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IF TRAINING IS THE ANSWER, WHAT’S THE QUESTION? TOWARD AN EVIDENCE-BASED SYSTEM FOR INNOVATION SUPPORT

IF TRAINING IS THE ANSWER, WHAT’S THE QUESTION? TOWARD AN EVIDENCE-BASED SYSTEM FOR INNOVATION SUPPORT. Abraham Wandersman U. Of South Carolina wandersman@sc.edu. QUESTIONS. IF TRAINING IS THE ANSWER, WHAT’S THE QUESTION? IF TRAINING EVALUATION IS THE ANSWER, WHAT’S THE QUESTION?. OVERVIEW.

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IF TRAINING IS THE ANSWER, WHAT’S THE QUESTION? TOWARD AN EVIDENCE-BASED SYSTEM FOR INNOVATION SUPPORT

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  1. IF TRAINING IS THE ANSWER, WHAT’S THE QUESTION?TOWARD AN EVIDENCE-BASED SYSTEM FOR INNOVATION SUPPORT Abraham Wandersman U. Of South Carolina wandersman@sc.edu

  2. QUESTIONS • IF TRAINING IS THE ANSWER, WHAT’S THE QUESTION? • IF TRAINING EVALUATION IS THE ANSWER, WHAT’S THE QUESTION?

  3. OVERVIEW • AMBITIOUS GOALS • THE INTERACTIVE SYSTEMS FRAMEWORK FOR DISSEMINATION AND IMPLEMENTATION • DEMYSTIFYING ACCOUNTABILITY AND GETTING TO OUTCOMES ® (TAKING A VACATION) • TOWARD AN EVIDENCE BASED SYSTEM FOR INNOVATION SUPPORT • SUMMARY (JEOPARDY)

  4. AMBITOUS GOALS

  5. Dr. von Eschenbach: I believe we are at what I call a strategic inflection in biology, which means we're at a point of unprecedented growth in three key areas related to cancer research: knowledge, technology, and resources. The integration of growth in these three sectors provides an opportunity for exponential progress. To achieve this progress, we must set a clear direction and focus our efforts into a cohesive strategy.

  6. The goal of eliminating suffering and death due to cancer provides this focus. It does not mean "curing" cancer but, rather, it means that we will eliminate many cancers and control the others, so that people can live with -- not die from -- cancer. We can do this by 2015, but we must reach for it. We owe it to cancer patients around the world -- and their families -- to meet this challenge. May 16, 2003 BenchMarks

  7. ADDITIONAL AMBITIOUS GOALS • SAFETY • PERMANENCY • CHILD WELL-BEING

  8. DATA - EVIDENCE

  9. THE GAP BETWEEN RESEARCH AND PRACTICE • IN THE DOCTOR’S OFFICE

  10. OVERALL 54.9% RECEIVED RECOMMENDED CARE ASCH ET AL STUDY, NEJM, 2006

  11. POSSIBLE SOLUTION • VA MEDICAL SYSTEM HAS 67% RECOMMENDED CARE SYSTEM HAS ELECTRONIC MEDICAL RECORDS, DECISION SUPPORT TOOLS, AUTOMATED ORDER ENTRY, ROUTINE MEASUREMENT AND REPORTING ON QUALITY, INCENTIVES FOR PERFORMANCE

  12. As Yogi Berra supposedly said, "In theory there is no difference between theory and practice, but in practice there is."

  13. Gates Foundation Preventive Intervention Vaccine/Drug Mechanism Syringes Physician Health System Support System Medical Schools Government Funding

  14. Traditional Evaluation Model Stage 1 Stage 2 Evaluator Agency Funder Funder

  15. Partnership Model Agency Evaluator RESULTS Funder

  16. HOW DO WE GET FROM HERE TO THERE ?

  17. THE INTERACTIVE SYSTEMS FRAMEWORK FOR DISSEMINATION AND IMPLEMENTATION

  18. io Funding Putting It Into Practice—Prevention Delivery System General Capacity Use Innovation-Specific Capacity Use Supporting the Work—Prevention Support System Macro Policy Climate General Capacity Building Innovation-Specific Capacity Building Distilling the Information—Prevention Synthesis & Translation System Synthesis Translation Existing Researchand Theory

