Stages of Implementation: State Process Guide

Establish the State Leadership Team (SLT) to guide the exploration and planning process.

1. Include the following on the SLT:
   • Representatives from state agencies and personnel development entities with financial and decision-making authority to make decisions and expend resources.
   • People who can work on this initiative over several years.
   • No more than 15 members. Work or task groups, focus groups, or surveys can provide additional perspectives.
   • People, knowledgeable and experienced in guiding implementation processes and knowledge of potential innovations or practices that fit identified needs.
   • People that reflect the racial and cultural diversity of the population served.
   • Agency representatives who know about the social determinants of education and health outcomes relevant to the program or practice goals.
   • Families who will receive services and community and program leaders.
   • People who have a background in data or evaluation.
2. Establish structure and norms for attendance, orientation, and facilitation strategies for meetings and decision-making.

Establish avenues for two-way communication with partners to gain critical perspectives and develop a foundation for ongoing collaboration.

1. Identify partners who reflect the multiple diversities of the population that the innovation will serve and include their input in decision making.
2. Use compensation, flexible scheduling, focus groups, surveys, interpreters, and other strategies to fully engage family members as partners.
3. Clarify partners' roles, responsibilities, and projected time commitment by:
   • Determining if role is advisory or working.
   • Confirming how each partner will contribute.
   • Using qualitative and quantitative data to communicate the purpose and rationale for change.
4. Identify concerns and problems the state will address being specific to all levels of the service system impacted.
5. Identify desired outcomes and changes for each level of the system, noting barriers to and opportunities for change.
6. Facilitate a review and discussion with partners on infrastructure and current practices.
   • Crosswalk strengths, concerns or problems with the specific agencies and policies which affect service delivery. Identify systemic constraints to target for change.
   • Review or realign the system's mission and values with desired outcomes and new vision for a change in practices.
   • Identify and acknowledge opposition, the reasons for it, and strategies to positively address it. These include incidences when district leaders question the sustainability and when programs express feeling burdened by the requirements of data collection.

Gather and review relevant data documenting current performance and the need for improvement.

1. Identify the extent of the need by its impact, depth, barriers, and opportunities.
2. Identify root causes.
3. Identify vision for meeting need.
4. Identify goals of potential innovations.
5. Review data to identify equity issues that the innovation will address, for example, family and provider access to innovation, or regional or community needs.

With your partners, assess the feasibility of potential innovations in relation to needs, desired outcomes, contexts, vision, mission, values, and system resources. Review the research and evidence for the potential innovation:

1. Review the research and evidence for the potential innovation.
2. Explore core features, functions, and benefits of potential innovations.
3. Gather information from other states, programs, and consultants experienced in implementing the potential innovations.
4. Explore context, including existing strengths and needs of the state and local system related to the innovation.
5. Analyze requirements of the implementation process and potential impact on state and local system resources.

Use established criteria and partner input to select innovations.

1. Establish criteria to select each innovation to adopt, for example:
   • Usability.
   • Required supports.
   • State need.
   • Alignment with mission, vision, values, and current initiatives.
   • System capacity to install, modify, and commit to the innovation.
2. Share a written summary of all perspectives and information gathered with partners.
3. Examine, with partners' input, which innovation best meets the selection criteria.
4. Select the innovation to implement with consensus of partners.

Secure necessary cross-sector support and awareness from additional state leaders, policy makers, and potential funders.

1. Identify additional state administrators, decisionmakers, and potential funders to assure necessary resources for implementation, scale-up, and sustainability.
2. Include decision makers from the collaborating agencies who can secure needed resources, especially for family engagement strategies.
3. Identify early adopters and champions among community and program leaders.

Adopt teaming norms and expectations, confirm membership and review roles and responsibilities.

1. Ensure that SLT members have the knowledge, skills, and resources to oversee the implementation process for the next two to five years including staff and commitment of time. Ensure that there is representation of diverse partner groups.
2. Finalize a vision statement to guide the work of the SLT and any sub-workgroups.
3. Establish effective teaming strategies through a member orientation that includes vision, mission, roles and responsibilities, ground rules, and structures of teamwork, that includes making decisions and reaching consensus.
4. Schedule regular opportunities to jointly examine practice or innovation, process, outcome, and fidelity data to improve implementation.
5. Establish a plan for maintaining diverse perspectives when recruiting new members.
6. Establish an orientation for new members that supports their meaningful participation and sense of belonging as a team member.
7. Ensure that the SLT studies and understands the Statewide Implementation Guide, the Essential Support Structures, and implementation stages.
8. Use the state Benchmarks of Quality to identify strengths and needs to develop an action plan and establish work groups to implement action plans. Work groups include SLT members and other experts and partners who may not be on the SLT.

