Make a Plan for Implementation

Make a Plan for Implementation

Detailed plans are important to the success and careful implementation of a program. Without them, details can fall through the cracks, reducing the effectiveness of your work. The time you spend on creating a clear plan saves time and resources later while also increasing your chances of achieving outcomes. You can also use a detailed plan once you start implementing the program to help you monitor what's working or not working well so that adjustments can be made to improve your program's functions.

Overview of planning

Step 6 will help you finalize the selection of a home visiting program and show you how to create a detailed plan for it. Your plan will bring together all the decisions you've made in the first five steps and help get your team ready for implementing, monitoring, and evaluating the program you selected. This step helps you decide who does what and by when, so that no details are forgotten. When you finish the tasks outlined in this step, you'll be ready to begin program implementation.

The tasks in this step will help you:

  • consider and plan appropriate program adaptations
  • finalize your program selection
  • develop a work plan to implement your selected program, including breaking down the program into smaller components and activities
  • consider and select participant recruitment strategies
  • complete a program budget
  • confirm that have you done all you can to make sure your program is culturally appropriate.

Note that you may have decided that a different program or strategy other than home visiting is right for your community. If so, then you can still use this step to plan how you will implement that program.

Finalize your program selection

If you haven't already identified the program you want to implement, now is the time to finalize your selection before moving ahead. If you are still not ready to finalize a choice, or have other programs yet to consider, then you need to revisit Steps 3, 4, and 5 and work through the tasks again. In both cases, you may need to do some additional exploration to find other potential programs.

Maybe you decided that home visiting wasn't the right strategy for you, and you decided on a different evidence-based program, or perhaps you decided to work on developing your community's system of care. In either case, you can still move forward with the rest of this chapter.

Finalize adaptations

If you've selected an evidence-based program, do the following:

  • Document the adaptations you plan to make. As discussed in Step 4 on fit, your goal here should be to make only those green-light adaptations that are really necessary to improve the fit of the program to your participants and community context.
  • Remember—If you believe you need to make yellow-light adaptations, you should talk first with the program developer or someone with expertise in curriculum development, evidence-based program implementation, and health education theory, such as a university professor. Do not make red-light adaptations to an evidence-based program.
  • Be sure that you have checked these planned adaptations against what the national program model office will allow. Many program models restrict the types of adaptations that can be made.
  • When you are done with these tasks, you are ready to go on to the next section, Develop the program implementation plan.

Tip 6-1. Budgeting for Your Home Visiting Program

An important part of program implementation is a well thought-out budget. Many home visiting programs will have their own guidance and support for budgeting, so look at your narrowed list of programs and go to your program model representative first for guidance.

If the program model that you are considering doesn't have specific budgeting guidance, a good place to start is the University of Kansas's "Community Toolbox" chapter on developing and managing a budget: http://ctb.ku.edu/en/tablecontents/section_1303.aspx.

Develop the program implementation plan

If you have settled on a home visiting program that has a national office, discuss your decision with a representative from that office. He or she may be able to help you in the process of implementation planning, and may have additional implementation resources that can complement what is included in this and subsequent steps. Obtain all available program materials and review the curriculum and related materials closely. Make a detailed list of all the activities that will be included in your chosen program. You will probably be able to integrate any technical assistance that comes from the program office as you complete Step 6.

Tool 6-1. Program Implementation Plan

We've provided the Program Implementation Plan Tool to help you through this process. Implementing a home visiting program requires a lot of preparation, including developing a budget, securing space, having necessary policies and procedures in place, hiring qualified staff, ensuring training and data management systems are in place, and recruiting families. Creating a work plan now can help you cover all your bases and ensure that you are ready to implement the program well. Good program implementation is needed to help reach the desired program outcomes. The details of a work plan include:

  • a description of all types of activities needed to effectively prepare for implementation, such as administration, policies and procedures, facilitation, location and materials, recruitment and retention, staff training, data management, and implementation
  • a timeline for when activities will be done
  • an assignment of a person or group that is responsible for each activity
  • identification of what resources are needed and where they will come from.

