Workstream 5 Breakout Session
Understanding your Workstream and Priority
Tests of Change
Early Years Collaborative Learning Session Three – Day 2
We’ve been building will & generating ideas for
a while
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Dr Bruce Perry – neuroscience and brain development
EPPE Study –- 2004
GIRFEC - 2004
CMO’s report - 2007
Early Years Framework - 2008
The Foundation Years - Frank Field – 2010
Early Intervention - Graham Allen – 2010
Scottish Government economic modelling (Nov 2010)
Joining the Dots – Report from Professor Susan Deacon
(March 2011)
Components of a Learning System
1.
2.
3.
4.
5.
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”
6. Learning during scale-up and spread with a production plan
to go to scale
7. Periodic review
8. People to manage and oversee the learning system
From Tom Nolan PhD, IHI
Breakout Objectives
• Build a common understanding of the current theory of
what drives the overall aim for this Workstream;
• Identify where on the Driver Diagram your work is
having an impact.
• Identify and prioritize drivers by areas of highest
impact at a local level
• Reflect on the assets within your community that can
help you achieve greater impact in prioritised areas
• Develop a proposal for Tests of Change to be shared
with your CPP.
How we will spend our time ……
• Refresh on Driver Diagram theory and
presentation of current theory for Workstream 5
• Review and Reflect on Workstream 5 Driver
Diagram
• Identification of which Drivers you have the
biggest impact on
• Development of a proposed Test of Change to
share with CPP.
Conceptual Driver Diagram
Outcome
1⁰ driver
2⁰ driver
2⁰ driver
1
1⁰ driver 1
2⁰ driver
2
2⁰ driver
3
Aim or
Outcome
2⁰ driver
4
1⁰ driver 2
2⁰ driver
5
Outcome
Measure(s)
Process
Measure(s)
Local Process
Measure(s)
Specific Change Ideas
Ideas:
1
2
3
4
5
6
7
8
9
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N
Understanding Our Theory:
Early Years Workstream Diagrams
WORKSTREAM 1 (conception to 1 year)
Theory of what actions will
reduce infant mortality
Theory of what drivers infant mortality
Aim
2⁰
1⁰
Poverty
Social Issues
Housing
Domestic Abuse &
Violence
Attachment
Reduce infant
mortality
Health
Post-birth actions
Parenting skills
Maternal smoking
Detailed Aim:
To reduce by 15%
the rates of
stillbirth & infant
mortality by 2015
Maternal drinking
Improved teamwork,
communication and
collaboration
Improved uptake of
benefits
Increase rate of
breastfed babies
Quicker diagnoses of
Neonatal Abstinence
Syndrome
Improved leadership &
culture
Improved family
centred response
Improved stability /
permanence for LAC
Improved identification
Increase referrals
Pre-birth maternal
health
Maternal misuse of
drugs
Maternal Obesity
Maternal mental
health
Improved management
of care
Improved sharing of
information
Improved planning
Identification &
reasons for current
resilience
WORKSTREAM 2 (1 year to 30 months)
Theory of what actions will
ensure developmental
milestones are reached
Theory of what drivers developmental milestones
Aim
2⁰
1⁰
Social Issues
Improved teamwork,
communication and
collaboration
Poverty
Housing
Domestic Abuse &
Violence
Improved uptake of
benefits
Increase child’s dental
health
Improving child nutrition
Children have all
the developmental
skills and abilities
expected of a 2730 month year old
Health
Child’s physical
and mental activity
Attachment
Improving brain
stimulation and physical
play
Improved family centred
response
Mother’s level of
education
Improved stability /
permanence for LAC
Improved identification
Detailed Aim:
85% of all children
within each CPP
have reached all of
the expected
developmental
milestones at the
time of the child’s
27-30 month child
health review by
end-2016
Maternal health
and skills
Parental misuse of
drugs
Parental obesity
Maternal mental
health
Increase referrals
Improved management of
care
Improved sharing of
information
Improved planning
Parental misuse of
drinking
Improved leadership &
culture
Parenting skills
Identification & reasons
for current resilience
WORKSTREAM 3 (30 months to start of primary school)
Theory of what actions will
ensure developmental
milestones are reached at
the start of primary school
Theory of what drivers developmental milestones
Aim
2⁰
1⁰
Social Issues
Poverty
Improved teamwork,
communication and
collaboration
Housing
Improved uptake of
benefits
Domestic Abuse &
Violence
Increase child’s dental
health
Improving child nutrition
Children have all
the developmental
skills and abilities
expected at the
start of primary
school
Early Learning
Child’s physical
and mental activity
Health
Attachment
Mother’s level of
education
Improving brain
stimulation and physical
play
Improved family centred
response
Improved stability /
