A Model for Human Services Transformation Last Updated in March 2014 To strengthen our understanding of what an effective transformation effort looks like, we’ve scanned related research and efforts towards transformation, including from various private industries, political advocacy initiatives, school-based innovations and public health campaigns. We also asked a diverse set of transformation partners at a roundtable session during September 2012, and have applied and tested an initial version of the model since January 2013. What does an effective transformation effort look like? Both our scan and the roundtable input emphasize two overarching principles of effective transformation that apply to the effort as a whole: Transformation efforts should be “laser focused” on the desired future state, working back from a clear understanding of that vision, yet at the same time enabling a range of interrelated efforts by various partners with unique perspectives. Transformation efforts should be informed by an environmental scan which helps us understand our context, including where to move opportunistically for quick wins and where to be patient. The transformation we seek will take years or decades to achieve, requiring many tactical steps along the way. Both our scan and the roundtable input support the view that effective transformation efforts focus on four interrelated drivers, to be advanced in concert with the others as they are mutually reinforcing and interconnected: 1. Communication campaigns focused on target audiences, goals, framing and reframing, key messages, and methods, including securing influential champions, raising the consumer’s voice, and using social media methods 2. Real-world demonstrations of what works, including grassroots efforts, pilots, experiments, and tests of innovations 3. Tools and guidance for practitioners to use as they advance their innovations 4. Communities of practice and partnerships to advance and monitor all of these activities. Our scan also supports the view that effective transformation efforts move these activities through these four general phases: A. Opening the current system up to the possibilities and benefits of innovation B. Demonstrating related innovations to practice and foundational supports that have the desired impact upon consumers towards a desired future state C. Scaling and embedding these innovations through changes to policies, regulations and funding mechanisms, supporting infrastructure (including technology and workforce capacity), and to new, widely-shared terminology, theories and standards D. Sustaining these phases as an “upward spiral” of monitoring, learning and renewal. Page 1 And both our scan and roundtable input support the view that each transformation driver is strengthened through applying various related strategies: For Communication Campaigns Campaign goals include agency leadership sponsoring transformation efforts and the staff executing them, including understanding misperceptions and differences between expert understanding and target audience perceptions and the ways they might frame the information they receive Identifying and using champions is an important driver of a campaign’s success, as is knowing and proactively managing one’s opposition Campaign goals include a culture of accountability for outcomes through holistic engagement and service at all system levels, requiring us to understand the salience of various positions and claims for our target audiences that might result in fragmentation and silos Campaigns focus in part on evolving consumer demand and the general public’s perception of government’s capabilities and consumers’ motivations towards achieving desired outcomes Campaigns should be focused on a few ideas (“rallying points”) that speak meaningfully to those outside the system, including values and metaphors The communication strategy behind a campaign must be fluid, constantly evaluating its effectiveness and the audience’s receptivity to the message(s), making adjustments accordingly and consistent with data about their impact Having examples and stories, coupled with clear and meaningful data, are critical elements of support for an effective communication campaign For Real-World Demonstrations Demonstrations might be facilitated by sponsoring and directly supporting pilots, or they might be “discovered” at the local, grassroots level through scanning and reporting efforts. These reporting efforts should focus on how to scale and embed successes and learn from failures and struggles. A realization exists that many or even most demonstrations will fall short of desired outcomes and take years to mature Demonstrations focus in large part on what types of skills and capacity consumers need to achieve desired outcomes, and what skills and capacity the workforce needs to help them For Tools and Guidance Tools and guidance include those for policy, program, practice, infrastructure, business processes and governance structure at all system levels Tools and guidance are developed within a collaborative environment, such as including multiple levels of government and the consumer voice in the development of policies and practices Tools and guidance include those for change management and continuous improvement, especially at the local coalition-building level, and should reflect the concept of a “developmental trajectory” for closing performance gaps and driving innovation and partnership Tools and guidance include those for identifying and embedding best practices and for evaluating the impact/SROI and scalability of innovations Page 2 For Communities of Practice Communities of