Scottish Learning Festival
The Early Years Collaborative and the Model for Improvement
24th September 2014
The earliest years of child’s life represent the single greatest
chance to make a lasting impact on a child’s future
Joining the Dots (Professor Susan Deacon, 2011)
Chief Medical Officer’s Report
(CMO, 2007)
Early Intervention (Graham Allen,
2010)
Early Years Framework (2008)
‘Getting it Right for Every Child’ (GIRFEC,
2004)
Neuroscience and Brain
Development Research (Dr Bruce
Perry)
Scottish Government
Economic Modelling (2010)
The Evidence
Base
Scotland needs to work to bring
together the many people involved in
young children’s lives
To ensure that all children have appropriate,
positive experiences
Let’s provide a strong
foundation for future learning, behaviour and
health
Context National Outcome 2007
Our children have the best start in life and are ready to succeed
Early Years Framework 2008 10 key elements
Early Years Taskforce 2011 In partnership with local government, the NHS,
the police and the Third Sector
How?
Our Ambition
To make Scotland the best place in the world to grow up in by improving outcomes, and
reducing inequalities, for all babies, children, mothers, fathers and families across Scotland to ensure that all children have the best start
in life and are ready to succeed
Workstreams
Conception to 1 year
1 year to 30 months
30 months to
start of Primary School
Start of Primary
School to end of
Primary 4
Leadership
Scotland – the best
place in the world to grow up
Key Changes
The Big Ticket Items for Scotland
Informed by Early Years Collaborative testing across Scotland and experts in early years
Early support for Pregnancy and Beyond
Attachment and Child Development beyond Maternity Services
Continuity of Care in Transitions between Services
27-30 month Child Health Review
Developing Parenting Skills
Family Engagement to Support Early Learning
Addressing Child Poverty (inc. Income Maximisation)
Raising Attainment for All Twelve education departments
1-2 secondary schools and their cluster of primaries per local authority
Regional Learning Sessions
in September and December 2014
Full scale Learning Session will take place March 2015
MarshmallowChallenge
The
+ +
18 minutes
Rules1. It must be a free STANDING structure
2. You cannot be touching or holding on to thestructure after 18 minutes
3. Use as much or as little of the kit as you want
4. The entire marshmallow must be on top. Donot eat the marshmallow or cut it into pieces.
5. No phones allowed – no YouTube!
MarshmallowChallenge
The
Typical Progress
Start 18minutes
Typical Progress
Start 18minutes
Orient
Typical Progress
Start 18minutes
Orient Plan
Typical Progress
Start 18minutes
Orient Plan Build
Typical Progress
Start 18minutes
Orient Plan Build Ta-Da!
Typical Progress
Start 18minutes
Orient Plan Build Oh-No!
PoorPerformance?
What type of teamconsistently shows
Recent Graduates of Business School
GreatPerformance?
What type of teamconsistently shows
Nursery children!
Why?
Fail Win
Start18
minutes
Start18
minutes
• Find the best plan & execute• Focus on the structure
• Focus on the marshmallow• Play, prototype, experiment
DESIGN DESIGN DESIGN DESIGN APPROVE
Conference Room
Real World
The Typical Approach…
IMPLEMENT
DESIGN
TEST & MODIFY
TEST & MODIFY
APPROVEIF
NECESSARY
Conference Room
Real WorldTEST & MODIFY
The Quality Improvement Approach
START TO IMPLEMENT
Tests of Change?
https://www.youtube.com/watch?v=w0ffwDYo00Q
Special Thanks:
We are grateful to Tom Wujec for making his original Marshmallow Challengematerials available to the world!
Learn more at:
marshmallowchallenge.com
What do you want to improve for the children and families you work with?
The Model for Improvement
The Model for Improvement
A tool to achieve positive outcomes for children and families in Scotland
Why change?
