Change – Page 7 – Integration and Implementation Insights

Four best practices for scaling up effective innovations

November 20, 2025August 8, 2017

By Amanda Fixsen, Karen Blase and Dean Fixsen

authors_amanda-fixsen_karen-blase_dean-fixsen — 1. Amanda Fixsen (biography)
2. Karen Blase (biography)
3. Dean Fixsen (biography)

What is involved in effective scaling up of innovations in order to achieve social impact? Here are four best practices, drawn from our experience in scaling up human services innovations and programs for children and families. We also provide definitions of the key terms used.

1. Understand the target audiences

Effectively scaling innovations first requires attention to defining the denominator, or population of interest for the scale-up effort, as well as the numerator, or the number of children and families who are receiving the innovation with fidelity and good outcomes.

2. Purposeful design leads to high-fidelity use

Toolkits for transdisciplinary research

March 21, 2024July 25, 2017

By Gabriele Bammer

If you want to undertake transdisciplinary research, where can you find relevant concepts and methods? Are there compilations or toolkits that are helpful?

I’ve identified eight relevant toolkits, which are described briefly below and in more detail in the journal GAIA’s Toolkits for Transdisciplinarity series.

One toolkit provides concepts and methods relevant to the full range of transdisciplinary research, while the others cover four key aspects: (i) collaboration, (ii) synthesis of knowledge from relevant disciplines and stakeholders, (iii) thinking systemically, and (iv) making change happen.

Bringing the Immunity-to-Change™ process to the scientific community

February 11, 2025July 4, 2017

By Erica Lawlor and Cheryl Vaughan

authors_erica -lawlor_cheryl-vaughan — 1. Erica Lawlor (biography)
2. Cheryl Vaughan (biography)

How can scientists whose careers were formed in an incentive system that cultivates competitive and territorial behaviors be helped to meet the expectations of collaborative research frameworks? A team-based approach that transcends disciplinary boundaries may be a tall order for scientists who “grew up” in a system where funding and promotion are based upon a proven record of individual contributions to a field of research. But that is the direction in which much of science is heading.

Scaling up amidst complexity

October 9, 2025June 27, 2017

By Ann Larson

How can new or under-utilized healthcare practices be expanded and institutionalized to achieve audacious and diverse global health outcomes, ranging from eliminating polio to reversing the rise in non-communicable diseases? How can complex adaptive systems with diverse components and actors interacting in multiple ways with each other and the external environment best be dealt with? What makes for an effective scale-up effort?

Four in-depth case studies of scale-up efforts were used to explore if there were different pathways to positively change a complex adaptive system.

Keys to transformation: Interactions of values, rules and knowledge

February 10, 2025June 20, 2017

By Russell Gorddard, Matthew Colloff, Russell Wise and Michael Dunlop

gorddard_colloff_wise_dunlop — 1. Russell Gorddard (biography)
2. Matthew Colloff (biography)
3. Russell Wise (biography)
4. Michael Dunlop (biography)

Adapting to climate change can require profound alterations in environmental management and policy. However the social context of a decision process limits options and resists change, often dooming attempts to adapt to climate change even before they begin. How can decision makers in policy and management more effectively see the institutional and social water they swim in, in order to better drive change?

Values, rules and knowledge (vrk) provide a useful heuristic to help decision makers analyze how the social system shapes their decision context. Put simply, decisions require:

knowledge of options and their implications
values to assess the options
rules that enable implementation.

A primer on policy entrepreneurs

November 20, 2025April 18, 2017

By Jo Luetjens

In the world of public policy, it is interesting to consider how and why particular policy ideas catch on. What is it that makes some ideas succeed and others fail? By examining the role of policy entrepreneurs we may come closer to an answer. In making policy change happen, what – and who – are policy entrepreneurs? Why are they important? What strategies do they use to effect change? And finally, what are the attributes of a successful policy entrepreneur?

The what

Policy entrepreneurs are energetic people who work with others in and around policymaking venues to promote significant policy change.

Three theories to help overcome change resistance in service design implementation

May 12, 2021March 23, 2017

By Ricardo Martins

How can service designers improve implementation of their projects and overcome resistance to change?