permanence for LAC
Improved identification
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
Maternal health
and skills
Parental misuse of
drugs
Parental obesity
Maternal mental
health
Increase referrals
Improved management of
care
Improved sharing of
information
Improved planning
Parental misuse of
drinking
Parenting skills
Improved leadership &
culture
Identification & reasons
for current resilience
Secondary Driver(s)
WORKSTREAM
5
Poverty
Home environment
equalities
Domestic Abuse
Media Influences
Primary Driver
Employment /Workforce issues
Societal Issues
childcare
Impact of in
Access to wider opportunities
Accessibility and affordability of
CYP implementation
Secondary Driver(s)
Primary Driver
Child’s physical, cognitive, mental
health & emotional development
Aim
95% of children in each CPP
area will have reached all of
the expected developmental
milestones and educational
outcomes by the end of
Primary 4 by 2021
(Individual child’s
characteristics/profile)
Safe & secure home
Access to quality Early learning
Child’s & family aspirations
relationships
Health
Attachment
Participation in wider opportunities
knowledge, skills & understanding
Play
Ability to form
Workforce
Cultural activities
Disabilities
Child resilience
Secondary Driver(s)
Safe & secure home
Family resilience
Primary Driver
Family aspirations
Carers’/Parents’ physical &
mental health & skills
Disabilities & mental health
Level of education
Adequate income
Substance misuse
Parenting skills & knowledge
Nutrition/physical disabilities
Family relationships
Secondary Driver(s)
Primary Driver
Learning environment Achievement of Es
and Os at relevant CfE levelStandards of
delivery for meeting learners needs
Home learning environment
Parent’s engagement
involvement with services
School learning environment
school childcare, learning and play
Parental
out of
Support with homework
Secondary Driver(s)
Transport
Primary Driver
Access to wider opportunities
a key part of the community
Access to services Children
Parents on school councils/ committees
Children’s views sought and acted on in developing local resources
Community environment
Space to play
Use of schools and grounds community assets
Review of DD and Reflection
Step One: Take a few minutes to review the driver diagram
and discuss with the person next to you.
Step Two: Discuss the driver diagram with your table mates
using the following prompts:
1. Yes, I’m glad this was included ……
2. I would add….
3. I don’t understand …..
Don’t Forget!
If you have a question while at your table…
Raise your GREEN CARD for Improvement Sciencerelated questions
Raise your YELLOW CARD for Early Years Contentrelated questions
Raise your BLUE CARD for logistics questions (e.g.,
Can we have a few more marker pens, please?)
All Worksheets will be collected after the session!
Report Out to the Room
“What did you learn that came
as a surprise to you?”
Prioritization and Inventory of Assets
CPP:
Early Years Collaborative Learning Session 3
Inventory of Bright Spots and Creating Initial Tests of Change
PART 1: PRIORITIZATION OF DRIVERS & CREATING CREATING TESTS OF CHANGE
Prioritise the drivers with the highest impact for you, what specific interventions are you currently working on in this area? What
community assets will be needed to help you achieve maximum impact?
PART 2:
What test(s) could you run that could make that work even better/more impactful?
Describe your first test(s) of change:
Person responsible
When to be done
Where to be done
Prioritization and Inventory of Assets
Step One: Using the worksheet and driver diagram identify
which of the drivers you are currently working on and identify
the top 3 where you feel you can have the most impact.
Step Two: For these areas of highest impact, reflect on the
community assets that can help you have maximum impact.
You can work alone or team up with others on this exercise,
however everyone need to complete the worksheet.
Creating a Test of Change
Using your number 1 area of highest impact,
reflect on the tests you could run that could
make that work even more impactful and record
on the worksheet.
You can use this to share your proposed test of
change with your CPP.
Report out to the Room
• What intervention are your currently working
on, and what is your test of change?
• Keep all report-outs to a “twitter update” (1-2
sentences!)
Thanks for a great session!
Transition to CPP Planning Session
(Coffee available to take with you!)
Driver diagram for a new healthier me!
Aim
Primary drivers
Secondary drivers
Limit daily intake
CALORIES
IN
Substitute low
calorie
Limit alcohol
A NEW
HEALTHIER
ME!!
Tests of change
Track calories
Plan meals
Drink water not coke
Gym 5 x per week
Exercise
Cycle to work
CALORIES
OUT
Fidgeting
Chi balls