Use the communication and dissemination plan to build and maintain statewide understanding and support.

1. Identify audiences who need to understand and support the innovation. These include families and parent groups, early childhood programs and practitioners, referral sources, collaborating agencies, funders, and legislators.
2. Use quantitative and qualitative data to clearly demonstrate the need for the innovation.
3. Determine the messages, materials, data, and appropriate formats targeted to each audience impacted by the innovation. For example, materials provided to families and the public use plain language and are available in all languages represented across the state.
4. Describe the core features and components of the innovation, the evidence for it, and its expected outcomes. If applicable, describe the relationship between the innovation to relevant system change efforts, for example, the State Systemic Improvement Plan (SSIP).
5. Use established communication strategies, identify potential early adopters, and note reasons for their enthusiasm and perceptions of benefits.
6. Use established communication strategies, identify potential opposition, the reasons for opposition, and the team response.
7. Use multiple communication strategies and feedback loops between practitioners, program leadership, community partners, program implementation coaches, and other partners to:
   • Identify challenges for the SLT to address.
   • Evaluate the impact and dissemination of the messages.
8. Identify several metrics that will evaluate the effectiveness of communication strategies used.
9. Include plans to engage your partners and champions to promote the innovation.

Develop needed system supports and changes in state, regional (multiple districts), community or district, local program policies and systems.

1. Make necessary changes to state administrative structures (organizational drivers) to support desired changes in practice, for example, contracts, interagency agreements, general supervision, oversight, policies, procedures, data systems, guidance, or forms.
2. Establish the Professional Development Network (PDN) of Program Implementation Coaches. Allocate one FTE (can be shared between two individuals) for the coordination of the PDN. Determine and make changes needed in staffing and staff responsibilities, including allocating one FTE to support coordination of this initiative as a state leadership team coordinator.
3. Identify and allocate PDN support for all implementation sites.
4. Support the establishment of Community Leadership Teams (CLT), selecting membership from the partners and champions included in the initial exploration stage.
5. Adapt PDN staff schedules to allow for new activities, for example, teaming, planning, training, coaching, or evaluation responsibilities.
6. Find and align the fiscal resources to cover start-up costs, administrative structure costs, data collection, professional development, training materials and any new service delivery costs, for example for three to five years implementation and scale-up and expansion goals.
7. Establish a sustainability and scale up budget to address immediate and long-term funding needs of the innovation; plan for three to five, years of implementation.
8. Develop commitment to and processes for policy and practice feedback loops to support learning and improvement throughout implementation.
9. Engage in data-based decision making in all SLT meetings and activities.
10. Establish action plans for achieving policy and funding goals needed for implementation, scale-up and sustainability.

Develop or modify data systems and procedures to use for evaluation and monitoring, with an an annual report of the data and progress.

Additionally, identify a work group to be responsible for the data system and the quality improvement metrics and processes relevant to the innovation. This work group reports regularly to the SLT and is responsible for:

1. Determining the data needed to:
   • Make implementation and infrastructure decisions.
   • Monitor and evaluate aspects of the implementation process, for example, communication and feedback loops, professional development activities, or functioning of state and local teams.
   • Evaluate intervention effectiveness based on performance assessment, fidelity, and the emergence of desired outcomes.
   • Measure accessibility of the intervention for under-resourced and under-served areas of a community.
   • Measure the impact of the intervention on under-resourced and under-served areas of a community.
   • Display the effectiveness of the innovation for funders, policy makers, and implementation partners at the community level.
   • Establish a review plan and schedule to consider the efficacy of the data collection methods, data sufficiency, and needed changes.
2. Determining who needs to use the data, for example, teams, trainers, program implementation coaches, practitioner coaches, practitioners, and any other individuals.
3. Determining if there is relevant local data to be obtained or disaggregated and the processes by which to do that sustainably.
4. Determining the current data system's capacity to provide the reports needed for monitoring and decision-making; make necessary additions and improvements.
5. Developing a data and evaluation plan that will measure implementation outcomes, performance metrics, and child and family outcomes.
6. Identify criteria for program success and scale-up.
7. Developing a data process guide to collect and disaggregate the data being used at the community or program level. The guide will include training and TA strategies to support this effort.
8. Developing procedures to ensure timely access to data.

