The Breakthrough Series Collaborative

The Breakthrough Series Collaborative is a methodology adapted from the health care field which originated with the Institute for Healthcare Improvement and the Associates in Process Improvement in 1995. A Breakthrough Series Collaborative model brings together organizations and agencies that share a commitment to a specific issue and to making small, rapid tests of change that can be expanded to produce breakthrough results. Each agency and organization puts together a team that will make changes and implement new systems over 12 to 18 months.

Casey Family Programs has been a champion of adapting this methodology in the child protection field and in sponsoring teams from around the country to focus on challenging issues in child protection practice. The teams test multiple ideas, strategies and tools on a very small scale in their target sites. They simultaneously share what they learn with other teams via the Internet, phone conferences and meetings. The most successful field-tested and measurable strategies and tools are then rapidly introduced throughout the teams’ jurisdictions or systems.

In 2000, Casey Family Programs sponsored its first breakthrough series in partnership with the Institute for Healthcare Improvement, on helping children in foster care with health care issues. In 2002, in collaboration with the Packard Foundation, Casey Family Programs conducted a breakthrough series on recruiting and retaining resource families. The third Breakthrough Series Collaborative, on supporting kinship care, was launched in 2004. In 2006, Casey Family Programs completed the fourth series, on reducing disproportionality and disparate outcomes for children and families of color in the child protection system, and initiated a series on improving educational continuity and school stability for children in out-of-home care. Learn more about Casey Family Programs.

In July 2007, Casey Family Programs formed a unique partnership with the American Humane Association to use this innovative quality improvement methodology to help 21 teams from across the country improve the assessments of safety and risk in the child protection system.

Change Package and Measures Documents

1. The Breakthrough Series Collaborative methodology has five key elements:
2. Teams composed of staff and consumers at a variety of levels from each participating jurisdiction
3. A “change package” to guide the work of the participating jurisdictions
4. Faculty who mentor and support the process
5. The model for improvement, to lend structure to and accelerate the pace at which changes are tested and made
6. A shared learning environment to ensure that successes and lessons learned are spread quickly

The American Humane Association and Casey Family Programs Breakthrough Series Collaborative on Safety and Risk Assessments change package consists of two downloadable documents:

• The change package identifies the core principles and components that describe an effective system of safety and risk assessments and decision making.
• Teams will use the measures to evaluate their improvement in the way they use safety and risk assessments and related decision making in their work with children, youth and families.

Leadership, Faculty, Consultants and Staff

The Breakthrough Series Collaborative leadership is a diverse group of experts with experience, knowledge and passion for their work. The collaborative is co-chaired by Zeinab Chahine, managing director, Strategic Consulting Services, Casey Family Programs, and Lewis “Harry” Spence, Harvard Graduate School of Education and Kennedy School of Government, and former commissioner of the Massachusetts Department of Social Services.

The co-chairs will work closely with 11 faculty members:

• Debra Conway, birth parent, Washington
• Diane DePanfilis, director, Ruth H. Young Center for Families and Children, University of Maryland
• Kathy Deserly, director, Indian Child and Family Resource Center, Montana
• Maryam Fatemi, administrator, Los Angeles County Department of Children and Family Services, California
• Ernestine Gray, juvenile court judge, Orleans Parish Juvenile Court, Louisiana
• Suzanne Lohrbach, supervisor, Olmsted County Child and Family Services, Minnesota
• Shantay Mines, youth, New Jersey
• Barry Salovitz, senior director, Strategic Consulting Services, Casey Family Programs, New York
• Damon Saunders, supervisor, Fairfax County Department of Family Services, Virginia
• Tess Thomas, foster parent, Washington
• Tamika Youmans, youth, Massachusetts

The co-chairs and faculty members come to the collaborative with a history of success in implementing or changing practice in safety and risk assessments and decision making. The leadership team is composed of key stakeholders in the implementation of safety and risk assessments and decision making, representing consumers, parents, youth, caregivers, workers, supervisors, administrators and community partners. Download short bios of all the team members.

