted to help children, families, and individuals…”
(Fixsen, et al. 2005)
The ongoing challenge in mental health, education and many other human service organizations is that what we learn about effective practice and intervention from research seldom makes it systematically into day to day practice, creating what Dean Fixsen and his colleagues at the National Implementation Research Network (NIRN) refer to as “the science to service gap.” The extensive research conducted by NIRN identifies challenges and strategies for effective implementation in human services settings. Dean Fixsen and Karen Blase’, Co- Directors at NIRN identified the following as key features of this implementation gap (2011):
► What is adopted is not used with fidelity so doesn’t result in good outcomes for consumers.
► What is used with fidelity is not sustained for a long enough period to achieve desired changes and outcomes.
► What is used with fidelity is not used on a scale sufficient to truly impact social problems.
Perhaps you are considering whether or not LSCI is a good fit for your school district or agency or you have been implementing LSCI but would like to see implementation strengthened. The LSCI Institute wants to help our clients build sustainable delivery models that address these limitations.
Intervention and Implementation are Not the Same Thing
We often confuse training staff and expecting a change of their behavior with implementation. The team at NIRN points out that they are different variables in an important equation.
Interventions are the evidence-based strategies and practices that we know make a difference for the populations we serve and support. Implementation is the infrastructure and strategic plan that brings these interventions to life with fidelity, sustainability and ultimately to scale in our districts and agencies.
The Formula for Success (NIRN)
Effective intervention practices
X
Effective implementation practices
=
Good outcomes
Intervention without a clear implementation plan leads to hit or miss results, often referred to as train and hope. Money, time and staff resources are invested with good intention, but the outcomes are often disappointing. NIRN’s research has found that organizations who do BOTH (adopt effective interventions and implement them within a planned, systems delivery framework) have what they refer to as Disproportional Impact. That is: clients benefit 8 to 12 times more from interventions that are provided within the framework of a comprehensive system delivery model.
NIRN’s studies have found that effective implementation of key interventions happens in stages. The image below was developed by Steve Goodman as part of his work leading the implementation of Multi-Tiered Systems (MTSS) of Support in Michigan. This image outlines the process and timeline for building a clear, sustainable systems delivery model for an agency, district or school. When identifying training and interventions in our schools and agencies we seldom take the time to think through this entire process. NIRN’s studies have shown that to develop and effectively implement a service delivery model, it takes 2-5 years to move from the planning stages to a sustainable, regenerating system. We know that change is a process and not an event, so we must plan accordingly when implementing key practices in our schools and agencies.
NIRN’s studies have found the following to be crucial reminders for organizations building an implementation plan.
- Organizations don’t get to skip any stages! It is a process that must be taken in sequence.
- Do the right work for each stage. Make sure the questions explored and systems being built match the stage your organization is currently in.
- The exploration and installation stages are often neglected or rushed through, which often leads to initiative failure/fatigue.
- In any organization, large or small, somebody, somewhere is in the exploration stage. Plan for it and build a system to help these individuals or parts of your organization move through the stages effectively. It will pay off in the long run!
- The Stages of Installation are not necessarily linear; they can be iterative and overlapping over time as the reflect growth and changes in your organization. This is why a clear systems development plan will help you find your way.
Stages of Implementation (NIRN, modified by Goodman)
Why Does a Service Delivery Framework Matter with LSCI?
LSCI Trainers are available to work with you in developing a systems delivery model to maximize the effect LSCI has in your work. A clear systems delivery plan:
- Guides us in building a system for implementing LSCI in way that is effective and sustainable over time.
- Supports strategic integration of initiatives to comprehensively meet the needs of the young people we serve, as well as our staff.
- Builds systems for effective data-based decision-making and implementing LSCI with fidelity over time.
- Provides a framework for delivering LSCI across a continuum of supports and adapting it to the diverse needs of our agencies, schools, communities and families.
- Builds capacity for effective LSCI implementation over time and across levels of service. Move beyond train and hope!
To support our clients, the LSCI Institute has used NIRN’s Stages of Implement to outline elements of a service delivery model around LSCI. Certified LSCI Trainers are available to help your organization explore and customize this model in a way that meets your specific needs.
The Stages of Implementation of the LSCI Service Delivery Model
#1 Exploration /Adoption – Committing to adopting LSCI and supporting successful implementation
- What goals and challenges do you hope to address through the adoption of LSCI? Is there a good “fit” between the organization’s vision, philosophy, values, current initiatives, (e.g., discipline practices, etc.) and LSCI?
- Will the organization support implementation of LSCI over the long term (e.g., provide resources, guidance, training, coaching, technical assistance, etc.)?
- Are program level administrators and other key staff on board with the adoption of LSCI (e.g., active involvement in the process, integrated with other program/organization.
#2 Installation – Set up the infrastructure to facilitate successful implementation. Establish team to lead the process and data systems to guide implementation efforts.
- Identify the team to lead the process (e.g., planning, coordination, and communication of implementation efforts with organization, program level administrators, and front-line staff).
- Develop organizational plan for integrating LSCI within existing organization-wide improvement processes and other initiatives/programs (e.g., PBIS, MTSS, Restorative Practices, Social-Emotional-Learning (SEL), etc.).
- Establish data systems for collecting implementation outcomes, fidelity of implementation, and program quality measures.
- Plan for all staff to attend Foundations/Universal Supports Training (Conflict Cycle, etc.) and decide who will attend Targeted/Individual Student Supports (LSCI Certification Course).
- Identify the scope and sequence of the training
- How many buildings/classrooms/units will be involved in the initial training?
- What is the timeline and plan for the training of the initial group and beyond?
#3 Initial Implementation – Try out LSCI (e.g., work out the details, work through beginning implementation challenges, and improve before expanding implementation efforts)
Foundations: Universal Supports
- Decide the depth of knowledge needed by ALL staff (e.g., Conflict Cycle, Overview of LSCI, one-day LSCI training, two-day LSCI training, etc.)
- Develop a training schedule (who, when, where).
Targeted/Individual Student Supports
- Decide who will complete the LSCI Certification Course (teams who support individual students experiencing personal crises). Consider sending positive role models and those most likely to influence others.
- Develop a training schedule (who, when, where).
- Develop a system for referring students experiencing personal crises to staff trained in LSCI and conducting follow-up team meetings to discuss skill training and further support.
Data, Fidelity, Support
- Initiate data systems for collecting implementation outcomes, fidelity of implementation, and program quality measures. Who will be responsible for oversight at program and organization level?
- Decide who will be trained as LSCI senior trainers and on what schedule?
- How will staff be supported in beginning to implement LSCI practices?
#4 Full Implementation – Expand implementation of LSCI throughout the organization
- Develop a plan for completing Foundations and LSCI certificate training across the organization.
- Establish the role of the LSCI senior trainer(s) for periodic follow up and refreshers.
- Review and share LSCI data with staff and administrators.
- Integrate LSCI throughout other goals and initiates within the organization.
- Revise data collection systems and make implementation decisions based on the data.
Invest in Effective, Sustainable Implementation of LSCI!
For more information on bringing a certified LSCI Trainer to your school or organization, please email Signe at signewhitson@LSCI.org
For more information on the National Implementation Research Network and studies in implementation visit: https://nirn.fpg.unc.edu/
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).
Download all or part of the monograph at: http://www.fpg.unc.edu/~nirn/resources/detail.cfm?resourceID=31