Implementation Teams

Expertise is required to purposefully, effectively, and efficiently support using innovations as intended to produce desired outcomes reliably and repeatedly. This expertise is developed in Implementation Teams that are formed by reassigning and repurposing current staff in organizations and systems.

WHO does the work of implementation?  Purposeful, active, and effective implementation work (making it happen) is done by Implementation Teams.  Some Implementation Teams are developers and purveyors of individual evidence-based programs.  Some Implementation Teams are employed by intermediary organizations that help others implement a variety of evidence-based programs.  Other Implementation Teams are developed and embedded in organizations and systems.

An Implementation Team is more than a name.  Implementation Team members have special expertise regarding finding and developing Usable Innovations, using and teaching implementation best practices, and initiating and managing organization and system change methods (Van Dyke, 2015).  This expertise is developed in Implementation Teams that are formed in organizations and systems.  An Implementation Team has 3 – 5 expert members who work closely with the executive leadership of the organization.  They are accountable for making it happen; that is, for assuring that effective interventions and effective implementation methods are in use to produce socially significant outcomes reliably and repeatedly.

Implementation Teams “make it happen” in a purposeful and mission-driven way.  In this process, existing staff and stakeholder groups in an organization or system are included in the various activities, discussions, and decisions.  Especially in the first few years of practice, organization, and system change the staff and stakeholders are an important source of information and help to guide the Implementation Team toward key leverage points and help to balance urgency and the pace of change.  In this way, staff and stakeholders are co-developers of implementation supports for effective innovations and will sustain the implementation work for decades to come.

Co-development is directed by the principles of Active Implementation.  The goal of establishing the Active Implementation processes is clear and the task is to develop the necessary roles and functions to achieve the goals of change in the status quo and its outcomes.  In contrast, co-creation is a process where stakeholders meet to reach agreement on their goals, whatever they may be, and decide on next steps (Bombard et al., 2018; Metz & Albers, 2014).  Co-creation is best suited for Exploration Stage work with groups where agreement and certainty are not sufficient to proceed to use an effective innovation with fidelity and good outcomes (Hawkins, Catalano, & Arthur, 2002; Spoth & Greenberg, 2011; Stacey, 2002; Wandersman, 2003; Zimmerman, Lindberg, & Plsek, 1998).

The essential components of Implementation Team member skill sets have been operationalized in a practice profile (Van Dyke, 2015). The practice profile guides practitioners and supervisors in building the competencies of implementation practitioners by providing a detailed description of the essential functions of effective implementation practices.

The ten core competencies of implementation practitioners are relationship development, leadership engagement and guidance, implementation instruction, implementation facilitation, intervention operationalization, team development, data-informed decision making, strategic analysis to support change, team-based project management, and coaching. In any one situation, an implementation practitioner is likely to draw upon multiple core competencies simultaneously to analyze and respond; for example, using data for decision-making (data-informed decision making) may occur while facilitating an implementation drivers’ analysis (implementation facilitation) (Van Dyke, 2015, p. 6).

The Drivers Best Practices Assessment (DBPA) is used to assess Implementation Team performance in practice (Fixsen, Blase, Naoom, et al., 2015; Ogden et al., 2012).  Implementation Team functioning (use of the Implementation Drivers) is highly related to practitioner fidelity outcomes (Bjørg et al., 2018; Metz et al., 2014; Tommeraas & Ogden, 2016).

Years ago the Center for Research on Utilization of Scientific Knowledge (CRUSK) was perhaps the first organized group to attempt to define, develop, and support the use of identified implementation methods in practice and research (Havelock, 1969; Tornatzky, Fergus, Avellar, Fairweather, & Fleischer, 1980).  Havelock and Havelock (1973) wrote a book on training for change agents to support the use of innovations in practice.  They noted that change agents “advocate, organize, and agitate” to produce change.  They trained change agents to be a catalyst (prod and pressure, overcome inertia, create dissatisfaction, get things started), solution giver (know what and when, where, to whom to deliver assistance; technical proficiency), process helper (recognize and define needs, diagnose problems and set objectives, acquire needed resources, select or create solutions, adapt or install solutions, evaluate to determine progress), and resource linker (people, time, motivation, funds).  They defined many functions of modern Implementation Teams.

Intermediary Organizations

Implementation Teams may be developed in intermediary organizations that are not tied to any particular evidence-based program or other innovation.  These regional implementation sites have the full capacity to provide all of the essential implementation functions to support the use of innovations in a variety of organization.  For example, in the Teaching-Family Model, staff members employed by an implementation site are specially trained to provide selection, training, coaching, evaluation, facilitative administration, and systems interventions for treatment group homes within easy driving distance (Blase et al., 1984; Wolf et al., 1995).  In this approach, each implementation site becomes the source of its own core implementation components without continuing reliance on outside contractors.  For these implementation sites, fidelity is measured at the practitioner level to assure competent delivery of the essential intervention components and measured at the implementation site level to assure competent delivery of the essential implementation components (see section on fidelity).  Implementation Teams supporting Functional Family Therapy also work to develop self-sufficient implementation sites (Sexton & Alexander, 2000) and MST Services, Inc. develops “network partners” to provide training and support services at a more local level (Brunk, Chapman, & Schoenwald, 2014).

Embedded Organizations and Systems

The State Implementation and Scaling up of Evidence-based Programs Center (Caryn Ward, Director; Fixsen et al., 2013) develops linked Implementation Teams at multiple levels within large state education systems.  In that case, the system itself becomes the intermediary organization and is able to initiate, support, and sustain multiple innovations.