Build capacity for training and coaching on the innovation and its implementation.

1. Establish selection criteria and process for the Professional Development Network (PDN) of Program Implementation Coaches. Development is based on the characteristics of personnel and organizational structures that are most likely to support successful implementation of desired practices.
2. Build the PDN:
   • Describe roles and responsibilities of program implementation coaches.
   • Create selection criteria for program implementation coaches and select initial cohort; ensure program implementation coaches represent the demographics of communities and programs.
   • Provide orientation to program implementation coaches about the initiative and timeline.
   • Provide the program implementation coaches' initial training and coaching to build on their skills to support the innovation.
3. Use selection criteria to identify and assign program implementation coaches to local implementation sites (communities and programs).
4. Coordinate a needs assessment with the program implementation coaches to determine statewide needs for program implementation training and TA.
5. Develop a timeline for conducting professional development (PD) activities.
6. Identify relevant PD performance metrics, benchmarks, and outcomes to include in the data and evaluation plan.
7. Create feedback loops with the PDN to identify additional supports and resources needed to support their own capacity.

Establish the initial implementation communities and program sites.

1. Establish selection criteria for implementation communities and implementation sites, based on the characteristics of personnel and organizational structures.
2. Develop a plan to select and support communities and sites that are underserved and under resourced.
3. Sign agreements with implementation sites that specify SLT and site responsibilities, including the roles and responsibilities of the Professional Development Network (PDN) or Program Implementation Coaches.
4. Establish a Program Leadership Team (PLT) with the help of the PDN to:
   • Develop site plans and oversee its activities and timelines.
   • Provide PD that includes practitioner coaching.
   • Collect and use data for improvement.
   • Participate in communication loops with the SLT.
5. A Program Leadership Team (PLT) consists of administrators and direct service staff, practitioner coaches, parent leaders, and others who are (or will become) knowledgeable of the implementation process and practices.
6. Clarify the roles and responsibilities of team members and their long-term commitment to implementation and sustainability. This is especially true of the data coordinator who will assist in collecting data for decision making.
7. Establish a Community Leadership Team (CLT) with the help of the PDN to provide a network of local/regional level support to implementation sites.
8. Identify PDN support for each CLT and PLT to serve as a guide throughout the implementation process and to ensure they have the resources, information, and skills necessary to lead the change effort.
9. Establish criteria that distinguish between implementation sites and demonstration sites based on fidelity, implementation, willingness, and capacity to host visitors and share outcomes. Share with implementation sites during the orientation.

Finalize a plan to guide the statewide process of implementation.

1. Complete the Benchmarks of Quality to identify strengths, gaps and needs of the state implementation infrastructure.
2. Use the Benchmarks of Quality to develop an implementation action plan with activities, timelines, roles, responsibilities, data, and benchmarks, including process and outcome evaluation activities.
3. Include these components in the action plan:
   • Communication and dissemination plan.
   • Training and TA plan.
   • Data collection, analysis, and monitoring plan.
   • Needed improvements in organizational structures, data, and resources necessary for high fidelity implementation.
   • Evaluation activities.
   • Considerations for ensuring equitable access to the innovation.
   • Considerations for expansion or scale-up.
4. Identify and engage external expertise and additional resources to support the implementation plan.
5. Disseminate the plan broadly using partners and multiple avenues to receive feedback, for example, focus groups or surveys.
6. Develop a progress monitoring and evaluation schedule of the implementation plan that ensures regular review, updates, and improvements to the plan and the actual implementation of the plan.
7. Produce an annual report, based on the action plan, to keep various audiences apprised of progress.
8. Celebrate success with all partners and the public.
9. Use annual report to continue to build awareness and support.

Implementation sites begin to use the innovation with support from the PDN and the Benchmarks of Quality monitoring tools.

1. Program Leadership Teams meet regularly and begin implementation. Implementation includes:
   • Collecting, using, and reporting data.
   • Providing training and practice coaching.
   • Analyzing implementation activities regularly.
2. Practitioners begin to use the innovation and receive practitioner coaching to assure practice fidelity.

