Implementing Evidence Based Programmes

I’ve noted before that while having an evidence based programme is one thing, being able to implement it well is just as critical to getting good outcomes.

The DfE have just published a paper on implementing evidence based programmes in children’s services and it looks to have some interesting key messages that we may want to think about as part of our work.

Here are the key findings they report:

  • Carefully planned and well resourced implementation is critical to achieving better outcomes and programme success.
  • Implementation of an evidence-based programme may be aided by the involvement of an implementation team to plan for the changes that are required at four different stages: exploration and adoption of the programme; installation; early implementation and full operation.
    • Exploration and adoption: Before selection, careful consideration should be given to whether a programme could work in the local context, with existing agencies and available resources.
    • Installation: Planning for successful implementation of an evidence-based programme requires change at the practitioner, supervisory and administrative support levels, as well as the system level (Fixsen et al 2005). There are however no purely administrative decisions – they are all treatment decisions (National Implementation Research Network). Support for these changes has to be resourced both prior to and during implementation.
    • Early implementation: The implementation phase requires ongoing support and fidelity monitoring, as well as evaluation of the new processes being introduced.
      • Maintaining fidelity to the original evidence-based programme has been improved by working with a ‘purveyor’ – individuals or groups who work in a systematic way with local sites to ensure that they adopt a pure and effective model of the programme.
    • Full operation: Over time the programme should become accepted practice, staff become fully competent and procedures become routine. Sustainability of a programme depends on commitment to ongoing funding and continued staff training and monitoring.
  • Examination of the experiences of implementation of four high intensity evidence based programmes in children’s services has shown that it is possible to successfully implement them in a different cultural context. This has been aided by maintaining fidelity to the programme, but allowing some planned adaptations to processes to accommodate different national and local systems. Successful implementation was boosted, for instance, by early concentration on changes in staff working patterns, careful focus on referrals of appropriate clients, and modification of training materials to suit local culture and language needs.

The full report can be downloaded here.

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