practice and partnership should be high-integrity, highly motivated agents of transformation, if possible demonstrating how desired outcomes can best be achieved These coalitions draw broadly and from uncommon places for members, thereby “leveraging disruptive forces” to ensure a diverse, innovative and consumer-oriented perspective Communities of practice are often virtual and managed through social media channels APHSA may be a broker of transformation, but it’s the community and stakeholders that comprise the effort; they should have concrete bodies of work to support, advance and monitor. Again, these drivers, phases and supporting strategies are not described as distinct from the others, unfolding in a linear sequence. Rather, the drivers might be viewed as waves that mingle and interact with each other, and the phases might be viewed as a rising tide that builds upon itself over time. Finally, our scan clarifies that transformation can be a “sustaining” or a “disruptive” phenomenon: Sustaining transformations are guided by current leadership within a field Disruptive transformations are prompted by marginal or new field participants We may be engaged in a sustaining transformation effort overall, but with an aim towards major, perhaps disruptive changes to human services products, services, infrastructure and governance. An approach to planning and monitoring a transformation effort. A good approach to planning a transformation effort should bring these drivers and phases together to form a picture or “map” of how various transformation activities “fit into the whole” and relate to each other. It should also help partners in transformation work effectively as communities of practice that advise and support the communication, demonstrations and tool development taking place. It should also help those assessing the entire effort to identify things to add or to shift in sequence, based on the phases being reached in various areas of the work. This approach should also help us assess where we are currently in our transformation efforts and develop plans or maps that include not only ourselves but our partners and others. Page 3 A transformation planning approach based on these phases and drivers might look like this (current APHSA efforts used to illustrate): Drivers and Phases Communication Campaigns Opening Up Open Letter to policymakers setting the Pathways frame Demonstrating Scaling and Embedding Continuing Champions, positive press and consumers “Scoring” policy and program recommendations and changes Innovations Innovation Center Concept Papers Raise the Locals Voice cases Evidence based/informed practices Tools and Guidance Policy Briefs SNAP pilots Federal and state policy and program changes NWI guidance chapters in support of an integrated system Child welfare waiver cases A new business model for an integrated system Transformation toolkit and ongoing support to those using it An Organizational Effectiveness (OE) Practice Successful OE projects Changes to child welfare financing Transformation Roundtable Page 4 OE Toolkits, textbooks, curriculum, certification Continuously improved versions of the business model Formal OE evaluation and practice changes Communities of Practice Membership committees and task forces (e.g., PCEC, affiliates, Locals Council) A series of roundtables that actively support these efforts A Communities of Practice website Member-driven groups providing concrete support to these efforts Transformation Model: Bibliography "War on Drugs". (n.d.). Retrieved January 2013, from Wikipedia : http://en.wikipedia.org/wiki/War_on_Drugs#Efficiency Beattie, H. (2012, July). Amplifying Student Voice: The Missing Link in School Transformation. Management in Education , pp. 158-160. CBC News. (2007, January 15). Canada's Anti-Drug Strategy A Failure, Study Suggests . Christensen, C., Baumann, H., Ruggles, R., & Sadtler, T. (2006, December ). Harvard Business Review. Retrieved January 2013, from http://hbr.org/2006/12/disruptive-innovation-for-social-change/ar/1 Greenwood, R., Suddaby, R., & Hinings, C. (2002). Theorizing Change: The Role of Professional Assocations in the Transformation of Institutionalized Fields. Academy of Management Journal , 58-80. Human Services Transformation Roundtable Meetings. (2012, September 21; 2013, January 25 and December 6; 2014, February 28). Washington , D.C. . Kotter, J. P. (2007, January ). Harvard Business Review . Retrieved January 2013, from http://hbr.org/2007/01/leading-change-why-transformation-effortsfail/ar/1 Liu, H. (2009). The Effect of Anti-Smoking Media Campaign on Smoking Behavior: The California Experience. Annals of Economics and Finance , pp. 29-47. PBS. (n.d.). Drug Wars. Retrieved January 2013, from Thirty Years of America's Drug War: http://www.pbs.org/wgbh/pages/frontline/shows/drugs/cron/ Porter, E. (2012, July 3). Numbers Tell of Failure in Drug War. The New York Times. The C. Everett Koop Papers. (n.d.). Retrieved January, from Profiles in Science National Library of Medicine : http://profiles.nlm.nih.gov/ps/retrieve/Collection/CID/QQ Page 5 Turning Point. (2004). States of Change Stories of Transformation in Public Health. Retrieved January 2013, from http://www.turningpointprogram.org/toolkit/pdf/TP_storybook.pdf Independent Sector (2012). Beyond the Cause: The Art and Science of Advocacy. Retrieved in December 2012, from indpendentsector.org Karia, J. and Kramer, M. (2011). Collective Impact. Stanford Social Innovation Review, Winter 2011. Wikipedia. (n.d.). Retrieved January 2013, from List of Smoking Bans in the United States : http://en.wikipedia.org/wiki/List_of_smoking_bans_in_the_United_States Page 6