LOCI CORE PRINCIPLES

Evidence ALIGNMENT COMMUNICATION FEEDBACK sUSTAINED CHANGE ADAPTIVE & fLEXIBLE

 Evidence: Evidence is at the core of LOCI. Its purpose is to improve the implementation of evidence-based practices (EBPs) so that clients receive optimal care and have the greatest chance for success. Just as clinical and health practices should be evidence-based, implementation strategies should also be evidence-based. LOCI was designed with the best research evidence in mind to ensure that leaders and organizations have the tools that give them the highest likelihood of success. Our research program is continually and rigorously testing, adapting, and improving LOCI while developing evidence of effectiveness. Consistent with this approach, a core component of LOCI is using data to provide feedback and guide the implementation process so that leaders can develop evidence-based individual development plans to improve their effectiveness. Data is also used to develop and guide upper and middle management organizational strategies to support leaders in their implementation efforts and move the whole organization to more effective EBP implementation and sustainment.

Alignment: Implementation will be most successful when there is consistency across the organization in what is communicated and valued. Thus, leaders across various programs, clinics, or departments in the organization as well as leaders across levels in the organization (from the bottom to the top) need to be aligned in their support for implementation. In a similar way, the policies, practices, procedures, and reward systems in the organization need to also be aligned in support of implementation efforts. When there is not alignment, front-line workers receive mixed messages about what is valued, and a strong climate for EBP implementation will be unlikely to result. As a result, clients won’t get the high quality care they need.

Communication: Communication is critical during implementation. Although leaders often believe that they communicate the importance of EBPs and effective implementation, these communications can go unnoticed or be undervalued by workers as they address the competing demands of their day-to-day work. Therefore, in order to demonstrate that EBP implementation is a top priority in the organization, leaders must consistently communicate their support for implementation multiple times and in multiple ways.  

Feedback: LOCI is based on creating a psychologically safe environment in which feedback is sought out and used to develop plans for improvement. In order for the implementation process to be effective, workers need developmental feedback on how they are doing and where they can improve. If they feel as though that feedback is being used in an evaluative way, they will become defensive and more resistant to change. In the same way, leaders need feedback about how they are perceived by others to gauge their effectiveness and formulate strategies for how they can improve their leadership.

Sustained Change: LOCI is not about silver bullets or quick fixes. It is a process designed to get long-term results. Organizational change, leadership development, and effective implementation all take time to get right and ensure they are sustained. Through an iterative process of training, coaching, and assessments over the course of a year, LOCI is intended to keep leadership development and alignment top priorities in the organization in order to deeply embed a climate for EBP implementation to maximize the chance for lasting change and a long-term return on investment. 

Adaptive & Flexible: LOCI recognizes that service systems, organizations, clinical staff, and patient populations vary.  The LOCI team works closely with system leaders, agency leaders, and first-level leaders to apply LOCI principles in a way that will be most effective in their settings. The LOCI team works with service systems and organizations to identify options for developing system- and agency-wide implementation climate and for supporting first-level leaders and clinical staff. Some strategies are generalizable across systems, organizations, and leadership levels. There are also unique features and processes that emerge as targets for change identified through ongoing collaboration between the LOCI team and the systems, organizations, and leaders involved in implementation. LOCI is flexible in developing locally relevant strategies for improvement.