1. Scottish Learning Festival The Early Years Collaborative and the Model for Improvement 24 th September 2014

2. The earliest years of child’s life represent the single greatest chance to make a lasting impact on a child’s future

3. 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

4. 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

5. Let’s provide a strong foundation for future learning, behaviour and health

6. 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

8. How?

9. 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

10. 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

11. Key Changes The Big Ticket Items for Scotland Informed by Early Years Collaborative testing across Scotland and experts in early years

12. 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)

13. 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

14. Marshmallow Challenge The

15. + +

16. 18 minutes

17. Rules 1.It must be a free STANDING structure 2.You cannot be touching or holding on to the structure after 18 minutes 3.Use as much or as little of the kit as you want 4.The entire marshmallow must be on top. Do not eat the marshmallow or cut it into pieces. 5.No phones allowed – no YouTube!

18. Marshmallow Challenge The

19. Typical Progress Start 18 minutes

20. Typical Progress Start 18 minutes Orient

21. Typical Progress Start 18 minutes OrientPlan

22. Typical Progress Start 18 minutes OrientPlanBuild

23. Typical Progress Start 18 minutes OrientPlanBuildTa-Da!

24. Typical Progress Start 18 minutes OrientPlanBuild Oh-No!

25. Poor Performance? What type of team consistently shows

26. Recent Graduates of Business School

27. Great Performance? What type of team consistently shows

28. Nursery children!

29. Why? FailWin

30. Start 18 minutes

31. Start 18 minutes Find the best plan & execute Focus on the structure Focus on the marshmallow Play, prototype, experiment

32. DESIGN APPROVE Conference Room Real World The Typical Approach… IMPLEMENT

33. DESIGN TEST & MODIFY APPROVE IF NECESSARY Conference Room Real World TEST & MODIFY The Quality Improvement Approach START TO IMPLEMENT

34. Tests of Change? https://www.youtube.com/watch?v=w0ffwDYo00Q

35. Special Thanks: We are grateful to Tom Wujec for making his original Marshmallow Challenge materials available to the world! Learn more at: marshmallowchallenge.com

36. What do you want to improve for the children and families you work with? The Model for Improvement

37. The Model for Improvement A tool to achieve positive outcomes for children and families in Scotland

38. Why change?

39. The First Law of Improvement “Every system is perfectly designed to achieve exactly the results it gets.” Dr Paul Bataldan

40. The Primary Drivers of Improvement Will

41. The Primary Drivers of Improvement Ideas

42. The Primary Drivers of Improvement Will IdeasImplementation 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

43. The Primary Drivers of Improvement Implementation?

44. ‘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. Berwick Administrator of the Centres for Medicare & Medicaid Services Professor of Paediatrics and Health Care Policy at the Harvard Medical School The Model for Improvement

45. The Improvement Guide, 1996 The Thinking Part The Doing Part

47. Developing an Aim Statement What are we trying to accomplish?

48. Setting the Aim Ambitious, unachievable by hard work alone

49. Setting the Aim Measurable …..without measurement you will never know if a change is an improvement

50. Setting the Aim Time specific ….. ensures focus

51. Setting the Aim Specific Define the group you are focusing improvement efforts on

52. Setting aims: Characteristics What? Measurable (How good?) Time specific (By when?) Define target group (Who?)

53. 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

54. Got your aim? Check!

56. 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

57. Improvement? Judgment? Research? Why are you collecting data?

58. Aggregated Data Tells us very little about the improvement journey

61. Median = 9

62. 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

63. % 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

64. Got your measures? Check! How will you know your change is an improvement?

66. What are your change ideas? What do you think will make a difference? What changes can we make that will result in improvement?

67. 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. 68 A practical need often drives creativity!

69. 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

70. What now?

72. Tests of Change

73. 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

74. 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? ”

75. Start small! 1 family 1 child 1 class 1 teacher

76. Three options after each test Abandon (glad did small!) Adopt (as tested) Adapt (& test further) Study Act Plan Do

77. Changes that will result in improvement Evidence, ideas, theories, hunches, intuition, Build confidence through testing

78. Think Big Start Small Scale Fast

80. This is new, so be brave!

81. @EYCollaborative #bestplacetogrowup EYCollaborative@scotland.gsi.gov.uk www.scotland.gov.uk/earlyyears