Module 1: An Overview of Active Implementation Frameworks

Welcome to the Active Implementation Module Series. In this module you will learn about the five active implementation frameworks and how to begin applying them in your setting.

Learning Objectives

After this module, you should be able to:

Terminology

 


Module 1 Table of Contents

The Rationale for Active Implementation

Over the past decades the science related to developing and identifying evidence-based programs and practices has improved significantly. However, the science related to implementing these programs, with high fidelity, in real-world settings, has lagged far behind.

Recent reports from groups such as the Institute of Medicine (2000, 2001, 2007) and The U.S. Department of Education (2011) have highlighted the gap between researcher knowledge of effective innovations and the services actually received by persons who could benefit from research-based interventions. In fact, the lag time for translating research into practice has been documented as 20+ years.

The research-to-practice gap is a critical issue because students cannot benefit from interventions they do not receive.

 

Video Vignette 13: Active Implementation and Scaling-up In Education

How can we take these good ideas that work in some places, and get them to work in all places… so all children in all schools would have access? Listen to Dean Fixsen and Karen Blase discuss active implementation and scaling up.

 

In 2005, the National Implementation Research Network released a monograph synthesizing implementation research findings across a range of fields. Based on these findings, NIRN developed five overarching frameworks referred to as the Active Implementation Frameworks.

In these modules we provide an overview of the Active Implementation Frameworks as follows:

Active Implementation Frameworks

Framework 1: Usable Innovations

To be usable, it’s necessary to have sufficient detail about an innovation. With detail, you can train educators to implement it with fidelity, replicate it across multiple settings and measure the use of the innovation. So, an innovation needs to be teachable, learnable, doable, and be readily assessed in practice.
 

Before implementing an innovation (i.e., an evidence-based program), it’s vital to have a clear understanding of the program and its' suitability for your State, district or school. It’s necessary to have sufficient detail about the innovation that you can train staff and administrators to implement it with fidelity; that the innovation can be replicated across all of your classrooms, schools, and districts; and that there is an assessment that allows you to measure the use of the innovation. In other words, the innovation needs to be teachable, learnable, doable, and be readily assessed in practice. The following criteria need to be in place to ensure that your innovation is usable:

Evaluation and Planning Tools: The Hexagon Tool

This tool can help you and your team appropriately select EBPs/EIIs by reviewing six broad factors in relation to the program or practice under consideration.

Clear Description of the Program

Not every program or practice is a good fit with the needs, values and philosophy of your State or district.  Having a good description of a program and its foundations is necessary so that administrators and staff can make informed choices about what to use. The Hexagon Tool used during the Exploration Stage provides some guidance for assessing the fit of an innovation with the goals and needs of an organization.

Additionally, make sure that you can identify these components:


Clear Essential Functions

The speed and effectiveness of implementation may depend upon knowing exactly what has to be in place to achieve the desired results for students. Not knowing the core components of the innovation wastes time and resources on attempting to implement a variety of nonfunctional elements. Knowing the core innovation components may allow for more efficient and cost effective implementation, and lead to confident decisions about what can be adapted to suit your school or district.  Clear descriptions also allow for evaluations of the functions of those procedures. Clear essential functions that define the program, or core components, include a clear description of the features that must be present to say that a program exists in a given location.

Operational Definitions

Knowing the essential functions is a good start. The next step is to express each core component in terms that can be taught, learned, done in practice, and assessed in practice.  Engagement, for example, is fundamental to interactive innovations. What does this mean for teachers? What should they say and do to ensure engagement of students?

Practice profiles describe the core components that allow a program to be teachable, learnable and doable in practice, and promote consistency across educators at the classroom, building and district levels.

Practical Performance Assessment

How well are educators saying and doing those things that are in keeping with the essential functions and with the intentions behind the innovation? Are the intended outcomes being realized? An effective performance (or fidelity) assessment provides evidence that the program is being used as intended and is resulting in the desired outcomes.

Look for these features in your performance assessment:

Activity 1.1
Getting started with Usable Innovations

To be usable, it’s necessary to have sufficient detail about an innovation. With detail, you can train educators to implement it with fidelity, replicate it across multiple settings and measure the use of the innovation. With your team, consider a current or upcoming initiative and work through the tasks provided.


