Compliance versus Learning Culture

The Brits have been hard at work reviewing and reforming their child welfare system. The Munro Report, an independent report requested by the government, calls for a move from a culture focused on CYA and paperwork to a learning culture that preferences expertise.  The Munro report doesn't  reference it, but icanstockphoto9362982t invokes for me the Just Culture movement, the notion that workplaces can value open communication within a system of accountability that supports safe behavioral choices among staff. Here is a nice slide show applying Just Culture to medicine. How just is your social service workplace?

 

 

Evidence-Based Baseball and the Social Service Enterprise

hanging out shoesMajor League Baseball emailed me this week to let me know that my renewal subscription to mlb.com is ready, so I can watch up to 200 spring training games and 2340 regular season games. It is typical that they told me about the upcoming season in numbers. Baseball may be art. It may be sport. But baseball is also statistics. Before Nate Silver started forcasting U.S. elections, he was a bonafide baseball statistician.

Baseball managers manage by statistics. Should I pinch hit for lefthanded hitter Skip Schumaker late in the game against a left handed pitcher? Let's look at the evidence. What are his batting statistics against left handers? Against this pitcher? With runners in scoring position?

Continue reading

Abusive residential programs

sipriano-89Two stories from the past, but in the news this week, resonate with implications for today's services for troubled youth. The first was the NPR story of the laundries run by the Catholic church to which thousands of young Irish girls were sent for minor transgressions. The second piece, in the New York Times today, about the suspected deaths from years of abuse at the Arthur G. Dozier School for Boys in Florida, reminds us that this is not just a story about the unquestioned authority of the Catholic Church in Ireland. It is a story about a lack of oversight, a lack of checks and balances, and thousands of employees and consumers who somehow never managed to get the truth out during the time when it could have mattered most.

Continue reading

Novel models for dissemination and implementation

Alan Kazdin

Alan Kazdin

In an article pre-published online, prolific Yale child psychologist Alan Kazdin and colleague Sarah Rabbitt detail what they call five novel models for delivering mental health care that move beyond a highly trained mental health clinician sitting in an office with an individual client. This post lists the five models and discusses two for application in the social services.

Continue reading

Sixty-three years behind the times

Only three stops on a trip to LAX! Sign me up.

Only three stops on a trip to LAX! Sign me up.

Here is a great quote about the state of substance abuse treatment in America, lifted from a new book, Inside Rehab, by Anne Fletcher and broadcast in this post by NY Times health writer Jane Brodey. Despite substantial gains in learning what works in substance abuse treatment, most programs "use exactly the same kind of treatment you would have received in 1950," according to A. Thomas McLellan, co-founder of the Treatment Research Institute in Philadelphia.

Ready to board your flight to LA in a 1950 Douglas DC-3?

Continue reading

Start a Blog, They Said

At the 2013 Society for Social Work and Research meeting in San Diego, Tina Rzepnicki and Curtis McMillen hosted a dinner of social work academics and leaders to discuss what to do, in the most general terms, about social service quality.

We bemoaned the lack of an outcry for quality in the social services, like there was for other industries, like healthcare or nuclear power. People, we knew, we injured by poor social services and saved by terrific social services.

Where should we start, this group asked, to spark a quality revolution in the social services? How do we generate notice, propose solutions, point people toward resources? How do we build a cadre of social service professionals who work to measure quality, monitor quality, improve quality? How do we leverage advances in evidence-based practice, evidence-based management, quality science and implementation science?

Of all the ideas generated, one was easiest to accomplish. Start a website.

So here it is, just two weeks later, a website,  its eyes not yet fully open, and its promise not yet sullied by complexity and competing interests. But look at those claws.kitten canstockphoto4976675

This kitty ain't backing down.