Organizational core conditions and activities for an evidence-based practice focusing on client outcome a model

Transcription

1 Organizational core conditions and activities for an evidence-based practice focusing on client outcome a model Anna Gärdegård, City of Stockholm anna.gardegard@stockholm.se Lars Oscarsson, Ersta Sköndal University College lars.oscarsson@esh.se The Capital of Scandinavia

2 BACKGROUND and AIM Background Experiences from social work practice: There are difficulties to introduce and apply EBP in practice One thing to implement one or two diagnostic tests, documentation templates or evidence-based methods but another to make them integrated parts of an EBPsupportive organizational structure Corresponds to a growing literature on the importance of organizational and staff-based core factors for successful implementation and sustainable utilization of an evidence-based practice. More knowledge is needed about what is needed to conduct an EBP in social work organizations Aim of presentation To present a comprehensive conceptual model aimed as an analytical tool or map to discuss organizational core factors with managers and practitioners in social work practice, and to identify and assess them in practice.

3 CONTEXT Dissemination, implementation and utilization of evidence-based methods: From technical-educational models, via program-evaluation perspectives, to perspectives and models including larger contextual and societal conditions related to, e.g., culture, policy-formation, and economic factors. Research: Inspired by and builds partly on, i.e., - The PARiHS framework (Rycroft-Malone, Kitson et al.) - Austin & colleagues (knowledge management, research-minded practitioners, etc) - Fixsen & colleagues (implementation drivers) -Damschroder et al., Grey, et al., Wike et al, Kluger, A. FEATURES - general & context-specific core factors - organizational & staff-based core factors - step-wise concretization of nominal concepts/factors for empirical identification & assessment in practice

4 Time Information technologies Fig. 1 A social work practice focusing on client outcome - Organizational core factors FACTORS COMPONENTS CHARACTERISTICS INDICATORS (e.g.) Access to journals, reviews & conferences Evidence Research evidence Professional experiences Client s preferences Evidence-based assessments, decisions & interventions Case & experience exchange meetings Standardized assessment tools, investigation & documentation support Evidence-based methods and intervetions Methods and routines for client involvement Learning culture Focus on - Outcome - Knowledge Participation & common view on target groups, theories of change & improvement efforts Innovative thinking Recurrent workshops Testing new approaches & methods Routines for staff members improvement ideas Learning from research & local data Routines & systems for measuring outcomes Follow-up & evaluation on different levels & with different methods Strategic leadership Focus on - Improvement of practice - Client outcome Convey a clear direction Establish prerequisites Systematic follow-up Explicit expectations regarding goals, outcomes & activities Staff members have commitment, competence & resources Continuous follow-up at an individual, work group & organizational level Facilitation Linking research & practice Methodological & improvement competence Task & holistic perspective Implementation support Case support Organized dissemination of knowledge Facilitating local improvement projects Optimal processes Process routines & charts System perspective Logic of activities Flow charts Theories of change Copyright: Oscarsson, Gärdegård & Larsson 2014

5 Time Information technologies Fig. 1 A social work practice focusing on client outcome - Organizational core factors FACTORS COMPONENTS CHARACTERISTICS INDICATORS (e.g.) Access to journals, reviews & conferences Evidence Research evidence Professional experiences Client s preferences Evidence-based assessments, decisions & interventions Case & experience exchange meetings Standardized assessment tools, investigation & documentation support Evidence-based methods and interventions Methods and routines for client involvement Learning culture Strategic leadership HOW? e. g. Shared decision making, surveys, focus groups, interviews Facilitation Optimal processes Copyright: Oscarsson, Gärdegård & Larsson 2014

6 Time Information technologies Fig. 1 A social work practice focusing on client outcome - Organizational core factors FACTORS COMPONENTS CHARACTERISTICS INDICATORS (e.g.) Evidence Learning culture HOW? E g Esablish agreement on goals. SMART goal setting HOW? E g e.g. Appreciative or feedforward interview (FFI) Competence plans Material available Strategic leadership Focus on - Improvement of practice - Client outcome Convey a clear direction Establish prerequisites Systematic follow-up Explicit expectations regarding goals, outcomes & activities. Staff members have commitment, competence & resources. Continuous follow-up at an individual, work group & organizational level. Facilitation Optimal processes HOW? E g Visible time series charts LOOP Survey (appstore) Be aware of all step in the right direction and celebrate success! Copyright: Oscarsson, Gärdegård & Larsson 2014

7 To Summarize: THE WHAT Practice specific tools and routines Organizational core factors THE HOW Individual core factors THE NEXT STEP Organizational structures and staff-based competencies for an evidence-based practice in social work

8 Read more Oscarsson, L., Gärdegård, A., Larsson, A., (in press). Organizational Core Factors for the Implementation and Exercise of an Evidence-based Practice focusing on Client Outcome a model. Research on Social Work Practice. Anna Gärdegård, R&D officer, City of Stockholm anna.gardegard@stockholm.se Annika Larsson, R&D officer, City of Stockholm annika.larsson@stockholm.se Lars Oscarsson, Professor in social work, Ersta Sköndal University College lars.oscarsson@esh.se