Preparing for the State Systemic Improvement Plan

Virginia - March 2014(Content adapted from 2014 MSRRC Forum)Preparing for the State Systemic Improvement PlanCatherine, Beth and I went to MSRRC Forum on the SSIP a couple of weeks ago. Phyllis was there too as part of the Part B contingent from DOE. Lots of great info. Wanted to make sure VICC members, as our primary stakeholder group, had some baseline understanding, since this is really going to drive our work and resources over the next 6 years. This presentation and supplemental materials were developed prior to OSEPs publication of the final SPP/APR package. Please use these materials accordingly.1First thoughts

Like me, your first thoughts upon hearing about the requirement for another improvement plan may be that Im going to need to SSIP a cocktail! But theres reason to be excited about this plan first, because were going to be focusing on improving results for children and families instead of compliance; and second, because it will fit in with what were already doing in Virginia. 2OverviewPart of the SPP/APRComprehensive, ambitious yet achievablePlan for improving results for infants and toddlers with disabilities and their familiesMulti-year plan developed in two phasesMust engage stakeholders in the processEnded previous SPP/APR cycle. Other indicators the same (except 9 and 14). Will no longer have to list improvement activities for each indicator. Why an SSIP have focused on compliance and it has improved. That did not lead to improvement in results, outcomes for children and families. Now we get to focus on results more interesting, more closely tied to why were in this field.. Important to know that this will drive our use of resources over the next 6 years. This is what well be measured on; must show impact so it will involve our time, focus, and money. 34

The proposed SSIP is to be developed in 2 phases and then implemented in a third phase that occur over the new APR reporting period of 2015-2020. Phase III continues thru 2020. Will focus mostly on Phase 1 today since thats our task between now and February 1, 2015.

4Focus for ImprovementData AnalysisIn-depth Analysis of Quantitative and Qualitative Data Related to Primary Concern Area to Confirm Focus Area for ImprovementInfrastructure AnalysisIn-depth Analysis of Quantitative and Qualitative Data Related to Primary Concern Area to Confirm Focus Area for ImprovementPhase I ComponentsWhat is the problem?Data AnalysisBroad Analysis of Quantitative and Qualitative Data to Identify Areas of Low and High PerformanceInfrastructure AnalysisBroad Analysis of Quantitative and Qualitative Data to Identify Systemic Issues Impacting PerformanceWhy is it happening?Theory of ActionWhat will we do about it?The SSIP will be based on a detailed data and infrastructure analysis. Presented as a list of steps or items to complete, but not really linear; may loop back.

5Data AnalysisIdentify and analyze key data to determine areas for improvementDisaggregate data as neededLook at data qualityDetermine any compliance issues that are barriersStart BROADIdentify areas of high and low performanceIdentify potential focus area for improvement

The Broad data analysis is about examining a wide range of data to be confident that an area of focus that eventually is selected has been well informed. When we look at our data, well see highs and lows that will begin to give us a sense of where we want to head. A broad analysis will prioritize low areas or areas of concern to help direct where we want further deeper analysis6Variety of Data SourcesQuantitative DataSPP/APR data, Section 618 data (child count, etc.)Other data related to infants and toddlers (Health, DOE, Infant Mental Health, etc.)Qualitative DataFeedback from VICCFocus groupsSurveys

Determine which indicators you want to focus on and the questions you want to answer. Then look for variety of data sources that can help answer those questions. Look for patterns, trends, gaps, outliers, etc.7Infrastructure AnalysisAnalyze capacity of system to support improvement and build capacity in EI programs and providers to implement EBP to improve results for infants, toddlers, familiesAnalyze initiatives in state that can have impact on infants, toddlers, familiesDescribe how decisions are made within state system and representatives that must be involved in planning for systemic improvementsStart BROAD big picture viewCompleted simultaneously or immediately following broad data analysisAre there any initiatives in the state that are producing improved results/outcomes for children and youth with disabilities?Identifies areas of system strengths and weakness which can be further explored during the in-depth infrastructure analysis

8System ComponentsThese are the system components that make up the infrastructure. In broad infrastructure analysis, want to think about which of these are associated with/contribute to high performance on child and family outcomes and which are associated with low performance.9Primary Area of ConcernArea(s) in which there is lower performance and, if addressed, could have most impact on outcomes for children and families Factors to consider in prioritizing:Magnitude of concernEquity issueAgency prioritiesLeveraging of resourcesFeasibility/doabilityBecomes the potential focus area of improvement for the SSIP

10Focus for ImprovementData AnalysisIn-depth Analysis of Quantitative and Qualitative Data Related to Primary Concern Area to Confirm Focus Area for ImprovementInfrastructure AnalysisIn-depth Analysis of Quantitative and Qualitative Data Related to Primary Concern Area to Confirm Focus Area for ImprovementPhase I ComponentsWhat is the problem?Data AnalysisBroad Analysis of Quantitative and Qualitative Data to Identify Areas of Low and High PerformanceInfrastructure AnalysisBroad Analysis of Quantitative and Qualitative Data to Identify Systemic Issues Impacting PerformanceWhy is it happening?Theory of ActionWhat will we do about it?Now that you have potential focus area, need to do a more in-depth data and infrastructure analysis to confirm and figure out why its happening

