Category: Social Work in Research and Evaluation

Embracing the idea we are working within a system, article from INTEGRATION AND IMPLEMENTATION INSIGHTS – helps us to move to long term action within our systems

Helpful article from INTEGRATION AND IMPLEMENTATION INSIGHTS for front line mental health workers trying to work in advancing… practices for the communities we serve. The authors put substance to the idea of thinking beyond the individual, ringing true of the breadth involved with care system change that aims for “the long term” instead of “quick changes.”

” move from a focus on separate dramatic events to a focus on the persistent, often almost continuous, pressures giving rise to the discrete events we see.”

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Our mental health care system feels like a super tanker on the ocean that is trying to turn direction – but it needs a lot more than high level planners thinking of the long term.  Anyone in eenetconnect world had any experience with the kind of approach Richardson and Anderson offer to help groups map out decisions to advance practice change?

The fields of systems thinking and system dynamics modelling bring four important patterns of thought to such a group decision and negotiation:

  1. thinking dynamically;
  2. thinking in stocks and flows;
  3. thinking in feedback loops; and,
  4. thinking endogenously.

See the article here: https://i2insights.org/2019/07…for-group-decisions/


I realize for system planners, my question about how people approach understanding systems may be a basic question,  I am curious how from a front line practice perspective, as a cog in the system workers are:

  • engaging in framing  systems in their minds
  • acting and interacting with planners on long term system change
  • bridging our everyday care within a system model

An example — gaps, unmet needs, planned actions, goals are embedded in our organizations and systems focus of care to advance the recovery model .  The Ontario Common Assessment of Need (OCAN) is framed as a key activity with individuals (clients) and posited by our care system to advance system change and measure performance. http://eenet.ca/tags/ocan

 ocan data use

The two above images are from the eenetconnect.caOCAN Community of Interest (COI) which is a good example of creating a resource for thinking systems. https://www.ee

Thinking systems and collaboration in organizational use of ICT to achieve: accountability, governance and multidisciplinarity

ksenia cheinman‘s analysis of Information Communication Technology (ICT) content in organizations and government in the context of efforts towards an innovation, points to the need for a cooperative whole system approach. 

She provides useful resources on how to improve our approaches to knowledge/content sharing, no matter how basic the task. 

For most health and social involved organizations the resource capacity to manage such an approach dissuades bothering to read these ideas.  It is worth the time though if we are seeking accountability, governance and multidisciplinarity, the title of Cheinman’s article. 

… Innovation in the government can often seem like a symptom of wanting to prove that we are not years behind the private sector, an internal competition or a way to strategically launch one’s career. It is a means to the wrong ends. It operates under the guise of genuine service improvement, but if you look closely and more importantly broadly, in a sweeping gesture, across the whole organization ecosystem, more often than not every individual innovation breaks something else along the way. In fact, sometimes it creates irreparable large-scale damage and it spreads and propagates the same mentality across the organization, creating more of the same.

Gerry McGovern describes this production-first mindset very accurately:

Everyone wants to produce. Nobody wants to service and maintain. If you’re a new manager you must do something new. You must initiate new projects. You must produce. You must produce. […]

In 99 out of 100 conversations I have about digital, management only cares about volume. More. More. More. New. New. New. Innovative. Innovative. Innovative. It is so incredibly rare to find a manager who will invest time and money in helping people find stuff more easily. And, once a customer has found something, helping them understand it more easily. …

See the article herehttps://medium.com/@altspaces/digital-content-needs-accountability-governance-and-multidisciplinarity-48212ba03e2a

A guide to Politics and Coalitions in the dance of neutrality in —contested policy making activities

Karin Ingold’s post explains the role of scientific knowledge brokering in coalitions  in Integration and Implementation Insights https://i2insights.org/     In Ottawa, we have had various examples of this, be it the  Alliance to End Homelessness or  harm reduction networks.  I find it useful to reflect on Ingold’s point that suggests that the loss of neutrality in Adversarial advocacy results in, ” no possibility for knowledge brokerage exists.” and need to become “non neutral actors.”

What roles can science and scientific experts adopt in policymaking? One way of examining this is through the Advocacy Coalition Framework (Sabatier and Jenkins-Smith 1993). This framework highlights that policymaking and the negotiations regarding a political issue—such as reform of the health system, or the introduction of an energy tax on fossil fuels—is dominated by advocacy coalitions in opposition. Advocacy coalitions are groups of actors sharing the same opinion about how a policy should be designed and implemented. Each coalition has its own beliefs and ideologies and each wants to see its preferences translated into policies.

via When are scientists neutral experts or strategic policy makers?

“Developing a framework to evaluate knowledge into action interventions”

A logic model to help think and measure knowledge mobilization for practice change from BMC Health Services Research 18:133Cite as

 

There are many challenges in delivering and evaluating knowledge for healthcare, but the lack of clear routes from knowledge to practice is a root cause of failures in safety within healthcare. Various types and sources of knowledge are relevant at different levels within the healthcare system. These need to be delivered in a timely way that is useful and actionable for those providing services or developing policies. How knowledge is taken up and used through networks and relationships, and the difficulties in attributing change to knowledge-based interventions, present challenges to understanding how knowledge into action (K2A) work influences healthcare outcomes. …

See the article here: https://link.springer.com/article/10.1186/s12913-018-2930-3

Some tools to help us think about implementing evidence in our practice

Health Evidence www.healthevidence.org shares tools that guide practice evidence, developed in collaboration with local public health organizations.  While targeted at public health some of the tools provide useful approaches for emerging front line projects.

File:Garden tools.jpg

photo by: SpitfireTally-ho! / Spitfire at en.wikipedia

Looking for tools to help you find and use research evidence? Use the Health Evidence™ practice tools to help you work through the evidence-informed decision making process; search for evidence, track your search, and share lessons learned with your public health organization.

Example of tools:

See the current tools at their site herehttp://www.healthevidence.org/practice-tools.aspx

Architecture to keep track of the big picture of health learning and the ensuing interventions

From the journal of Implementation Science, https://implementationscience.biomedcentral.com/articles/10.1186/s13012-017-0607-7

…In this paper, we propose the use of architectural frameworks to develop LHSs that adhere to a recognized vision while being adapted to their specific organizational context. Architectural frameworks are high-level descriptions of an organization as a system; they capture the structure of its main components at varied levels, the interrelationships among these components, and the principles that guide their evolution.

Intersectionality explained

This paper shared as one of the resources was found by Vicky Ward https://kmbresearcher.wordpress.com/, who was at the Canadian Knowledge Mobilization Forum, http://www.knowledgemobilization.net/event/2017-canadian-knowledge-mobilization-forum/

 

PUT SIMPLY: According to an intersectionality perspective, inequities are never the result of single, distinct factors. Rather, they are the outcome of intersections of different social locations, power relations and experiences.

paper by  Olena Hankivsky, PhD of https://www.sfu.ca/iirp/ 

see the paper here: https://www.sfu.ca/iirp/documents/resources/101_Final.pdf