Because the Breakthrough Series Collaborative methodology is built on an evidence-based practice framework, teams often want to hear “how this worked” in other sites throughout the country. The co-chairs and faculty members will serve as practice experts on the selected topic. They will share their expertise and experience in applying the framework’s best practices (from the practitioner’s or family’s perspective). This sharing will often include data, stories that highlight a specific systemic shift and “lessons learned” in their jurisdiction.

The Breakthrough Series Collaborative leadership will also play a critical role in supporting and mentoring teams -- helping teams learn the practice framework, understand the methodology, and brainstorm changes they will test. Faculty members will facilitate communication within and between teams, building a culture of cross-team learning.

Co-chairs and faculty members will also serve as consultants to the staff and planning team. They may identify team-specific issues that need to be addressed, provide insight into how teams approach the change process, point out common themes and learning across teams and serve as a “think tank” to resolve problems.

Expert Meeting

The expert meeting for the American Humane Association and Casey Family Programs’ Breakthrough Series Collaborative on Safety and Risk Assessments was held in Houston, Dec. 4-5, 2007. More than 60 experts from across the country, including youth, birth and foster parents, practitioners, administrators, policymakers, researchers and community providers, helped the project staff and planning team define and design the framework on safety and risk assessments and sound decision making. Thirty site teams from across the country will use the change package as they focus on enhancing safety and risk assessments to improve outcomes for children, youth and families. The change package will guide them in administration, supervision, case management and direct practice related to the assessments of safety and risk. Experts provided refinements to the framework and recommended a body of measures that teams will use to promote, develop and implement quality practice improvements in assessments and decision making.

A subset of experts has been recruited to provide technical assistance to mentor the work of the participating teams throughout the collaborative.

Learning Session One

Twenty-one teams from across the country gathered with Breakthrough Series Collaborative staff, faculty and guests to improve safety and risk assessments and decision making in child welfare using small tests of change. The objectives of the first learning session included:

• Team and collaboration building
• Understanding basic breakthrough series collaborative methodology and the model for organizational improvement
• Exchanging successful strategies to improve safety and risk assessments and decision making
• Team development of small tests of change in priority areas specific to their self-assessments

The two-day session included opportunities for the teams to plan; to hear from other teams, staff and faculty; and to get informed and ready for the work. Participant feedback identified that gathering together to share struggles, strategies and ideas and hearing the voices of youth and birth parents were particularly valuable experiences. Teams left with plans for action that will be implemented, supported and discussed over the next four months. Everyone will reconvene for Learning Session Two at the end of October to continue along this important collaborative journey.

Meet the Teams

Twenty-one teams representing state, county and tribal organizations across the country will participate in the Breakthrough Series Collaborative on Safety and Risk Assessments. Each team will embark on a quality improvement process to make small, rapid tests of change focused on safety and risk assessments and decision making. Successful small improvements will be sustained and spread, resulting in transformative, systemic change to improve outcomes for children and families. Throughout their 18-month commitment to the project, teams will be supported by series collaborative staff, faculty and fellow team participants. The selected teams are:

• California:
  • Fresno County Department of Children and Family Services
  • Los Angeles County Department of Children and Family Services - Pasadena Office
  • Los Angeles County Department of Children and Family Services - Pomona Office
  • San Francisco City and County Human Services Agency: Family and Children’s Services
  • Stanislaus County Community Services Agency: Child and Family Services Division
• Chippewa Cree Tribe
• Colorado: Larimer County Department of Human Services
• Florida:
  • Department of Children and Families in Collaboration with Community Based Care of Seminole
  • Department of Children and Families in Collaboration with Kids Central
• Indiana: Department of Child Services - Lake County
• Minnesota:
  • Carver County Community Services
  • Olmsted County Child and Family Services
• Navajo Nation Division of Social Services:
  • Shiprock Region
  • Southwest Region
• North Carolina:
  • Buncombe County Department of Social Services
  • Catawba County Social Services
• Oklahoma: Department of Human Services
• Philadelphia: Department of Human Services
• Texas: Department of Family and Protective Services: City of El Paso: Department of Human Services
• Utah: Division of Child and Family Services
• Wyoming: Uinta County Department of Family Services