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Framework 2: Implementation Stages

An implementation stages diagram portayed as four overlapping circles, reading left to right

Implementation is not an event.  Implementation is “a specified set of activities designed to put into practice an activity or program of known dimensions.”  These activities occur over time in stages that overlap and that are revisited as necessary dimensions.
 

The next framework we would like to introduce is Implementation Stages.  Implementation is a process involving multiple decisions, actions, and corrections to change the structures and conditions necessary to successfully implement and sustain new programs and innovations.

Research shows implementing a well-constructed, well-defined, well-researched program can be expected to take 2 to 4 years (Bierman et al., 2002; Fixsen, Blase, Timbers, & Wolf, 2001; Panzano & Roth, 2006; Prochaska & DiClemente, 1982; Solberg, Hroscikoski, Sperl-Hillen, O’Conner, & Crabtree, 2004). There also is substantial agreement that planned change is a recursive process that happens in discernible stages. Conducting stage-appropriate implementation activities is necessary for successful new practices to be used and for organizations and systems to change in order to support new ways of work.

There are four functional Implementation Stages. Notice that each stage of implementation does not cleanly end as another begins. Often stages overlap with activities related to one stage still occurring as activities related to the next stage begin. Likewise, stages may be revisited when circumstances change.

The following section describes each of the four stages in more detail.

Implementation Stages

An implementation stages diagram with the stages "exploration", "installation", "initial implementation" and "full implementation" listed

Exploration Stage

An implementation stages diagram with the first stage highlighted

Involves:

  • Assessing the needs of students
  • Identifying possible programs and practices to meet those needs
  • Assessing the fit and feasibility of implementing and sustaining the identified programs

The goal of the Exploration Stage is to examine the degree to which a particular program or innovation meets the school or district’s needs and whether implementation is feasible. In this stage, schools and districts must assess the goodness of fit between potential programs and innovations, and the needs of the students they serve.

For example a school or district would assess the fit between potential evidence-based practices and the academic, behavioral, and health needs of the students they serve.

Requirements for implementation must be carefully assessed and potential barriers to implementation examined. Key activities during exploration include getting key stakeholders involved, forming an implementation team, and identifying potential programs. It’s also important to ensure that core innovation components of potential programs are identified and well operationalized. Even with existing evidence-based and evidence-informed practices, more program development work might need to be done before implementation decisions to move forward can be made.

Evaluation and Planning Tools: The Hexagon Tool

This tool can help you and your team appropriately select EBPs/EIIs by reviewing six broad factors in relation to the program or practice under consideration.

Installation Stage

An implementation stages diagram with the second stage highlighted

Involves:

  • Developing communication pathways
  • Ensuring financial and human resources are in place
  • Finding physical space
  • Purchasing equipment and technology
  • Developing practitioner competency

The Installation Stage begins as the decision is made to move ahead.

The Installation Stage is often overlooked in implementation. Practical preparations needed to initiate the new program or innovation are central to the Installation Stage. Once a decision is made to adopt a program or innovation, changes often must be made in multiple settings and systems to accommodate and fully support the new practice, program or innovation. These can include practical activities such as:

  • Developing communication protocols
  • Ensuring financial and human resources are in place
  • Finding or reallocating physical space
  • Purchasing equipment and technology

In addition, developing the knowledge, skills and abilities of teachers and administrators is a key function of the Installation Stage. This means that training, coaching, and data systems are conceptualized, created, or purchased.  It also means those expected to implement the new program or practices receive the training and support needed.  Well prepared teachers are more likely to feel confident and to be able to implement new programs and practices with fidelity.

Initial Implementation Stage

An implementation stages diagram with the third stage highlighted

Involves:

  • Special attention to coaching
  • Attention to continuous improvement and rapid cycle problem solving
  • Using decision support data systems (DSDS)

The Initial implementation Stage begins when the new program or practice is first being put to use.

