scholarly journals Testing the Usefulness of the Evidence Integration Triangle for Implementation of EIT-4-BPSD

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 155-155
Author(s):  
Barbara Resnick
Keyword(s):  
Behavioral Interventions ◽  
Pragmatic Trial ◽  
Implementation Process ◽  
Term Care ◽  
Implementation Framework ◽  
Evidence Based Practices ◽  
Team Meetings ◽  
Practical Progress ◽  
Staff Behavior ◽  
Evidence Integration

Abstract The effectiveness of evidence-based practices, such as use of behavioral interventions, can be improved when delivered under conditions of an implementation framework. This pragmatic trial used the Evidence Integration Triangle (EIT) which is a parsimonious, community-engaged participatory framework that brings evidence and facility stakeholders together. Active engagement empowers key stakeholders to integrate evidence into practice using a simple three-pronged framework: (1) A participatory implementation process which was done via monthly meetings and weekly emails between stakeholders and a clinical expert as they worked on facility based goals; (2) Implementation of the four steps delineated in the EIT-4-BPSD; and (3) evaluation using practical progress measures. There was some evidence of implementation of the EIT-4-BPSD based on participation in Stakeholder team meetings, settings working towards goal achievement, and increased use of behavioral interventions among staff. The EIT approach is a useful implementation framework to help change staff behavior in long term care.

scholarly journals Implementing an Interdisciplinary Committee to Reduce Psychotropic Drug and Increase Behavioral Intervention Use

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 306-306
Author(s):  
Lauren Hess Conrad ◽  
David Portman
Keyword(s):  
Psychotropic Drug ◽  
Behavioral Intervention ◽  
Psychotropic Medication ◽  
Behavioral Interventions ◽  
Psychotropic Medications ◽  
Interdisciplinary Treatment ◽  
Fiscal Year ◽  
Term Care ◽  
Care Plans ◽  
And Behavior

Abstract In Fiscal Year (FY) 2018, the Butler VA Health Care System’s Psychotropic Medication and Behavior Management Committee was identified as a Veterans Integrated Service Network 4 Best Practice. The goal of this committee is to reduce unnecessary psychotropic medication use and polypharmacy and to increase behavioral intervention implementation among Community Living Center (CLC) Veterans. This committee meets quarterly to review Psychotropic Drug Safety Initiative data, behaviors and behavior care plans, and all psychotropic medications prescribed to Veterans. Psychiatric diagnoses, changes to psychotropic medications, and appropriate behavioral interventions are discussed. Committee members take responsibility for action items in accordance with their discipline; documentation of recommendations are made in quarterly behavioral health assessments in CPRS; and follow-up on action items is completed at twice weekly interdisciplinary treatment team meetings, weekly behavior rounds, and/or as needed. From the first quarter (Q1) of FY16 to Q1 FY20, the Butler VA CLC has seen decreased prescriptions of 2 or more anticholinergics (6.6% to 0.80%), antihistamines (12.5% to 5.9%), benzodiazepines (24.7% to 11.0%), and benzodiazepines or sedative hypnotics (23.2% to 9.0%). While prescription of antipsychotic use has increased (Q1 FY20 = 23.8%), the committee will follow Long Term Care Institute guidelines for gradual dose reductions, behavioral interventions, and as needed psychotropic medication PRN use. This committee provides an interdisciplinary forum to discuss and implement beneficial changes to pharmacological and non-pharmacological interventions among all CLC Veterans. The committee is a valuable process for monitoring and reinforcing best practices that may be easily replicated across VA CLCs nationwide.