Remember—Be sure to have your collaboration partners be responsible for some activities. Describe the roles each will play in the implementation of your program. This could include such things as a local organization coordinating shared staff training or a partner involved with identifying families in need and making referrals to your program.

The Program Implementation Plan Tool will help you create a plan for implementation. This tool is actually a group of five worksheets that will help you think through different elements of the implementation process. You may want to do rough drafts of the plan as you gather the needed information, then prepare a final draft to distribute to everyone involved when you are done. This work plan should be considered a living document that your team updates as you identify new tasks. A copy of the plan should be easily accessible by program staff so they can review it often to ensure they are on track.

As you work through this tool, consider setting more limited and achievable goals at the outset in order to set yourself up for success. Then, if you find that there is sufficient capacity, you might expand the reach of your goals in later years. Think of this as "stepped" implementation planning.

Instructions for Using the Program Implementation Tool:

  1. Gather together all of the material you've developed in previous GTO steps. This includes all of the completed tools as well as the adaptation guide, and all of the information that you have collected on programs.
  2. Fill in the basic program information at the top of the form.
  3. GTO-HV suggests that programs be broken down into components, because it is simpler to plan component by component than plan a large complicated home visiting program that has many different elements all going on at the same time.

Identify program components and list them on the first worksheet, "Identifying Program Components." A program component is a major element of a program. Your chosen program might just have one component, or it could have many components. Examples of program components include:

  • Hospital screenings
  • Parenting classes
  • Home visits
  • Well-child check-ups
  • Community meetings
  • A public education campaign
  • Recruitment activities
  • Staff training and supervision
  • Program activity documentation.
  1. Fill in your identified program components on each of the subsequent worksheets. You will plan for each of these components separately to make sure that you do not miss anything.
  2. Each relevant worksheet has its own set of instructions included in the Program Implementation Plan Tool; first you should read through them all, and then fill them out one by one.

Worksheet 1: Identifying Program Components

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Fill in each of the program components in the left-most column. Now try to link each of those program components to your desired outcomes (completed in GTO Step 2, Goals and Desired Outcomes Tool). The worksheet has room for up to three components; you may identify fewer or more components that you want to consider here. Please feel free to modify all of the worksheets so they work for you.

Worksheet 2: Planning Each Program Component

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Now that you have identified each of your program components, each one needs to be planned. Here you need to think about all the activities that need to be completed to make each component successful. Each component is made of one or several activities.

This worksheet is where you plan in detail the activities that make up your program's components. Some activities could include:

  • Recruitment of participants. How will you "enroll" participants into your program? Will you post flyers to advertise the program, collaborate with other agencies such as CPS, WIC, or health care clinics, or access the participants of your own agency?
  • Staff training. If staff are unfamiliar with the program, one of the first key activities would be staff training for conducting the program.
  • Other activities. In addition, there are many programming activities to be considered (e.g., planning meetings, transportation issues, providing food).

For every activity above and all of the others that you identify, consider the important planning elements:

  • Scheduled dates. When will the activities occur? By deciding on the approximate dates for the completion of each activity, a timeline will emerge. Use these dates to assess whether your program is being implemented in a timely fashion.
  • Who will be responsible? Before implementing a program, decide which staff will be responsible for each activity. Will the responsible individuals come from the existing staff? Will new staff or an outside agency be hired?
  • Resources needed. Consider what resources are needed for each activity. This may be financial resources as well as specific supplies such as food, markers, or paper. Do they need to be purchased with grant funds? Will they be donated by local businesses? Are the specific amounts in the initial budget request still correct? If not, what changes are needed?
  • Location. Determine where to hold the various activities. Will you hold your program in a boardroom? In a gymnasium? In a church? Certain locations will require significant lead time to reserve, and the space available may determine the type of program that can be conducted.

The tool has room for up to three components; you may identify fewer or more components that you want to consider here.

Worksheet 3: Recruiting Target Groups

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This worksheet will help you to identify how recruitment will be carried out for those program components that require recruitment of participants.

