What

1
Whats in a Name? What out-of-home care
managers think evidence-based practice really
means!

• Deirdre Cheers
• ACWA Conference - 2nd September 2002

2

• 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

3
Looking After Children (LAC)

• A case management system for children and young
  people in out-of-home care

• Developed in the early 1990s by UK Department of
  Health

• Based on extensive research into outcomes for
  children and young people in care

4
Out-of-Home Care Past and Present

• Changes in how care is provided

• Emerging trends

• Impact of research

5
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)
6
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.
7
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)

8
Research Aims

• Explore definitions of evidence-
• based practice
• Consider the influence of research
• Look at barriers to
• implementation of evidence-
• based systems

9
Two Associated Areas Explored

• Comparison of government and non-government
  agencies
• Similarities and differences between agencies on
  a state/territory basis

10
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

11
The Interviews Senior Managers (cont.)

• Knowledge of Looking After Children

• Decision making process in agency

• Individual reservations and agency barriers
• to the use of Looking After Children

12
The Interviews Team Leaders

• Additional questions about the use of LAC as a
  tool for supervision

13
Senior Managers

• Nine offered theoretical definitions of
• evidence-based practice

• Eight Senior Managers reported active and
  conscientious use of research to inform practice

14
Senior Managers (contd)

• Four talked about increased knowledge of outcomes
  for children and young people in care as a result
  of examining research-informed practice
  interventions

• Only one could not offer a definition of
  evidence-based practice

15
Senior Managers (contd)

• 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

16
Team Leaders

• No Team Leaders were able to give a
• theoretical definition of evidence-based
  practice

• Two said evidence-based practice was a term that
  they had never heard of before

• Only one of nine reported using research
  knowledge in day-to-day practice

17
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

18
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

19
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

20

• Senior Managers were more likely than Team
  Leaders to be open to implementation of
  evidence-based systems such as LAC

21
Expressed Reservations About the Use of
Evidence-Based Practice

• Restriction on professional autonomy
• Reduction of worker independence
• Impediment to practice creativity

22
Expressed Reservations About the Use of
Evidence-Based Practice contd

• Political and bureaucratic hidden agendas -
  fear of reduction of resources, and avoidance by
  governments of fiscal responsibility for children
  and young people in care

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CHILD PROTECTION Messages from Research (the
blue book) UK Department of Health, HMSO, 1995
24

• 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

25

• High profile ministerial launch
• Extensive circulation of free copies
• Series of regional day conferences
• High profile at national events

26
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

27
Guided Practice
Practice tools that assist professionals to
deliver evidence- based services and provide
effective case work and case management
28
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)
29
Evidence-Based Practice is Guided Practice?

• Closely related concepts
• but not interchangeable terms

30
Evidence-Based Practice is Guided Practice?

• Evidence-based practice

Practice shaped and informed by research
31
Evidence-Based Practice is Guided Practice?

• Guided practice

Prescribed tasks and recommended processes
contained within a practice framework
32

• The Looking After Children (LAC) a case
  management system that is evidence-based, guided
  practice

33
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

34
Evidence-Based Practice in out-of-home care

• 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

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LAC - Guiding the Journey Through Care