Workstream breakouts
Format for Workstreams sessions
• Introductions at your table
• Improvement Bootcamp overview and other
improvement journeys
• Components of a learning system – how does our
work stack up?
• Workstream presentations – 30 mins each including
Q&A
• Table top reflection on own learning and application
of improvement methodology
The Bootcamp Experience : from this…..
The Bootcamp Experience : to this……
Components of a Learning System
1.
2.
3.
4.
5.
6.
7.
8.
System level measures
Explicit theory or rationale for system changes
Segmentation of the population
Learn by testing changes sequentially
Use informative cases: “Act for the individual learn for
the population”
Learning during scale-up and spread with a production
plan to go to scale
Periodic review
People to manage and oversee the learning system
From Tom Nolan PhD, IHI
Scottish Borders
SOA- Reducing Inequalities
(Early Years strategy 12-15, Children and Young Peoples Service Plan 12-15, Healthy Living
programme, PASPE strategy 2011)
65.4
Our children have the best start
in life and are ready to succeed
% of S4 pupils with 5 awards at
SCQF at level 5 or above-
40.5
National
average
36.6
12.8
Least deprived areas
Scottish Borders
Most deprived areas
Aim: To establish an assessment that enables
the CPP to accurately record and plan for the
developmental milestones of children on
entrance into P1
by August 2014
Early Years Collaborative
Aim- to establish and implement an appropriate measure for
Workstream : Lead- Amanda Cronin
Workstream 3 by December 2014
Primary Drivers
Secondary Drivers
Local Actions
Suitability of
assessment
Education Based
Health Based
Other Authority
Develop own
Test using SOGS
Test Using PIPs
Review tests and combine
Various tests to establish
the most appropriate age
Establish process
Establish appropriate
assessment for P1
entrants
Purpose of
assessment
Age of Child
Profession of Assessor
Criteria for P1 assessment
Quality assure 27-30
planning
Establish appropriate plan
for P1
Establish tests that look
who should be assessed
at P1
Conduct tests using
various professionals to
conduct the assessment,
HV, NN (Health) NN
(Education) Staff Nurse,
Nursery Teacher
Conduct tests to review
effectiveness of the 24
month plans
Conduct tests that allow
nursery teachers and
partner agencies to
support children in
transition to school
Aim: To establish an assessment that enables the CPP to accurately
record and plan for the developmental milestones of children on entrance
into P1
by August 2014
Measures
Cycle 1e:????????????
A P
S D
Cycle 1d:????????????
Cycle 1c:????????????????
A P
S D
Cycle 1b: Ask the same HV to test a different child at the same age using
SOGS who had a 24 month assessment
Cycle 1a: Ask one HV to test one child aged 50 months using the
SOGS tool who had a 24 month assessment
Process Change: Implement a measure for children upon entrance into P1
We have built relationships
Start together
Plans for next 3-6 months
• Review data from 24 & 27-30 month assessment
• Review driver diagram with all testers to ensure we
have all elements covered
• Continue cycle of testing
What needs to be done?
-
Identify test and appropriate testers
Establish a robust system to measure
Secure support for implementation
Involve everyone in the design collection and
understanding of the data
East Dunbartonshire
East Dunbartonshire CPP and community
Life Expectancy:
Males 79.4 Females 82.7
Highest in Scotland
Residents in Owner Occupied Housing: 85%
Scotland: 65%
Average gross weekly earnings:
£549.60
3rd highest in Scotland
Hillhead:
Amongst the 5% most
deprived areas in Scotland
Our aim
Working together to achieve the best with the people of East
Dunbartonshire.
We will strive for the best possible outcomes for children, young
people and their families and support the Scottish Government’s aim
to make Scotland the best place in the world to grow up.
Culture change
Systems change
Practice change
Getting It Right for Every Child
Key wins for Workstream 3: driver diagram
•
Societal Issues
•
Aim
Children have
all the
developmental
skills and
abilities
expected at the
start of primary
school
Detailed Aim:
90% of all children
within each CPP
have reached all of
the expected
developmental
milestones at the
time the child starts
primary school, by
end-2017
Access To
Services
•
•
•
•
Child’s physical
& mental health
and emotional
development
Carer’s physical
& mental health
and skills
Early Learning
& Play
•
•
•
Additional
Support
•
•
•
•
Parenting skills
& knowledge
•
•
Agree a protocol for sharing the 27/30 month
assessment with education and consent issues with
parents.
Review and develop early years provision within EDC
to meet aim of 600 hours for every pre-school child.
Ensure clear referral pathways.