Examining Teaming and Tier 2 and 3 Practices Within a PBIS Framework

2021 ◽  
pp. 109830072110510
Author(s):  
Rhonda N. T. Nese ◽  
Angus Kittelman ◽  
M. Kathleen Strickland-Cohen ◽  
Kent McIntosh
Keyword(s):  
Behavioral Interventions ◽  
Data Use ◽  
Future Research ◽  
Evidence Based ◽  
Tier 2 ◽  
Behavior Support ◽  
Evidence Based Practices ◽  
Research And Practice ◽  
Positive Behavioral Interventions ◽  
Core Feature

One core feature of Positive Behavioral Interventions and Support (PBIS) is a systems-level teaming process for coordinating staff implementation of evidence-based practices and monitoring student progress across all three tiers. Prior research has shown schools that report regular teaming and team-based data use are more likely to successfully adopt and sustain implementation of multi-tiered systems of behavior support. However, more research is currently needed to better understand the various teaming configurations, structures, and practices commonly used by PBIS teams in typical schools, particularly at advanced tiers. For the current study, members of school and district PBIS teams representing 718 schools were surveyed to better understand (a) teaming configurations and practices currently being used in schools implementing PBIS and (b) common interventions that PBIS teams report implementing at Tiers 2 and 3. Survey findings are discussed, along with implications of those results for future research and practice in applied settings.

scholarly journals Implementation of Assistive Technologies and Robotics in Long-Term Care Facilities: A Three-Stage Assessment Based on Acceptance, Ethics, and Emotions

2021 ◽  
Vol 12 ◽  
Author(s):  
Annette Franke ◽  
Elmar Nass ◽  
Anna-Kathleen Piereth ◽  
Annabel Zettl ◽  
Christian Heidl
Keyword(s):  
Transformational Leadership ◽  
Long Term Care ◽  
Implementation Process ◽  
Well Being ◽  
Emotion Management ◽  
Assistive Technologies ◽  
Care Staff ◽  
Term Care ◽  
Care Facilities

Assistive technologies including assistive robots (AT/AR) appear to be a promising response to the increasing prevalence of older adults in need of care. An increasing number of long-term care facilities (LTCFs) try to implement AT/AR in order to create a stimulating environment for aging well and to reduce workload for professional care staff. The implementation of new technologies in an organization may lead to noticeable cultural changes in terms of social interactions and care practices associated with positive or negative emotions for the employees. This applies especially for LTCFs with high rates of vulnerable residents affected by increasing care needs and specific ethics in nursing and cultural rules within the setting. Thus, systematic consideration in leadership management of emotions and ethical aspects is essential for stakeholders involved in the implementation process. In this article, we explicitly focus on the emotions of the employees and leaders within LTCFs. We relate to direct consequences for the organizational well-being and culture, which is of course (indirectly) affecting patients and residents. While aspects of technology acceptance such as safety and usefulness are frequently discussed in academic literature, the topic of emotion-management and ethical questions during the organizational implementation process in LTCFs received little attention. Emotional culture entails affective values, ethical norms and perceptions of employees and further investigation is needed to address the importance of transformational leadership during implementation process. For this purpose, we developed a three-staged assessment tool for implementation of AT/AR in long-term care institutions. Acceptance (A), ethical acceptability (A) and emotional consequences (E) are considered as comprehensive assessment, in which emotional consequences comprise management aspects of transformational leadership (T), emotion-management (E) and organizational culture (O). Based on AAE and TEO, this paper presents an integrated framework illustrated with a illustrative example and aims to combine established approaches with ethical insights in order to unfold potentials of AT/AR in LTCSs.

scholarly journals Risk and Opportunity—The Leadership Challenge in a World of Uncertainty—Learnings from Research into the Implementation of the Australian National Disability Insurance Scheme

2021 ◽  
Vol 14 (8) ◽  
pp. 383
Author(s):  
David Rosenbaum ◽  
Elizabeth More
Keyword(s):  
Large Scale ◽  
Service Providers ◽  
Implementation Process ◽  
Disability Insurance ◽  
Framework Analysis ◽  
Insurance Scheme ◽  
Implementation Framework ◽  
Non Profit ◽  
Leadership Challenges ◽  
Implementation Challenges