Attempts to implement a new program or innovation often falter (or end) during installation or initial implementation.  This is because everyone is learning and challenges emerge as the status quo is changed.  Key activities during this stage include intensive coaching to help practitioners through this awkward stage. As problems emerge the team develops and engages in strategies to promote continuous improvement and rapid- cycle problem solving. In addition, data are used to assess the quality of implementation, identify problems and solutions, and inform decision making. It is critical to address barriers and develop systemic solutions quickly rather than allowing problems to re-emerge and reoccur.  The processes for doing so are discussed later in the Improvement Cycles section.

Full Implementation Stage

An implementation stages diagram with the fourth stage highlighted

Involves:

  • Teachers skillfully employing new practices
  • An infrastructure to support teachers
  • Integrating new learning at all levels in classroom building and district

Full implementation occurs as teachers skillfully provide new programs and outcomes are achieved. New learning at all levels becomes integrated into classroom, building and district settings. In full implementation, the processes and procedures to support the new way of work are in place. The system has largely been recalibrated to accommodate and support the new ways of work.

The time it takes to move from initial implementation to full implementation will vary depending upon the complexity of the new program or innovation as well as the development of the infrastructure to support teachers and the availability of implementation supports and resources.

Sustainability

One final note on Implementation Stages: sustainability planning and activities need to be an active component of every stage and attention to both financial and programmatic sustainability are required.

Financial sustainability involves ensuring that the funding streams for delivering the new practice are established, adequate and sustainable.  This means funding for teacher, staff, and administrative time. 

Programmatic sustainability involves ensuring that the implementation infrastructure is established, reliable, effective, and sustainable.   The infrastructure needed to ensure continued quality implementation includes plans and activities for:

  • Continuing to provide timely and effective training, coaching and fidelity measurement processes making data-driven decisions for continuous improvement and problem-solving
  • Ensuring that policies and procedures continue to support and facilitate full implementation

Activity 1.2
Getting started with Implementation Stages

How do you start engaging in stage-based implementation activities? Review the Module 1 material on Implementation Stages then consider these questions.  We encourage you to discuss these with your team and/or to write down your responses.


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Framework 3: Implementation Drivers

An implementation drivers diagram portrayed as a triangle

Implementation Drivers are key components of capacity and infrastructure that influence a program’s success.  They are the core components needed to initiate and support classroom, building, and district level change.

The next Active Implementation Framework we would like to discuss is Implementation Drivers.

Implementation Drivers are based on common features that exist among many successfully implemented programs and practices. The structural components and activities that make up each Implementation Driver contribute to the successful and sustainable implementation of programs and innovations.

There are three types of Implementation Drivers:

When integrated and used collectively, these drivers ensure high-fidelity and sustainable program implementation. Let’s briefly look at each driver.

Competency Drivers

An implementation drivers diagram portrayed as a triangle with the words "compentency drivers" highlightedCompetency drivers are activities to develop, improve, and sustain teachers’ and administrators’ ability to 1) put programs and innovations into practice, to 2) benefit the students.

The four competency drivers include: selection, training, coaching and fidelity assessment. Collectively they can effectively provide professional development that makes a difference for both teachers and students.

  • Selection—Effective staffing requires the specification of required knowledge, skills and abilities that relate to program-specific needs. This means specifying skills and abilities that are pre-requisites for the work ahead and determining those that will be developed once the person is hired.
    • The criteria initially are used to select candidates among those already employed in a school or district who will be among the first to implement the innovation.  Subsequently, each new hiring opportunity is an opportunity to select with implementation in mind.
    • Once requirements have been identified, schools and districts must identify methods for recruiting candidates who possess these skills and abilities, as well protocols for interviewing and criteria for selecting teachers, administrators and even program or practice leads.
  • Training — Teachers, administrators and staff need to learn when, how, and with whom to use new skills and practices. Training should:
    • provide information related to the theory and underlying values of the program or innovation
    • use training processes grounded in adult learning theory to actively engage participants
    • introduce the components of and rationales for key practices
    • provide opportunities to practice and re-practice new skills and receive feedback in a safe and supportive training environment
  • Coaching — Most new skills can be introduced in training, but must be practiced and mastered on the job. Coaching is the key. Districts and schools should:
    • actively develop and implement coaching service delivery plans that detail how often, where, when, with whom, and why coaching will occur
    • use multiple sources of data to provide feedback to practitioners and always include  direct observation
    • use coaching data and information from coaches to inform training improvements and improve organizational supports
  • Fidelity Assessment  — Implementing the evidence-based program or innovation as intended is the outcome of selection, training and coaching.  This means that the entire organization is accountable for instructional or program quality.  Teachers are not in it alone. Districts and schools should develop and implement transparent fidelity assessments, use multiple sources of data to assess fidelity, institute positive recognition so assessments are seen as an opportunity to improve fidelity and use fidelity assessment data to improve practice fidelity, organizational and system supports.