Input the program's target population (i.e., the populations that you will be recruiting) into the "target group(s)" column. Different components may have different target groups. For example, a home visiting program may include public education in addition to home visits for teenage mothers. In that case, the public education target group would be the general public, while the target group for the home visits would be teenage mothers.

In the second column of the worksheet, identify the number of individuals that you expect to serve in each target group. In the example in the previous paragraph, you might expect that a public education campaign would serve all adults in the community, whereas the number of teenage mothers you anticipate serving would be much lower.

In the final column of the worksheet, enter your recruitment plan. Program materials may specify the recruitment plan that you should use, or you might need to come up with a recruitment strategy on your own. The recruitment plan should specify who is responsible, when and where the recruiting will take place, and how it will be done.

The tool has room for up to three components; you may identify fewer or more components that you want to consider here. Please feel free to modify the tool so that it works best for you.

Worksheet 4: Identifying Collaboration Partners

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In this worksheet, you identify the collaborative partners and the roles each partner will play in the implementation of your program. Collaboration, including the development of partnerships in your community, is an integral part of delivering an effective home visiting program. Effective programs enhance the efficiency and effectiveness of their own efforts by developing partnerships with other agencies. Such efforts promote the sharing of ideas, resources, and even staff members.

Who are the collaboration partners for your program or strategy, and what are their intended roles? Enter that information here. Feel free to add as many rows as necessary to complete this table.

Worksheet 5: Implementation Barriers

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Home visiting programs can be difficult to implement and often face many challenges. It is helpful to forecast what these challenges or barriers might be and generate possible solutions for them. Below is a worksheet for you to use in considering what the barriers to your program might be and to generate solutions to those barriers. You may not know the solutions now, but you will be able to come back to this page and update it at any time in the future.

Feel free to add as many rows as necessary to complete this worksheet.

Townville Example 6-1. Townville's Program Implementation Plan

The Townville community coalition is excited to begin implementing the XYZ program. In this section, we show you how Townville filled out several of the worksheets in the Program Implementation Plan Tool. For more information on this tool, including directions for how your community coalition might fill it out, take a look at the tool itself.

First, Townville identified each of the major components of the XYX program. They identified two main components of the program, which they inputted into the Program Implementation Tool. The next step was to link the components to the desired outcomes that Townville specified in Step 2 to the components of the programs. Home visits were really the place where parenting practices were addressed, and this was why Townville decided that the home visiting component was related to both of their desired outcomes. Well-child visits were included as a second component. Even though the XYZ program only refers families out to well-child visits, it will be useful to think through those processes during planning. Reflective supervision is a critical element of the XYZ program, and since it was connected to improving the quality of home visits, it was decided that this element was also related to both desired outcomes.

Townville's Program Implementation Plan Worksheet #1. Program Components for XYZ Program

Program component

Which desired outcomes are linked to each component?

If using a model program, will it be implemented as intended? If not, what is the adaptation plan?

Home visits

Reduced child maltreatment

Reduced hospitalization for unintentional injuries

None, implementing as intended

Well-child visits

Reduced hospitalization for unintentional injuries

None, implementing as intended

Reflective supervision for home visitors

Reduced child maltreatment

Reduced hospitalization for unintentional injuries

None, implementing as intended

Next, Townville specified all of the key activities for each of the components, and began to identify a timeline, assign responsibilities, and identify materials needed. This was a helpful task: The coalition realized that they would have to hire a programmer to get a database in place. They also realized that they would need to begin identifying partnering health clinics that would accept program referrals for well-child visits.

Townville's Program Implementation Plan Worksheet #2. Planning Program Components

Program component

Specify key activities and their details

Scheduled dates

Who is responsible?

