The less "unwitting" way to get results

"All organizations (and systems) are designed, intentionally or unwittingly, to achieve precisely the results they get."

It may be short on pith, but this quote, attributed to R. Spencer Darling, founder of The Leadership Institute Inc of Chicago, is a popular choice among implementation research PowerPoint presenters.

It's all down to the sighing double-entendre of that "unwittingly". Not as good as, "In a democracy we get the government we deserve" but on the same pointedly ambiguous lines.

Karen Blase and Dean Fixsen from the US National Implementation Research Network [1] (NIRN) turned to Darling to introduce their argument about the prerequisites of paradigm shift and systems change in a paper for the Society for Research in Child Development [2] (SRCD).

"More rigorous research on the 'what' (the intervention) will not tell us 'how' to implement with fidelity nor how to secure good outcomes over time, and across practitioners in complex settings," they wrote. "Choosing well will not help the community implement well."

That the implementers of evidence-based practice, wherever in society they are located, need partners and expert "purveyors" to make it happen is a key NIRN precept. Elsewhere Fixsen and Blase draw on a conversation between broadcaster and former White House press secretary, Bill Moyers, and the civil rights and peace activist The Rev. William Sloane Coffin [3].

"You can say, with prophet Amos, let justice roll down like mighty waters," Coffin said, "but figuring out the irrigation system is complicated."

The point Coffin sought to make was essentially about the necessary practical mechanics associated with social justice — the virtuous social engineering at the the heart of socialism.

In the context of Fixsen and Blase's argument about the urgencies of evidence-based practice, the quotes support the case in favor of what implementers have come to call "operating systems".

On the one hand, Blase and Fixsen wrote in their SRCD commentary, communities, agencies and funders needed to be disabused of the false notion that if they chose evidence-based programs and practices no-one would have to fund process or outcome evaluation — they would just sit back and watch those mighty waters flow.

On the other hand, they pointed out: "While scholars may contribute to understanding these emerging entities and functions, it is not likely that they will participate in directly providing such implementation services and expertise."

The "purveyors" of evidence-based practice, meanwhile, who are convinced of the need for irrigation systems and for building bridges between communities and academies prefer to borrow their own professional language from computing.

So their "operating systems" are akin to Microsoft Windows of MacOS which provide the foundation for software "solutions"; prevention programs by that reckoning are analogous to Word or Excel.

A robust operating system, therefore, will ensure that practitioners consistently follow a logical path when identifying community concerns and putting in place programs to reduce or prevent problems, or – more optimistically – to encourage social development.

Other benign fragments of PC language also have a place in the rationale: frequently asked questions, manuals, updates, technical support, for example.

A number of 'operating systems' are on the stocks in the US and UK. Communities that Care [4] is notable for having introduced the idea of "community coalitions" to the process. Coalitions take responsibility for gathering local epidemiological data and selecting effective strategies for dealing with the needs they identify. They often include full-time coordinators who manage training workshops and provide technical assistance to community practitioners.

Shared between Iowa State and Penn State universities, PROSPER [5], (Promoting School-Community-University Partnerships to Enhance Resilience) is another collaborative approach links research scientists with community teams from state land-grant funded Universities. Like CtC, PROSPER has successfully undergone experimental trials.

Other system-wide approaches include Common Language, a model designed by the Social Research Unit in Dartington UK to improve outcomes for all children, Getting To Outcomes which helps communities develop or improve substance-use prevention programs for children and adults, and Results Based Accountability, a management tool designed to help communities work together to improve "results".

• For more information about all of these strategies and the thinking behind them, visit the Let justice roll down like might waters! [6] special issues page and follow the story links.