Evaluation and Planning Tools: Compentency Drivers

Coaching System Delivery Plan Template
This template provides the basis for developing a Coaching Service Delivery Plan. The Coaching Service Delivery Plan is a proactive approach to purposeful and supportive coaching.

Coaching System Development Worksheet
The Coaching System Development Worksheet can be used to initiate those early discussions about the importance of coaching and the facilitative supports administrators need to consider to ensure a systemic commitment to coaching.

Training Plan Template
The tool is designed to help guide your team’s planning process in developing a training program. This tool can be used to guide discussions around rationale, core components, knowledge, skills, outcomes and assessment.

Organization Drivers

An implementation drivers diagram portrayed as a triangle with the words "organizational drivers" highlightedNow let's turn to the Organization Drivers.

Organization Drivers are used to intentionally develop the supports and infrastructures needed to create a hospitable environment for new programs and innovations. These supports may need to be developed across the building and district levels.  Let’s briefly touch on each component.

  • Decision-Support Data Systems —Better decisions are made when data are available to inform the decision-making process.  A functional decision-support data system includes quality assurance data, fidelity data and outcome data. Data need to be reliable, reported frequently, built into every day routines, accessible at the classroom and building levels and used to make decisions at the student, teacher, and building level.
  • Facilitative Administration — Administrators drive decision making. They make use of a wide range of data to inform decision making to support the overall implementation processes as well as keep staff organized and focused on achieving the desired outcomes. Administrators need to be committed to facilitating the development of an organization that is committed to the new program.  This means that administrators and their teams proactively look for ways to:
    • identify and effectively address challenges
    • develop clear communication protocols and functional feedback loops
    • adjust and develop policies, procedures, and guidelines to support the new way of work
    • reduce administrative barriers to using the program as intended
  • Systems Interventions — System Interventions are strategies to work with external systems or levels of the education system that are not under the direct control of the administrators.   Systemic issues and barriers that need to be addressed at a level above the organization need to be identified, communicated to relevant system partners, and resolved.   For example, there are issues that cannot be resolved at the building level and must be addressed by the district.  Similarly there are issues that the district cannot address without the support and engagement of the state department of education. Resources, regulations, and systems supports at each level need to be aligned to support implementation.

Leadership Drivers

An implementation drivers diagram portrayed as a triangle with the words "leadership drivers" highlghtedLeadership is foundational to the work of implementation.  Volumes have been written about effective leadership and there is strong agreement about the importance of knowledgeable and engaged leadership.  Within this Active Implementation Framework we are focused on the role rather than the authority position of a leader. We emphasize technical and adaptive leadership strategies because there are data to indicate that the ability to engage in such leadership impacts student achievement.  This does not mean that many other aspects of leadership are not important.

Video Vignette 17: Leadership and Innovation

Dean Fixsen from the National Implementation Science Network (NIRN) talks about the role leadership plays in implementing innovations (running time 26 sec.).

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Integrated and Compensatory

Finally, a key feature of the drivers is their integrated and compensatory nature.