According to the Service Design Network, “Service design is the activity of planning and organizing people, infrastructure, communication and material components of a service to improve its quality and the interaction between the service provider and its customers. The purpose of service design methodologies is to design according to the needs of customers or participants, so that the service is user-friendly, competitive and relevant.”

Although service designers have hundreds of methods to map the current state of a service, to elicit requirements from stakeholders and to propose new processes for services, they often spend little effort on implementing the ideas they generate.

Successful implementation demands a great liaison person: Nine tips on making it work

September 11, 2024March 21, 2017

By Abby Haynes on behalf of CIPHER (Centre for Informing Policy in Health with Evidence from Research)

cipher-group — CIPHER Sub-group (Participants)

When external providers deliver a complex program in an organisation, it is crucial that someone from that organisation—a liaison person—gives ‘insider’ advice and acts as a link between their organisation and the program providers. What are the characteristics to look for in filling that role? And how can liaison people best be supported?

Here we describe what we learnt about the pivotal role of liaison people during the implementation of SPIRIT (Supporting health with Research: an Intervention Trial). SPIRIT was a novel multi-component trial designed to increase individual and organisational capacity to use research in policymaking. Six Sydney-based health policy organisations took part – each nominating a member of their staff to coordinate the implementation of SPIRIT in their organisation. These liaison people turned out to be far more than administrators – they had a profound impact not only on how the program was implemented, but on perceptions, engagement and participation across their organisations.

We provide nine tips for identifying and supporting liaison people.

Overturning the design of outcome measures

December 2, 2022February 21, 2017

By Diana Rose

Outcome measures in research about treatment and service provision may not seem a particularly controversial or even exciting domain for citizen involvement. Although the research landscape is changing – partly as a result of engaging stakeholders in knowledge production and its effects – the design of outcome measures has been largely immune to these developments.

The standard way of constructing such measures – for evaluating treatment outcomes and services – has serious flaws and requires an alternative that grounds them firmly in the experiences and situations of the people whose views are being solicited.

Critical Back-Casting

August 24, 2022February 9, 2017

By Gerald Midgley

How can we design new services or strategies when the participation of marginalized stakeholders is vital to ethicality? How can we liberate people’s creativity so we can move from incremental improvements to more fundamental change?

To answer these questions, I have brought together insights from Russ Ackoff and Werner Ulrich to develop a new method that I call Critical Back-Casting.

Russ Ackoff, writing in the 1980s, is critical of organizations that focus on incremental improvements without ever asking whether they are doing the right thing in the first place. Thus, they are at risk of continually ‘improving’ the wrong thing, when they would be better off going for a more radical redesign. Ackoff makes two far-reaching prescriptions to tackle this problem.

Enabling co-creation: From learning cycles to aligning values, rules and knowledge

September 11, 2024January 19, 2017

By Lorrae van Kerkhoff

How do we improve? In the context of sustainable development, we continually confront the question of how we can develop meaningful and positive actions towards a ‘better’ world (social, ecological, economic outcomes) despite inherent uncertainties about what the future holds.

Co-creation is one concept among several that seek to reorientate us from simplistic, largely linear ideas of progress towards more nuanced, subtle ideas that highlight that there are many different aspects of ‘progress’, and these can be deeply contested and challenging to reconcile. Enabling co-creation, then – or operationalizing it – means finding practical ways to work together, to deal with our different experiences, aspirations and expectations as well as the uncertainties of the future.

Co-creation sits within a learning paradigm that suggests engagement, social and mutual learning, adaptation and flexibility are key to enabling action in the face of uncertainty. But how do we think about learning?

Improving health care services through Experience-based Co-design

September 11, 2024October 20, 2016

By Glenn Robert and Annette Boaz

authors_glenn-robert_annette-boaz — 1. Glenn Robert (biography)
2. Annette Boaz (biography)

There is lots of talk about the potential of co-creation as an approach to improving public services, but what does it actually look like (and do) in practice?

We describe one specific approach that has been used extensively for improving the quality of health care services: Experience-based Co-design.

Key Features and Stages

Experience-based Co-design draws on elements of participatory action research, user-centred design, learning theory and narrative-based approaches to change.

The key features of Experience-based Co-design are that it:

places patients at the heart of a quality improvement effort working alongside staff to improve services
maintains a focus on designing experiences (not just systems or processes).

It has six stages.

Stage 1 involves establishing the governance and project management arrangements.