  19. Support System Model

  20. TOOLS

  21. TRAINING

  22. TECHNICAL ASSISTANCE

  23. QUALITY IMPROVEMENT/QUALITY ASSURANCE

  24. DEMYSTIFYING ACCOUNTABILITYGTO®

  25. GTO as a Painter’s Palette #3 Best Practices #4 Fit #2 Goals #1 Needs/ Resources #5 Capacities RESULTS #6 Plan #10 Sustain #7 Implementation Process Evaluation #9 Improve/ CQI #8 Outcome Evaluation

  26. VACATION EXAMPLE

  27. What Is Getting To Outcomes-2004? • By Matthew Chinman, Pamela Imm & Abraham Wandersman • A system based on ten empowerment evaluation and accountability questions that contain elements of successful programming • Published by the RAND Corporation (quality review) • Available at no cost at: http://www.rand.org/publications/TR/TR101/ • “Best Practice Process” –WINNER OF 2008 OUTSTANDING PUBLICATION AWARD • DOWNLOADED OVER 75,000 TIMES

  28. Levels & Accountability

  29. TOWARD AN EVIDENCE BASED SYSTEM FOR INNOVATION SUPPORT (EBSIS) WANDERSMAN, CHIEN, KATZ (ACCEPTED WITH REVISIONS)

  30. EVIDENCE BASED SYSTEM for INNOVATION SUPPORT

  31. AN ILLUSTRATION OF EBSIS • THE MOMS PROJECT FOR SUBSTANCE ABUSING PREGNANT WOMEN

  32. Core Components of MOMS program • Client-Centered Care • Getting to Outcomes ® • Motivational Interviewing • Rewards system

  33. EBSIS Components • Tools • Training • Technical Assistance • Quality Assurance/Quality Assistance

  34. Tool: MOMS Manual • Developing Fall 2009-Spring 2011 • Three versions: Clinician, supervisor, and client • Described: • GTO process for individual treatment planning and deliver • Use of assessment tools for planning, monitoring, and evaluating client progress • Use of motivational interviewing to move clients through the GTO Steps • However, we know that many tools end up sitting on shelves!

  35. Training for Outcome (TFO) • Developing in conjunction with LRADAC leadership and clinicians • Utilized thorough assessment of training needs to assure training transfer • Separated into modules tailored to specific job descriptions • Delivered 10.21.10-10.22.10 to over 70 staff!

  36. Technical Assistance • Began immediately following training • Implementation planning January 2011 • Using the Quality Implementation Tool (QIT) • Regular meeting with clinical/supervisory staff around imp. Issues and program refinement • Clinician booster session re: use of MI and other MOMS components 2.11

  37. QI/QA • Monitoring process and Evaluating Outcomes • Assessment of Information System Capacity • Streamline collection and utilization of information • Designed to: • Inform Continuous Quality Improvement (CQI) • Evaluate multi-dimensional outcomes

  38. ENHANCING THE SCIENCE AND PRACTICE OF INNOVATION SUPPORT • ZOOM OUT--THE 40 CELLS OF EBSIS

  39. ZOOM IN--GTO AND WEBINARS

  40. QI/QA iGTO Funding GTO Contracting Implementation Putting It Into Practice—Prevention Delivery System Outcomes General Capacity Use Innovation-Specific Capacity Use Implementation Supporting the Work—Prevention Support System Macro Policy Climate General Capacity Building Innovation-Specific Capacity Use Distilling the Information—Prevention Synthesis & Translation System Synthesis Translation Existing Research and Theory

  41. WHAT CAN FUNDERS, PRACTITONERS, AND RESEARCHERS/EVALUATORS HAVE IN COMMON?

  42. Accountability Partnership Model Agency Evaluator RESULTS Funder

  43. As Yogi Berra supposedly said: “It’s déjà vu all over again.”

  44. SUMMARY

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