  • Integrated – means the philosophy, goals, knowledge and skills related to the new program or practice are consistently and thoughtfully expressed in each of the implementation drivers.  For example, if the use of data for progress monitoring is an important key feature of the innovation, then comfort and experience using data will show up in the selection process, be part of training, be a focus of coaching, and measured in fidelity protocols.  Similarly, the decision-support data system will function to provide timely, reliable data; the building and district administrators will ensure that resources are allocated to the data function; and barriers to creating such systems that are beyond the school level are communicated to the district and from the district to the state as necessary.
  • Compensatory – means that the skills and abilities not acquired or supported through one driver can be compensated for by the use of another driver. Let's continue with the example of data-based progress monitoring. If teachers and other school staff do not have experience with data at the point of hire but are enthusiastic about learning to use data, then training can compensate for skills not present at the point of hire.  Similarly, only so much can be learned during training, no matter how well done. Coaching and fidelity monitoring can compensate for the different skill levels that are achieved through training.
     

 

Activity 1.3
Getting started with Implementation Drivers

So, how could you leverage the Implementation Drivers framework in your work? Discuss these questions with your team and/or to write down your responses. Thinking about a specific innovation (practice or behavioral) may make this exercise more meaningful for you.

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Framework 4: Implementation Teams

An implementation teams diagram portrayed as four inter-connected blocks

Who does the work? The role of Implementation Teams is to leverage implementation science principles and systems change best practices to support the widespread use of evidence-based programs and practices.

Next, let’s take a look at Implementation Teams and expert implementation support. There is evidence that creating Implementation Teams that actively work to implement programs and innovations results in more efficient, higher-quality implementation.

Traditional dissemination and diffusion approaches to implementing evidence-based programs for children and families have not been successful in closing the research-to-practice gap. In extensive reviews of dissemination and diffusion literature, past efforts to support implementation have been characterized as “letting it happen” or “helping it happen”.

Approaches that “let” implementation happen leave it to administrators, teachers or to State staff to make use of research findings on their own. Approaches that “help” implementation happen provide manuals or web sites to help implementation happen in real world settings.

Both of these approaches have been found to be insufficient for promoting the full and effective use of innovations. There is another category of activities called “making it happen.” In this approach, expert implementation teams play a role in actively supporting implementation of a new program or innovation.

Implementation teams provide an internal support structure to move selected programs and innovations through the stages of implementation. They also ensure that the implementation infrastructure, as detailed in the implementation drivers discussed earlier, is effectively used to support the programs and practices. Here is an example of an implementation teaming diagram in education. When multiple teams are engaged in a larger-scale change effort they need to be purposefully linked to support communication and engage in problem-solving. The functions of each team need to be clearly defined and known to all other teams.



Implementation Teams focus on:

Too often innovations rely on just a champion or two. Those champions can move on to new challenges or burn out. So innovations come and go with individuals.  An advantage of relying on implementation teams is that the team collectively has the knowledge, skills, abilities, and time to succeed and sustain the work. The team embodies the capacity needed to implement well and maintain and improve programs and practices over time and across staff.

Ideal core competencies of an Implementation Team include:

 

Activity 1.4
Getting started with Implementation Teams

So, how could you leverage the Implementation Teams framework in your work? Consider the following questions when creating teaming structures to support new programs and innovations. We encourage you to discuss these with your team and/or to write down your responses.


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Purveyors and Intermediary Organizations

Implementation teams might actively work with external purveyors, vendors, or technical assistance providers of programs or innovations. For example, early childhood program purveyors represent a group of individuals very knowledgeable about an evidenced-based program or evidence-informed innovation. The purveyor actively works to help others implement the program or innovation with fidelity and good effect. Purveyors are often affiliated with university-based researchers and/or technical assistance centers or may be private consultants.

External implementation support could also be provided from intermediary or regional entities or organizations. Intermediaries facilitate the exploration, installation, implementation and sustainability of a number of programs and innovations by:

  • Broadly educating and stimulating interest
  • Assessing evidence and fit/feasibility
  • Linking program developers and purveyors with implementing schools and districts
  • Ensuring effective implementation and fidelity systems are developed and maintained
  • Building capacity to implement well and integrating efforts to implement multiple initiatives
  • Assisting with alignment of policies, procedures, and guidelines to support new ways of work
  • Working at multiple levels of the education system to promote quality implementation and scale-up
     

Framework 5: Improvement Cycles

Improvement Cycles support the purposeful process of change. Implementation teams use improvement cycles to change on purpose. Improvement cycles are based on the Plan, Do, Study, Act process.

