Administrative Management or Enhanced Practice: The role of Evidence-Based Practice on the Road to Quality AWAC Conference18 th August 2008 Dr Angela Murphy University of Ballarat Lisa Lodge Child and Family Services Ballarat

Conceptual Background  Shift in concepts of professionalism  Conceptualising professionalism (Evett, 2006) : Organisational:  external standardisation practice  increased accountability & outcome Occupational:  discretionary decision making  Reflective practice  contemporary evidence base

Potential for Conflict? Standards attainment using based on dominant notions of compliance:  Tick boxes Form filling  Two conceptualisations not inevitably at odds: a continuum Evidence-Based Communities Reflective Practice Evidence Base Shared Knowledge Quality through workforce professionalisation

What does it mean?  Quality process a continuum  Administrative compliance processes one end  Embedded evidence based reflective practice other end.  Evidence-Based Communities of Practice explored as critical to professional and sector development.

Context  Children, Youth and Families Act (2005)  Agency Registration requirements  Family Services and Out of Home Care.  Overt link between Standards attainment and Quality Enhancement.  Stated assumption: Compliance equates to enhanced outcomes for service users.

Initial Case Study  Two Victorian CSOs: Lisa Lodge, Ballarat Child and Family Services Ballarat  Quality Practice Position Role for standards management Training provision: LAC Evidence Based Journal Clubs Evidence Based Library

Looking After Children (LAC) Case Management Model  Evidence Based Model for Practice using series of evidence based tools: Essential Information Record (EIR) Case and Placement Plan Assessment and Action Records  Moved Practice reality from ‘form filling’ to the adoption of an ‘evidence-based case management model’

Evidence Based processes  Monthly inter agency journal club  Evidence based library  Intra agency induction and training resources  Mentoring program  Increased understanding of quality link to reflective practice  Lack of capacity for sustainability

The model across programs and agencies Professional Expertise Local Context Most Current Evidence on an issue Evidence Based Communities of Reflective Practice

Statewide Context  Need for evidence and reflection acknowledged and promoted by funding body  Provision of inter sectoral training and development  Philosophy needing to translate to practice context  What role Standards?

Next phase  Statewide research project reviewing the implementation of reforms and emerging impacts  Involves 9 CSO and Statewide body  Key focus on extent to which the accreditation process (and the financial and human cost involved) can be directly linked to enhanced professionalism and improved service outcomes.

Initial findings  Family Services and professionalisation: Increased acknowledgement as professionals Linked to knowledge, skills and building of evidence base ‘Becoming more skilled and knowledgeable in more areas linked to research insights – this has resulted in an increase in both how we perceive ourselves and how we are perceived by funders’

Initial findings  Out of Home Care and professionalisation: Administrative focus resulting in de professionalisation and loss of autonomy Staff feeling de skilled because they are constantly working in crisis mode ‘ In the last 5 years we are a much more professional sector; using EBP and understanding which interventions are the best.. And this is being stifled by the bureaucratic layers with which we must work in the name of quality’

Initial findings - organisational ‘Meeting the standards does not result in a better service. An exercise of ticking the right boxes does not substantially change practice; Just organises information on what we do in a more systematic way’ ‘What is needed goes so far beyond standards; need a more specialised and professionalised workforce with an evidence base to meet highly specialised needs’

Initial findings  Standards are important and meet some existing gaps but are not quality indicators in themselves  Meeting standards is not equating to enhanced outcomes  Staff are not making link between standard compliance and practice outcomes  Resource issues are huge – not a recognised and funded aspect of implementation  The focus on ticking boxes results in limited capacity to reflect and research

Initial findings  Enhanced quality consistently linked to the capacity to be reflective and informed  Decreased level of worker satisfaction across all research participants  Higher levels of risk being carried by CSOs  Need for increased specialisation  Strict adherence to standards to guide practice is decreasing professional autonomy

The focus for the future? Notions of professionalism with strong discipline control, as well as strict closure are nonsensical in modern practice... Surrender in professionalism to corporate and measurement ideals are also nonsensical. New ways of organising work can be found between these divergent and radical perspectives. This requires a reflective understanding of – and feel for- hybrid professionalism as reflective practice (Noordegraaf, 2007, 781)

References  Benveniste, G. (1987). Professionalising the organisation: Reducing bureaucracy to enhance effectiveness, San Francisco, C.A: Jossey-Bass Inc Publishers.  Evetts., J. (2004). ‘From profession to professionalism: A discourse of occupational change’, The first CSP Conference in the Studies of Professions  Oslo, Norway, June 17 – 19.  Evetts, J. (2006). ‘Short Note: The Sociology of Professional Groups: New Directions’, Current Sociology, Vol. 54, No. 1, pp. 133 – 143.  Morgan Roberts, L. (2003). ‘Changing Faces: Professional Image Construction in Diverse Organisational Setting’, Harvard Business School, Press.

References  Noordegraaf, M., (2007). ‘From Pure’ to ‘Hybrid’ Professionalism: Present-Day Professionalism in Ambiguous Public Domains’, Administration & Society, Vol 39, No. 6, pp  Schön, D. A. (1983). The Reflective Practitioner: How Professionals Think, Temple Smith, London.  Swailes, S. (2003). ‘Professionalism: evolution and measurement’, The Services Industries Journal, Vol 23, No. 2, pp. 130 – 149.  Webb, S. (2001). ‘Some considerations on the validity of evidence-based practice in social work’, British Journal of Social Work 31, no. 1, pp. 57–79.

Acknowledgements The presenter would like to acknowledge both Lisa Lodge and Child and Family Services Ballarat for their support and input Acknowledgement and thanks is also given to all CSO and Statewide agency staff and management for their current and future participation in the University of Ballarat, Reform Agenda research project