Improve the quality of provision in local authority and
partner providers
Implement GIRFEC policy and procedures in all early
years establishments.
Provide Stay and Play (for parents with their children)
within a local authority nursery.
Improve the knowledge and skills of early years
workforce on child development.
Develop a transition programme with parents, health
and education for children starting nursery.
Develop and implement common assessment of
developmental milestones at the end of early years
Develop and implement support for children with ASN
in all EDC early years providers.
Improve identification and support for children who
require support.
Provide additional family information via the Play Talk
Read Bus.
Provide BookBug sessions within a local authority
nursery.
Families in need of parenting support within one of
the local authority nurseries.
Provide parenting Provide drop in, surgery and taster
sessions (based on Triple P)
Key wins in Child Development training programme
Wellbeing
Consistent analysis structures
Staged interventions
Emotional health & wellbeing
Experiential play
Self management skills
Thinking and involvement
Creating memories
Communication
Language rich environments
Key wins in the area of measurement
Made strategy personal
Embedded methodology
Increased sharing of
ideas & knowledge
Diverse tests of change
Child focused: Ferre Laevers
Development focused: writing, reading,
nutrition
Population wide: improving attendance
Lessons learned in the area of measurement
Assistance, reassurance and updates for all staff
Framing tests of change in familiar language
Examples with identified measurements
Practical and relevant ideas
Positive focus not just ‘threat
of homework’
- though sometimes a deadline provides
the impetus required
Key wins in frontline testing
Staff feedback from initial tests of change
“The fact that it makes you think of the things you do daily to support
children in small ways – or how you develop certain areas to
accommodate individual needs …take that a step further – involving
parents more questioning etc. which we will most definitely do!”
“Continue to make adaptions and changes slowly
and gradually, to benefit children’s and staff
learning and experiences.”
“Picked up lots of good
ideas for encouraging
home links as test of
change.”
“The course has made
us think about our
practice and how
relevant it is.”
“It will encourage me
to look for missed
opportunities in
learning in my centres,
particularly in
interaction with
children, ensuring they
are challenged
appropriately.”
Lessons learned in frontline testing
Everyone assumed they were ‘doing it wrong’
Healthy competition
‘On the spot’ conversations
New concepts can worry people
Ideas spark change and build momentum
Key wins in our place approach
Through a mix of formal and informal services the provision of the
‘family room’ and ‘parent room’ in the school and nursery aims to
increase the security, education and welfare of children and parents
in the Hillhead community to significantly improve the lives of
families
Relocating staff to where they are most needed
Building resilience through fun activities
Changing the way we work for increased efficiency
e.g. A Support for All Group
Key wins for Workstream 3: Strengths & Difficulties
Aim: The questionnaire is intended to identify children’s readiness for learning prior
to transferring to school.
Measures: Total difficulties score
Changes: Common assessment tool (SDQ) implemented at a standard time across
East Dunbartonshire
Plan
Act
Do
Study
Key wins for Workstream 3: Strengths & Difficulties
Strengths and Difficulties Questionnaire (June 2013 pilot)
Total difficulties: Percentage of pre-school children without likely problems
98%
96%
94%
92%
90%
88%
86%
84%
EDC Sample Female
(n=29)
EDC Sample Male
(n=43)
All EDC Sample
(n=72)
Glasgow (n=4142)
Key wins for Workstream 3: Strengths & Difficulties
Staff feedback from the pilot
“It has made me stop and think about whether he is ready for school socially and emotionally I mean”
The universal approach to carrying out the questionnaire
“means that children who are ‘invisible’ won’t get missed”
The collaborative approach taken to completing the pilot was noted as being
particularly important in providing a richness of data –
“different members of staff see children differently so this [completing the SDQ
collaboratively] helps to get a picture of the whole child”.
Plans for next 3-6 months
Professional development driving methodology uptake
Positive behavioural strategies
Protocols - Looked after children
Emotional Health & Wellbeing
Acting on initial tests of change
Healthy eating: Thumbs up / Thumbs down
Outdoor play: Time out numbers
Communication: Leuven Wellbeing scale
Singing Time & Parental Involvement
Writing Register: Identifying one’s name
Implementing the Strengths and Difficulties
Questionnaire & transition programme
TABLE DISCUSSION
• Who are individuals and/or teams currently
working on in this area? Are they currently using
Quality Improvement methods/PDSA cycles to
guide their learning?
• Reflecting on the emerging knowledge within this
area, and today’s plenary session on scaling up
your work, what are some considerations you
need to plan for to get to scale for your project?