While there are many methods of improvement, two that can promote purposeful building and district level implementation are the Plan-Do-Study-Act Cycles (PDSA) and Policy-Practice Communication Cycles. 

Many times teachers and staff experience similar, consistent barriers to implementing an evidence-based innovation as intended.  These barriers need to be solved at a systems level. Implementation Teams employ PDSA cycles in order to intentionally identify, problem solve and hopefully alleviate these barriers. 

The PDSA cycles consists of four phases:  

PDSA cycles are one strategy Implementation Teams can use to make meaningful changes, alleviate barriers, embed solutions, and achieve expected outcomes. 

Not all challenges can be solved by the Implementation Team. At times solutions require support from leadership, policy makers or other key partners of the system.  Implementation Teams can help develop and then use practice-policy communication cycles to promote necessary changes needed at higher levels of the system to support new practices. Communication cycles are bi-directional forms of communication between policy and practice that are facilitated by the Teams. While we often see policy enacted that is intended to impact practice, the other side of the cycle (feedback to policymakers on intended and unintended impact at the practice level) is overlooked. Implementation Teams are responsible for promoting, developing, and negotiating the mechanisms for such communication and then using the agreed upon protocols. This bi-directional communication is critical to ensuring that policymakers understand the impact of their efforts and that those on the front line have the support they need.   Connecting policy to practice can help reduce barriers to high-fidelity implementation. There must be good policy to enable good practice. However, practice must also inform policy. It is important that these communication linkages are conceptualized and fostered in Exploration, and formalized, supported, and improved in the Installation, Initial Implementation and Full Implementation stages. 

But ask again, why do we purposefully use Improvement Cycles?

Effective practice to policy communication cycles must be embedded in the system’s way of work to ensure that change happens on purpose. New practices do not fare well in existing organizational structures and systems. Too often, effective innovations are changed to fit the system, rather than the existing system changing to support the effective innovations.

As an example, the figure here depicts the role that implementation teams can play in promoting policy to practice feedback cycles and linked communication in an education system. Such communication helps to ensure that procedures, structures and policies all serve to support quality implementation and student outcomes.

An sample diagram of a Practice-Policy Communication Cycle

 

Activity 1.5
Getting started with Improvement Cycles

Review these diagrams and consider the following questions. We encourage you to review and discuss these with your team and/or to write down your responses.


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Module 1 Summary

Active Implementation Frameworks
•    Usable Innovations
•    Implementations Stages
•    Implementation Drivers
•    Implementation Teams
•    Improvement Cycles

This concludes Module 1. In summary, students cannot benefit from services they do not receive.  Active Implementation promotes the full and effective use of evidence-based programs and evidence-informed innovations so that student outcomes are improved.

Key Takeaways

  1. Active Implementation is guided by five frameworks:
    • Usable Innovations
    • Implementations Stages
    • Implementation Drivers
    • Implementation Teams
    • Improvement Cycles
       
  2. Conducting stage-appropriate implementation activities is necessary for successful service and systems change.
  3. Developing core implementation components results in an implementation infrastructure that supports competent and sustainable use of innovations.
  4. Creating Implementation Teams that actively work to support the implementation of innovations results in more efficient, higher-quality implementation.
  5. Connecting policy to practice can help reduce systems’ barriers to sustainable, high-fidelity practice.

Working together, these Active Implementation Frameworks provide the foundation for putting evidence-based programs and evidence-informed innovations into practice.

 

Capstone Activity 1.6
Implementation is a piece of cake

Read an outside reading and answer a set of questions related to the article, or discuss them with your team. [approxmiate time: 20 minutes]



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Capstone Quiz

Asha

 

Congratulations, you finished Module 1!  We invite you to assess your learning via the Capstone Quiz.

Your virtual coach Asha guides you through a quick set of questions
[approximate time: 5-10 minutes].

 

The Active Implementation Hub, AI Modules and AI Lessons are an initiative of the State Implementation & Scaling-up of Evidence-based Practices Center (SISEP) and
the National Implementation Research Network (NIRN) located at
The University of North Carolina at Chapel Hill's FPG Child Development Institute.
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