Infrastructure/ resources needed; materials to be provided

Location

Component 1: Home visits

Prepare database and data entry interface

June–July

Lead agency

Hire programmer (external consultant)

Database software

Computer for programmer

Lead agency

Hire

-home visitors

-data manager

-supervisors

June, July

Lead agency HR department

Job announcement

Cubicles for supervisors at lead agency offices

Lead agency

Training

-home visitors

-recruiting staff at hospitals

-lead agency administrative staff

- supervisors

August 1–10

Lead agency, expert trainers, XYZ program model contact

Location

Food

Training materials

Money for expert trainers

Conference center

Recruitment of participants

Ongoing, starting in September

Staff, hospital, partners

Flyers

Recruitment materials

Telephone line for participant opt-in

Hospitals

Child Protective Services

In-home visits

Ongoing, starting in September

Home visitors

Tablets for home visitors

Cars/driving allowance for home visitors

Curriculum materials

Homes

Data collection

Ongoing, starting in September

Home visitors

Purchase tablets for home visitors

Money for tablets

Staffed data manager

Lead agency

Component 2: Well-child visits

Identify participating providers

June

Collaborating health clinics already in the coalition

Lead agency staff will deliver materials

Materials to distribute to participating providers

On-site with potential health clinic partners

Referrals to well-child visits

Ongoing, starting in September

Home visitors

List of participating providers for home visitors

In homes

Component 3: Reflective
supervision for home visitors

Develop supervision protocols

June

Lead agency

Supervision protocol

Home visitor feedback forms

Lead agency

Implement reflective supervision

Ongoing, starting in September

Supervisors

Data system to track feedback

Lead agency, homes

Next, Townville needed to think through recruitment for each component. First, they identified the target group for the program, then they estimated the number that they would serve in the first year. Then, they had to think through a recruitment plan, specifying the "who, what, when, where, and how" of recruitment. This section didn't apply to the reflective supervision component, as it was required of all home visitors.

Townville's Program Implementation Plan Worksheet #3. Planning Recruitment for XYZ Program

Program component

Target group(s)

Anticipated number in target group

Recruitment plan

Component 1:
Home visits

Low-income families with children under the age of 5

50

Hospital partners will identify new parents on Medicaid and inform them about the free program, starting in September.

Child Protective Services (CPS) will identify families with children under the age of 5 that are identified as at-risk for maltreatment, provide them with information about the program

Families will opt-in on a free telephone line

Component 2:
Well-child visits

Families receiving home visits who have missed a well-child visit

25

Home visitors will identify families in need of a referral

Home visitors will then:

Identify closest clinic for family, discuss strategies to ensure families can access services (transportation, clinic hours)

Call clinic with family to schedule first appointment.

Provide family with reminder card with date and time of the clinic appointment.

Check up on family following clinic appointment to see if they received services.

Component 3: Reflective supervision for home visitors

Home visitors

All home visitors

N/A

The Townville community coalition then went on to fill in the additional worksheets in the Program Implementation Plan Tool. Due to the sheer number of tools, examples of each have not been included here. Instead, below we discuss how Townville thought about each of the worksheets provided. These included:

  • Identifying collaboration partners. Townville most critically needed to partner with hospitals to help support recruitment, as well as health clinics to accept referrals for well-child visits. Additionally, Townville identified CPS as a potential partner.
  • Identifying implementation barriers. The most significant implementation barrier that the Townville community coalition identified was successfully recruiting parents into this voluntary program. The community coalition hosted a set of focus groups with parents in the community to determine how best to market the program to potential participants.

Checklist 6-1. Completion of Step 6

When you finish working on this step, you should have done the following:

  • Finalized your program selection.
  • onsidered and planned appropriate program adaptations.
  • Identified program components and activities.
  • Considered and selected participant recruitment strategies.
  • Completed a program budget.
  • Developed a work plan for implementing your program.

Before moving on to Step 7

You've now brought all of the GTO tasks you've finished up to this point into a solid work plan. Before launching your program, we recommend you take some time to review the tasks in Step 7 (Process Evaluation) and Step 8 (Outcome Evaluation) before implementation. Doing so will help you identify the process and outcome measures you need to obtain or develop before you launch your program and which ones you need to monitor while the program is running.