11In-Depth Data and Infrastructure AnalysisFocus on the primary area of concernPurpose: Identify focus for improvement and determine the systemic issues that need improvement (contributing factors, root causes)Ask more specific questions based on findings from broad analysisMay need to collect more data but dont overdo itConsider qualitative dataMore specific questions will have you disaggregating data to look across subgroups or local systems, looking at trends, comparing sets of data. Will also have you looking at how each system component (infrastructure) connects to the primary area of concern and looking at coordination of the system components.Questions about Data or Infrastructure analysis??12Focus for ImprovementThe area of improvement on which the State will focus, that will lead to a measurable child or family resultHow addressing this area of focus for improvement will build local systems capacity to improve the identified result for children and families

As a result of putting together the information from the in-depth data and infrastructure analyses, you can confirm and/or further define primary area of concern you had as the focus for improvement13Good Focus for ImprovementIs supported by the dataWill make a significant impact on resultsAligns with current priorities and initiativesWill (has potential to) leverage resourcesAddresses issues of disparate outcomesIs supported by leadershipHas the necessary commitment to changeIs feasible/doable (2-4 years)

Theres a body of evidence from the data that substantiates the rationale behind the focus. The story you can tell from your data is convincing to stakeholdersFocus area aligns with current priorities and initiatives in the state. The system has adequate capacity to support improvements in this focus area

14Examples of Focus AreaImproving social emotional outcomes for children with autismImproving families ability to help their child develop and learnImproving social emotional outcomes for children with disabilities

Why top one is best immunization exampleQuestions about Focus for Improvement?15Focus for ImprovementData AnalysisIn-depth Analysis of Quantitative and Qualitative Data Related to Primary Concern Area to Confirm Focus Area for ImprovementInfrastructure AnalysisIn-depth Analysis of Quantitative and Qualitative Data Related to Primary Concern Area to Confirm Focus Area for ImprovementPhase I ComponentsWhat is the problem?Data AnalysisBroad Analysis of Quantitative and Qualitative Data to Identify Areas of Low and High PerformanceInfrastructure AnalysisBroad Analysis of Quantitative and Qualitative Data to Identify Systemic Issues Impacting PerformanceWhy is it happening?Theory of ActionWhat will we do about it?At this point weve done the broad and in-depth data and infrastructure analysis and identified our focus for improvement. The next step is to talk about what were going to do about it and develop our theory of action.16Theory of ActionDescribe the general improvement strategies that will need to be carried out and the outcomes that will need to be metA series of if-then statementsMake connection between what you are doing (Improvement Strategy) and what you expect to happen (Results)Focus on how and why you will produce the change, using if-then statements to generate a logical explanation (Rationale) and reveal strategies and assumptions about how resources and activities are used

Describe changes in the State system, LEA's and EISs , and school and provider practices that must occur to achieve the State-identified, measurable improvement in results States should consider developing a logic model that shows the relationship between the activities and the outcomes that the State expects to achieve over a multi-year period17ExampleIf I eat just before going to the grocery store, then I will be full and not craving a sugary treat while shopping.If Im full and not craving a sugary treat while shopping, then Ill be able to resist buying candy at the checkoutIf I can resist buying candy at the grocery store, then I wont have candy around the houseIf I dont have candy around the house, I will eat less candyWhat if the result I want is for me to eat less candy.See how each step builds directly from the last. The Theory of Action lays out the path youll take to get to your desired result and establishes checkpoints along the way, with evidence that its working or not working.18 resultImplementation of effective practicesImproved outcomes for children and familiesWhat do we know about how practices need to look in order to achieve the outcomes?Work backwards from your desired result19 resultImplementation of effective practicesImproved outcomes for children and familiesWhat do we know about how the system needs to look in order to support the practices?Connect that you have to look at all the systems, local and state systems. Blue is the local and state systems.20Relationships between Levels of the System to Achieve ResultsThe next fe

Showing relationships through logic model21Phase I: Conduct infrastructure analysis to identify system strengths and barriersConduct root cause analysis to identify contributing factorsPhase I and II: Search/evaluate evidence- based solutions (Exploration Phase)Develop Theory of ActionDevelop and implement plan for improvement (Implementation Framework)Phase I: Initiate data analysisIdentify problem area (Focus for Improvement, e.g. child outcomes for low income children)

Phase III: Evaluate progress annuallyAdjust plan as neededHow well is the solution working?What is the problem?Why is it happening?What shall we do about it?SSIPSource: Western Regional Resource Center.During Phase II, State will strengthen state infrastructure to support implementation of SSIP; support local systems in implementing EBP; and develop an evaluation plan.During Phase III, state will conduct and review results of ongoing evaluation; determine extent of progress and revise SSIP as needed

22Virginia SSIP DevelopmentWorked backwards from 2/1/15 due date. Took into account need to route through Dept. in January and review with VICC for approval in December.Identify stakeholders and mechanisms and timing for their input. Develop project and communication plan.Final review and approval of focus area based on completed data and infrastructure analysis

23Virginia SSIP DevelopmentTheory of Action identification of potential improvement strategies, series of if-then statementsReview at December VICC meeting and available for stakeholder review and comment through end of DecemberQuestions/reactions??24The C in Part C is for

ChaosChangeCrisisComplexityCHILDRENSSIP reminds us that Part C is about children!25