The PDN monitors the implementation and regularly reports to the SLT.

1. Use the implementation action plan and data to monitor progress of state and local implementation milestones.
2. Annually assess on the state Benchmarks of Quality and adjust the action plan accordingly.
3. Oversee all aspects of initial implementation, including review of evaluation and feedback.
4. Gather and review information and data regularly about the implementation process, practice fidelity, participant satisfaction, costs, and emerging outcomes.
5. Use knowledge gained from data and feedback loops to adapt organizational supports and resources as needed so that practices are implemented with fidelity.
6. Develop and apply decision-making criteria to expand innovation use.

Evaluate processes related to fidelity, quality, outcomes, and benefits of initial efforts.

1. Provide technical assistance through the PDN to support high quality and complete data collection from implementation sites.
2. Analyze data from the fidelity measures with the PDN to determine whether there is a need to adapt the training or coaching support.
3. Evaluate success of activities according to the evaluation plan, with particular attention to the implementation process, practice fidelity, participant satisfaction, costs, emerging benefits, and outcomes. This information will support the sustainability, scale-up and expansion plan.
4. Summarize and share data with partners for ongoing feedback and incorporation into dynamic plans.
5. Produce an annual report on progress and outcomes for partners, policy makers and funders.

Ensure the PDN has the resources they need and are functioning as intended.

1. Ensure the PDN has adequate resources to sustainably carry out training, TA, and community and program coaching.
2. Ensure there is adequate time allocated for the PDN to maintain support to existing implementation programs as needed while providing intensive support to new implementation sites.
3. Use an evaluation plan to monitor the success of training, coaching, and TA.
4. Communicate and coordinate regularly with the PDN.
5. Share successes and early wins with relevant partners.
6. Identify potential barriers to implementation or maintenance within the statewide infrastructure. Consider completing System Framework Self-Assessment to explore points for improvement or maintenance.
7. Maintain relationships with and provide materials to higher education and professional organizations to impact pre-service education and licensing requirements

Begin improvement cycles to adjust organizational and administrative structures at the state, regional and local levels to support implementation and practice fidelity.

1. Monitor innovations using quality improvement cycles. Include barriers and facilitators, especially those that impact underserved communities.
2. Use communication and evaluation to quickly resolve barriers, test adaptations, and identify additional supports or needed changes.
3. Adjust administrative structures, for example, revising contracts and interagency agreements.
4. Provide general supervision and oversight.
5. Revise policies, procedures, guidance, and forms based on feedback.
6. Implement fiscal policies, procedures, and funding mechanisms to promote sustainability and scale up of the innovation or adapt as needed.
7. Monitor, manage, and communicate any changes to the innovation or infrastructure to support continued use and fidelity of the innovation.
8. Record challenges, solutions, adaptations, and other feedback to inform recruitment and support of subsequent implementation sites.

Use the communication plan to disseminate early lessons learned and to engage partners in problem solving.

1. Identify meaningful messages to share about implementation processes, timelines, accomplishments, and outcomes to monitor and report their impact on underserved communities.
2. Gather qualitative data from early adopters related to perceived benefits and needed changes to sustain things going forward.
3. Using established communication strategies, collaborate with innovation challengers and note perceptions of challenges, what could be going better, and what needs to change to sustain capacity.
4. Use data from previously identified metrics to evaluate the impact and dissemination of messages to potential funders and policy makers.
5. Celebrate success with partners.

Review successes and challenges to date, and plans for transitioning into the full implementation stage, which includes sustaining and scaling-up.

1. The SLT reviews and revises its SLT vision statement, membership, ground rules, and logistics for the new implementation stage.
2. The SLT uses the Benchmarks of Quality to assess the sustainability and scale-up action plan.
3. The SLT focuses on policies, procedures and funding needed to sustain and to scale up statewide, particularly for historically underserved communities.

With the Professional Development Network (PDN) of Program Implementation Coaches, record and reflect on what you've learned over the course of the implementation process, for example:

1. What recruitment and selection policies are in place to train new community and program leaders, practitioners, and SLT or PDN team members?
2. What policies and procedures related to professional development activities are in place (for example, coaching supports)?
3. Is funding sufficient for the PDN to establish new implementation sites while maintaining support to current implementation sites?
4. Is there a PD coordinator who facilitates recruitment, training, and a community of practice for program implementation coaches?