This paper considers the risks and opportunities inherent in a major national change process through a descriptive approach to the implementation challenges for Australian non-profit disability service providers as they grapple with the implementation of the transformational National Disability Insurance Scheme (NDIS). It highlights the leadership challenges associated with the newly developed NDIS Implementation Framework and, in doing so, recognises the risk and opportunity issues contained with that implementation process. The research used grounded theory coupled with framework analysis in a qualitative study that, in part, sought to identify leadership characteristics deemed necessary to minimize risks, capitalize on opportunities, and support positive change outcomes leading to successful NDIS implementations amongst several participating organisations, each with differing demographics and at different stages in the implementation process. The findings, which have been grouped into phases, suggest a range of leadership attributes at key phases of the NDIS implementation that are necessary to minimise implementation risks and maximise opportunities associated with the NDIS. These phases have been identified as: (i) An input phase where the emphasis must be on internal change preparedness and external environmental impacts and drivers; (ii) A process phase where the emphasis is on direct implementation issues; and (iii) An outcomes phase where active consideration needs to be on organisational mission sustainability, as well as the risk and opportunity challenge. The study is crucial in revealing leadership challenges and lessons for large scale change and risk management in the non-profit sector, within and beyond the specific case of Australia’s NDIS implementation, useful for both scholars and practitioners.

Clinical Interventions in Problem-Solving Courts

2019 ◽  
pp. 33-49
Author(s):  
David DeMatteo ◽  
Kirk Heilbrun ◽  
Alice Thornewill ◽  
Shelby Arnold
Keyword(s):  
Problem Solving ◽  
Behavioral Interventions ◽  
Evidence Based ◽  
Therapeutic Communities ◽  
Evidence Based Practices ◽  
Clinical Interventions ◽  
Trauma Informed Care ◽  
Problem Solving Courts ◽  
Trauma Informed ◽  
Assessment Procedures

This chapter focuses on the clinical interventions most commonly delivered in problem-solving courts. The chapter begins with a discussion of the Risk-Needs-Responsivity Model, which provides a foundational context for the interventions used in problem-solving courts and highlights the importance of targeting offender needs—criminogenic needs—related to key outcomes (e.g., reduced recidivism, reduced relapse to drug use). The authors then discuss the various screening and risk assessment procedures used to admit offenders to problem-solving courts, the clinical interventions used in problem-solving courts (e.g., cognitive-behavioral interventions, 12-step programs, therapeutic communities, case management, trauma-informed care), and the use of evidence-based practices in problem-solving courts. The authors note the role of problem-solving courts as a watchdog for service provision and conclude with a section discussing “next steps” for expanding evidence-based interventions in problem-solving courts.

Case Studies Using Program Evaluation to Drive Evidence-Based Practices

2018 ◽  
pp. 109-131
Author(s):  
Julie Q. Morrison ◽  
Anna L. Harms
Keyword(s):  
Early Literacy ◽  
Case Studies ◽  
Behavioral Interventions ◽  
Single Case ◽  
Pilot Project ◽  
Evidence Based Practices ◽  
First Case ◽  
Single Case Designs ◽  
The Cost

This chapter consists of three case studies that illustrate how the evaluation approaches, methods, techniques, and tools presented in Chapters 1 to 5 can be translated into practice. The first case study describes an evaluation of the Dyslexia Pilot Project, a statewide multi-tier system of supports (MTSS) initiative targeting early literacy. In this evaluation, special attention was paid to the evaluating the cost-effectiveness of serving students in kindergarten to grade 2 proactively. The second case study features the use of single-case designs and corresponding summary statistics to evaluate the collective impact of more than 500 academic and behavioral interventions provided within an MTSS framework as part of the annual statewide evaluation of the Ohio Internship Program in School Psychology. The third case study focuses on efforts to evaluate the fidelity of implementation for teacher teams’ use of a five-step process for data-based decision making and instructional planning.

