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What’s in a Name? What out-of-home care managers think ‘evidence-based practice’ really means! Deirdre Cheers ACWA Conference - 2nd September 2002
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Senior Managers and Team Leaders thoughts and ideas about evidence- based practice How evidence-based practice impacts on direct work with children and young people in out-of-home care care
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Looking After Children (LAC) A case management system for children and young people in out-of-home care Developed in the early 1990’s by UK Department of Health Based on extensive research into outcomes for children and young people in care
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Out-of-Home Care: Past and Present Changes in how care is provided Emerging trends Impact of research
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“ there are considerable pressures on professionals to adopt evidence - based practice, that is, action which is grounded in sound knowledge of the needs of children & families and latest evidence about what works for whom, when and why” (Little, 1997 )
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The Research An investigation into knowledge held by Senior Managers and Team Leaders, and barriers to implementation of evidence-based systems, in three Australian States/Territories. The UK Looking After Children system is used as a case example.
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The Research ( cont.) 9 out-of-home care agencies (government and non government) 3 states/territories - NSW, ACT, WA 19 participants (10 Senior Managers and 9 Team Leaders)
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Research Aims Explore definitions of evidence- based practice Consider the influence of research Look at barriers to implementation of evidence- based systems
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Two Associated Areas Explored Comparison of government and non- government agencies Similarities and differences between agencies on a state/territory basis
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The Interviews: Senior Managers Understanding and definition of the terms “evidence-based practice” and “guided practice” Relationship between employed position and ability to undertake professional reading/training/updating of knowledge base
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The Interviews: Senior Managers (cont.) Knowledge of Looking After Children Individual reservations and agency barriers to the use of Looking After Children Decision making process in agency
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The Interviews: Team Leaders Additional questions about the use of LAC as a tool for supervision
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Senior Managers Eight Senior Managers reported active and conscientious use of research to inform practice Nine offered theoretical definitions of evidence-based practice
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Senior Managers (cont’d) Only one could not offer a definition of evidence-based practice Four talked about increased knowledge of outcomes for children and young people in care as a result of examining research-informed practice interventions
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Senior Managers (cont’d) One Senior Manager talked about the integration of theory with research and practice, forming a “feedback loop” Three felt the terminology “evidence- based practice” to be increasingly commonplace in social work literature and practice
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Team Leaders Only one of nine reported using research knowledge in day-to-day practice Two said evidence-based practice was a term that they had never heard of before No Team Leaders were able to give a theoretical definition of evidence-based practice
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Team Leaders (cont.) Three said research is important to increase knowledge of outcomes for children and young people in care Two said research is useful as a means of providing feedback and increasing accountability to clients
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General Findings Senior Managers had a better understanding of terminology and made links between research and practice Both groups found difficulty in conceptualising a link between care outcomes and guidance for practice
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Evidence-Based Practice, LAC and Out-of-Home Care Both Senior Managers and Team Leaders spoke of the benefits of evidence-based practice in bringing consistency of approach to collection of information when children and young people enter care
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Senior Managers were more likely than Team Leaders to be open to implementation of evidence-based systems such as LAC
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Expressed Reservations About the Use of Evidence-Based Practice Restriction on professional autonomy Reduction of worker independence Impediment to practice creativity
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Political and bureaucratic “hidden agendas” - fear of reduction of resources, and avoidance by governments of fiscal responsibility for children and young people in care Expressed Reservations About the Use of Evidence-Based Practice cont’d
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CHILD PROTECTION Messages from Research (the “ blue book”) UK Department of Health, HMSO, 1995
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Overview of 20 research studies brought together findings & themes from a range of reports and worked them into strong clear messages aimed to get professionals to evaluate their own practice and attitudes, not just to increase their knowledge
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High profile ministerial launch Extensive circulation of free copies Series of regional day conferences High profile at national events
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Improving the Spread of “Evidence” (Weyts, Morpeth, Bullock in Child and Family Social Work, Vol 5, Issue 3, August 2000) Publicity Training Guidance on implementation of the findings
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Guided Practice Practice tools that assist professionals to deliver evidence- based services and provide effective case work and case management
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“ To be successful such tools should also have the capacity to convey ideas as well as information and in doing so should reinvigorate the original research.” (Weyts, Morpeth and Bullock, 2000)
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Evidence-Based Practice is Guided Practice? Closely related concepts but not interchangeable terms
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Evidence-Based Practice is Guided Practice? Evidence-based practice: Practice shaped and informed by research
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Evidence-Based Practice is Guided Practice? Guided practice: Prescribed tasks and recommended processes contained within a practice framework
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The Looking After Children (LAC) a case management system that is evidence-based, guided practice
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Evidence-Based Practice in out-of-home care Grounded in good knowledge about: The needs of children and families The latest research findings about what works for which groups of children, when, and why
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Takes into account the known costs and benefits of interventions places evidence in a wider context of related concerns eg legal, community, consumer provides a common conceptual framework into which new ideas, new research and new projects can be fitted Evidence-Based Practice in out-of-home care
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LAC - Guiding the Journey Through Care
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