Evaluate for expected outcomes.

1. Prepare data to share with partners that is accessible, written in plain language, and available in multiple formats.
2. Review and analyze outcomes of practice and implementation fidelity, and progress on implementation plan.
3. Obtain feedback from partners at every level, including the SLT, PLT, CLT, PDN, practitioners, families, administrators, supporters, funders, and those resisting implementation of the innovation. Record their feedback about progress, concerns, and ideas about the innovation.
4. Share data with policy makers and funders to obtain funding and make policy that allows for sustaining and scaling.

Ensure data, personnel, communication systems, policies, procedures, and funding are integrated and fully functioning.

1. Review and reassess all Benchmarks of Quality (state, community, and program levels) annually to update priorities for ongoing implementation.
2. Assure that monitoring, support systems and reporting processes are in place and used regularly for program and practice fidelity and equity in service delivery.
3. Ensure data and feedback loops are integrated into statewide data processes.
4. Integrate reliable data systems and provide information about specific processes, practices, and outcomes.
5. Routinely share data with practitioners, coaches, and supervisors to improve performance.
6. Adjust state, district, and program policies, procedures, and budgets to support practice as needed.

Develop an action plan to extend the reach of the innovation sustainably, equitably, and systematically across the state. This action should address the following needs:

1. Budgeting and resource allocations.
2. Purchasing materials for new sites.
3. Expanding SLT to include other sectors.
4. Institutionalizing and embedding evidence-based practices within state initiatives, for example, quality rating systems or early learning guidelines.
5. Building awareness of and commitment to programs within policy makers, funders, and other partners.
6. Sustaining and scaling up of the PDN to include new sites while still supporting current sites.
7. Analyzing data to identify disparities for children, families, and practitioners to ensure equitable access, use, and benefits of the innovation.
8. Identifying program characteristics necessary for success.
9. Identifying criteria and procedures for selecting new implementation sites while supporting sites that need assistance in meeting the selection criteria with a focus on equity and inclusion.
10. Providing regular venues for implementation sites to share and learn from one another as well as inform the SLT.
11. Addressing turnover in leadership by the CLT, PLT and SLT. Programs have strategies to ensure the innovation will be maintained under new leadership. The SLT has strategies that ensure new members and new agency leaders understand and value the innovation and will maintain and expand it. The CLT orients new leaders to innovation and its importance to the community.

Develop a plan to sustain the innovation's structures and practices, including the following activities:

1. Continuing to provide and document administrative, organizational, and fiscal support.
2. Continuing to provide and document program implementation coaching to maintain fidelity.
3. Maintaining relationships with and provide materials to higher education and professional organizations for pre-service education and licensing requirements.
4. Continuing to promote awareness of optimal outcomes to expand support base.

Ensure that targeted fidelity is reached, and ready to expand the innovation within current sites.

1. PDN and PLTs identify practitioners who have reached practice fidelity and have the skills to be a practitioner coach.
2. Gather and review information and data regularly about the implementation process, program and practice fidelity, reach to under-served communities, participant satisfaction, costs, and outcomes (short- or long-term and unintended).
3. Use knowledge gained from data and feedback loops to determine whether other practices, policies, or programs should be discontinued. The SLT should inform partners what they have found to be ineffective, redundant, or contradictory to the innovation.
4. Combine the information learned from quality improvement cycles, evaluations, and partners into state, community, and program model implementation plans.

Select and support demonstration sites and next cohort of implementation sites.

1. Develop selection criteria and choose new implementation sites based on evaluation data, supports, experiences, and characteristics of success of implementation sites that were early adopters.
2. Designate the status of demonstration sites based on SLT criteria. Criteria to consider could be reaching fidelity on the program Benchmarks of Quality and on practitioner implementation of the practices, willingness to provide feedback, data, tours, a strong public awareness campaign, and success in achieving positive outcomes for under-served communities, as appropriate.
3. Publicly recognize demonstration sites for serving as models for other programs and agencies.
4. Update implementation site recruitment, selection and onboarding processes, including Memoranda of Understanding or Agreement (MOUs or MOAs), lessons learned from quality improvement cycles, evaluations, and partner feedback.
5. Recruit, select, and begin onboarding for next cohorts of implementation sites.

Return to the four implementation stages at the start of each new implementation site cohort. This builds capacity to support the innovation with fidelity.