Staff Training Aimed at Reducing Rearrest: Probation officer attitudes and experiences

2020 ◽  
Vol 12 (3) ◽  
pp. 238-264
Author(s):  
Jill Viglione ◽  
Lucas M Alward ◽  
DeCarlos L Sheppard
Keyword(s):  
Staff Training ◽  
Implementation Process ◽  
Probation Officer ◽  
Community Supervision ◽  
Successful Implementation ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Facilitators And Barriers ◽  
Training Programmes ◽  
Officer Attitudes

Community correction organisations have recognised the importance of implementing evidence-based practices to improve probation practice and reduce recidivism rates. Research finds when probation agencies implement evidence-based practices in line with the Risk, Need, Responsivity model with fidelity, reductions in recidivism are possible. However, challenges of implementation persist. To assist in the translation of evidence-based practices to real-world practice, researchers and practitioners developed community supervision officer training programmes. Using qualitative interview data of trained federal probation officers, this study examined the implementation of the Staff Training Aimed at Reducing Rearrest. This study explored (1) probation officer attitudes and perceptions of Staff Training Aimed at Reducing Rearrest, training and implementation process; (2) how users and coaches implement key components of Staff Training Aimed at Reducing Rearrest; and (3) the organisational facilitators and barriers associated with Staff Training Aimed at Reducing Rearrest implementation. Findings suggest positive attitudes towards Staff Training Aimed at Reducing Rearrest for improving supervision process and highlight key facilitators and barriers that can be addressed to support successful implementation efforts.

Evidence-Based Practices for Teaching Learners with Emotional and Behavioral Disorders

2020 ◽  
Author(s):  
Jessica Whitley
Keyword(s):  
Behavioral Disorders ◽  
Behavioral Interventions ◽  
Emotional And Behavioral Disorders ◽  
Relationship Building ◽  
Behavioral Disorder ◽  
Social Emotional ◽  
Evidence Based Practices ◽  
Social And Emotional ◽  
Positive Behavioral Interventions ◽  
Tiered System

Students identified with emotional and behavioral disorders (E/BD) comprise a diverse group in terms of academic, social, emotional, and behavioral strengths and needs. Identification and diagnostic criteria and terminologies vary widely across and within many countries and school systems, resulting in a complex research base. Estimates of prevalence range from 4 to 15% of students meeting criteria for an emotional and/or behavioral disorder or difficulty. Approaches to teaching learners with E/BD have shifted since the turn of the 21st century from an individual, deficit-focused perspective to a more ecological framework where the environments interacting dynamically with the learner are considered. Research increasingly demonstrates the benefits of multi-tiered systems of support (MTSS) where the needs of most students can be met through universal preventative and whole-class approaches. Students who do not find success at the first level of supports receive increasingly specialized services including intensive, wraparound services that involve partners beyond school walls. MTSS are common across North America and beyond and are typically focused on externalizing behaviors; positive behavioral interventions and supports (PBIS) is the most prevalent multi-tiered system currently being implemented. Since the mid-2000s, efforts have been made to focus on academic as well as behavioral goals for students, often through the inclusion of response-to-intervention approaches. Comprehensive strategies that combine academic and behavioral support while drawing on learner strengths and relationship-building are successfully being adopted in elementary and secondary settings. Approaches include social and emotional learning, mindfulness, peer-assisted learning, and a range of classroom-based instructional and assessment practices that support the academic, social, and emotional development of students with E/BD.

scholarly journals Why the Discretion Mix Matters: Understanding the Transformation of Long-term Care Services

2019 ◽  
Vol 56 ◽  
pp. 004695801987182
Author(s):  
Young Jun Choi ◽  
Hyejin Choi
Keyword(s):  
Long Term Care ◽  
Social Care ◽  
Implementation Process ◽  
Theoretical Concept ◽  
Care Provision ◽  
Term Care ◽  
Study Approach ◽  
Care Services

This study aims to extend the concept of discretion, ie, a certain degree of freedom in crucial decisions left to specific actors, to understand and examine the transformation of social care services in the era of aging and austerity. Although previous studies have reviewed and analyzed changes in care provision, they have been less concerned with who has the authority to make care decisions in the implementation process. We propose a new theoretical concept, the discretion mix, to understand the realignment of social care services beyond simply tracking institutional changes. Using a case study approach, this research investigates how the discretion mix of the Korean long-term care system has changed and the consequences of these changes; in addition, it discusses why the discretion mix can be a useful concept for analyzing the changing landscape of social care services.

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