Considerations for Implementing Systemic Change can be used by individuals planning, or in the process of making improvements to the service system. Considerations for Implementing Systemic Change provides questions a group should think about and answer for their specific long-term system change initiative. Groups will be more efficient and effective when guided by the stages, steps and activities as presented in this document.
How extensive is the change initiative?
What is motivating the desire to make a change?
What data support the need for change?
Will the change being considered require more than a tweaking of something you already do?
Is the change going to impact a wide range of people within your system across the state?
Will those people need training and support to implement the change correctly?
Will the change take considerable time, energy and resources to see it through?
Is more than one person needed to lead this change initiative over time?
If most or all of the questions indicate that the initiative will involve extensive time, resources and impact on personnel, then the initiative is mostly likely a systemic change effort. This type of change will require the use of well-planned implementation process to be efficient and successful. The considerations below can help you think through potential activities that should occur during the stages of implementation.
Is a team needed to share the work and provide leadership to the change initiative?
Should the team include:
people knowledgeable about the change process?
people knowledgeable about the potential initiative you are considering?
others from key agencies the change may impact?
people who have (or have access to people) with decision making authority?
Do you need a stakeholder group to:
review data on needs?
provide information from state, local or consumer perspectives?
explore the fit of potential innovations to the values, structures and resources of the system?
advocate for the change and promote acceptance among their constituent groups?
Has the team explored the feasibility of various potential innovations, (new ways of working) and any practices that are already available that can be adopted to address the needs and provide desired outcomes?
Can an existing innovation be adapted or will you need to develop and describe the innovation that fits the needs and resources of your system?
Have you discussed how you will sustain this change over time?
Develop the Innovation: The New Way of Working
Will you need to develop/write your own usable, doable innovations that spell out the desired change(s)?
Do you need a workgroup to develop/write or adapt innovations and practices?
Is the innovation clearly written in enough detail so that people will know what is changing, what will stay the same and what they will be asked to do?
Have you developed criteria to measure whether the innovation is in use as intended?
What do your stakeholders need to assist you in getting buy-in?
Installation: Getting the System Ready
Have you analyzed your current system and determined any necessary changes to your infrastructure that will need to be made to support the change?
Who will need to be trained and supported in order to do the new way of working?
Will training materials need to be developed?
Will doing the new way of working need more ongoing support such as local leaders, mentors or on-site consultants?
What data are needed to show progress and how well people are doing?
Will dollars need to be earmarked for change activities such as training and data collection activities?
Are there any policies or procedures that will need to be re-done?
Are there any changes needed to organization structures or administrative responsibilities?
Should you start small having a few people or programs make the necessary changes before going to the all intended users (phasing in)?
How will you communicate to varied audiences throughout about the changes?
Do you need to develop public relations materials targeted at different audiences?
What communication methods and structures are in place for all appropriate levels of the system (i.e. state, local teams, programs) to share information and data with leadership team?
Develop a Written Plan
Do you have a written plan that is reflective of the considerations in installation?
Does the written plan contain details of how to implement and sustain the change of time?
Does the plan address the following:
communication activities to build public support?
T&TA activities, resource people and materials to support personnel?
activities to reduce organizational barriers and strengthen system capacity, such as policy, procedures, funding, organizational structures etc.?
evaluation and monitoring procedures to track the implementation process and emerging outcomes and impacts?
Does your written plan include the steps and specific activities for all of the above actions with timelines and responsibilities clearly defined?
Is there a process to regularly review the plan and make any changes as needed?
Will you start with a few teams or programs and resolve any issues before spreading the change?
Are there equity issues or feasibility concerns that suggest you should not start small with pilots or a few programs (i.e. funding, fee changes, putting a new data system in place)?
Have the early users received enough training and support to feel comfortable to begin doing the new way of working?
Do the early users regularly provide feedback and ask for help or additional support when needed?
Are data and information being collected in a timely manner on how well things are going?
Are data and feedback from the early users being used to quickly make any adjustments or changes system structures?
Are early users performing as intended and showing fidelity with desired practice changes?
Are early users beginning to realize the expected outcomes and benefits?
Is there an expectation that the early users will help others and do they have time built into their job to do so?
If implementing statewide, do you have evaluation, monitoring and targeted TA processes to assure continuous improvement?
Are all organizational supports (leaderships, policies, procedures funding, data systems, training, monitoring) in place and working well?
If you started with pilots or field test sites, have lessons learned been incorporated into, procedures, policy, training and organizational structures?
Are you using your roll out plan with timelines and supports in place to spread the innovation?
Have new users received the necessary training and received needed support to make changes?
Can people or programs performing well and achieving expected results show others how to do the new way of working?
Are data that show intended outcomes and results being shared?
Have expectations for performance been added to job descriptions and supervision activities?
Have you built evaluation activities into on-going monitoring to prevent or quickly correct drift (deviation from desired practices or procedures)?
What plans do you have to assure long-term sustainability?