The First Law of Improvement
“Every system is perfectly designed to achieve exactly
the results it gets.”Dr Paul Bataldan
The Primary Drivers of Improvement
Will
The Primary Drivers of Improvement
Ideas
The Primary Drivers of Improvement
Will
Ideas Implementation
Having the Will (desire) to change the current state to one that is better
Developing Ideas that will contribute to making processes and outcome better
Having the capacity to apply QI theory, tools & techniques that enable the Implementation of the ideas
QI
The Primary Drivers of Improvement
Implementation?
‘This model is not magic, but it is probably the most useful single framework I have encountered in
twenty years of my own work on quality improvement’
Dr Donald M. BerwickAdministrator of the Centres for Medicare & Medicaid Services
Professor of Paediatrics and Health Care Policy at the Harvard Medical School
The Model for Improvement
The Improvement Guide, 1996
The Thinking Part
The DoingPart
Developing an Aim Statement
What are we trying to accomplish?
Setting the Aim
Ambitious, unachievable by hard work
alone
Setting the Aim
Measurable
…..without measurement you
will never know if a change is an
improvement
Setting the Aim
Time specific
….. ensures focus
Setting the Aim
Specific
Define the group you are focusing
improvement efforts on
Setting aims: Characteristics
What?
Measurable (How good?)
Time specific (By when?)
Define target group (Who?)
Aim Statements
80% of children in Nessie Nursery will access outdoor play on a daily basis by October 2014
85% of pregnant mums in Prestwick will book with a midwife before 12 weeks of pregnancy by December 2014
90% of eligible children in Eaglesham will be registered with a
dentist by April 2015
Attendance rates at Speech and Language Therapy initial assessments in Dumfries will be 95% by end-July 2015
Got your aim?
Check!
How do we know that a change is an improvement?
Improvement is not just about measurement
However… without
measurement you will never be able to answer
the question
Improvement?
Judgment?Research?
Why are you collecting data?
70
35
0
10
20
30
40
50
60
70
80
Avg BeforeChange
Avg AfterChange
Cycl
e Ti
me
(min
.)Aggregated Data
Tells us very little about the
improvement journey
Median = 9
62
Tips for effective measures• Plot data over time
• Seek useful not perfection
• Use sampling
• Integrate measurement into daily routine
• Use qualitative and quantitative data
% receiving a story
% of stories read at bedtime
% of parents reporting improved bedtime routine
% enjoying the bedtime story
% reporting increase in bedtime story reading
Types of measures
Got your measures?
Check!
How will you know your change is an improvement?
What are your change ideas?
What do you think will make a difference?
What changes can we make that will result in improvement?
Selecting Changes• Evidence base: use the literature and evidence to inform your practice
• Use your own experience as a practitioner: your own hunches and theories
• Be strategic: set priorities based on the aim, known problems and feasibility
• Steal shamelessly! Learn from others and their experiences, hunches and theories
68
A practical need often drives creativity!
CHECKPOINT
Answer the 3 questions associated with the thinking part of the model before you start
testing
70% of projects fail because they don’t answer these questions at the outset
What now?
Tests of Change
Why test changes?
• To increase the belief that this particular change works and will result in improvement for your clients
• To learn how to adapt the change to conditions in your setting
• To evaluate the costs and “side-effects” of changes
• To minimise the resistance when spreading the change throughout the organisation
Plan Do Study Act Plan Do Study Act
“What will happen if we try something
different?”
“Let’s try it!”“Did it work?”
“What next? ”
Start small!
1 family
1 child
1 class
1 teacher
Three options after each test
Abandon (glad did small!)
Adopt (as tested)
Adapt (& test further)
Study
Act Plan
Do
Changes that will result in
improvement
Evidence, ideas, theories, hunches,
intuition,
Build confidence through testing
Think Big
Start Small
Scale Fast
This is new, so be brave!
@EYCollaborative
#bestplacetogrowup
www.scotland.gov.uk/earlyyears
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