‘Sharing and owning knowledge in services’ Outcomes from the Autism Practice Improvement Framework (APIF)
Joanna Panese, Senior Autism Practitioner, Scottish Autism
The development, synthesis and sharing of new forms of autism knowledge within Scottish Autism has a clear goal - to improve the quality of the services we provide for autistic people. Whilst traditional ‘top –down’ organisational approaches are often tasked with improving quality, hierarchical initiatives are not frequently linked with a sense of staff autonomy and ownership. Scottish Autism recognises that our key processes and support environments have always developed expertise and innovation within practice, as autism services require staff to constantly adapt to improve the quality of life for autistic persons.
The development of the Autism Practice Improvement Framework (APIF) builds upon this recognition.
It provides a systematic and robust framework for staff teams to take formal ownership of the need to develop services via self-assessment and supports the development of programmes to improve practice. The APIF framework and the support of the APIF Advisor essentially create an autonomous organisational space where staff can design self-identified programmes to improve practice in a way described as ‘by staff for staff’. This framework gives greater autonomy to the ‘communities of practice’ which generate new learning within Scottish Autism and supports the dissemination of this knowledge.
To highlight this process, Central and Lothian APIF teams describe their own experiences of APIF and the outcomes from the process:
Central APIF team case study - Joanna Panese, Senior Autism Practitioner
The Central APIF team has focused on a number of projects highlighted through the APIF assessment process which have included improving and quality assuring changeovers, supporting the transfer of review outcomes into individual support plans, and improving the way in which staff access key information about supported persons.
The APIF process posed a number of questions throughout the initial assessment - what does good practice mean to front line support staff? What does it look like and how can we adopt real strategies that realistically work to improve what we do? It also wanted to highlight areas of good practice and share these throughout the organisation. The APIF process allowed practitioner voice as well as service user voice to be held at the heart of any developments.
The first project developed by the Central APIF team was the creation of a ‘changeover’ document to support the exchange of information between staff during shift changes. The APIF assessment process highlighted that whilst changeovers within Central services consistently involved a high level of detail, staff faced challenges when recording this information and passing it accurately from team to team.
The document focused on illustrating the ways changeovers could be delivered based on the experiences of staff across the region. A survey of frontline support staff highlighted each team retained a different method of recording changeovers. The use of changeover guidance aimed to support staff to adopt a ‘best practice’ model when delivering changeovers to produce consistent practice across the region.
The documents were designed with a clear ‘for staff, by staff’ approach which generated positive feedback from staff; many indicated that this approach spoke to them on a practical level and allowed them to adopt the strategies straight away. Staff also found that real practice examples within the document meant they could see what a model changeover should look like.
The Central APIF team are currently looking at developing a quick reference guide which will allow staff to access key information about supported persons. This will include core strategies for successful support across services and the identification of key communication needs. This document is not designed to replace the staff requirement to read and maintain support plans, but was developed after feedback highlighted when staff arrive on shift they often require certain immediate information about their supported person. Staff can then use the support plan to deepen their knowledge at a later point.
Laura Lamont APIF team member and Support Worker within central commented:
“The APIF quick reference guide that the team has put together is really easy to fill out - the guide is split into each part of the day which lets you get the information you need quicker than before. The guide has been received well by the staff team and they are keen to use it when new staff come to work with those we support. The quick reference guide offers a streamlined version of the most important parts of each supported person’s day and gives reference points so this can be used alongside the full support plan if more information is needed.”
A dual focus has been apparent throughout the APIF process; how to develop practice approaches that can be easily transferred ‘on the floor’, and continuing to keep the individuals that we support at the heart of what we do. As APIF continues, so does the reflection and refinement process which I think remains one of the strengths of APIF - it can be used flexibly by the APIF teams so that the outcomes mean something for that region and although these outcomes are shared, the ownership still lies with the staff that create them.
Lothian APIF team case study - Lucy McMath, Autism Practitioner
In early 2016, the Lothian and Borders APIF team prioritised three key areas for improvement across our services. At this point we agreed our aim would be to develop projects that benefitted all services and staff members.
Our first project ‘The implementation of a joint meeting between all teams in Lothian and Borders to promote knowledge share and development’ focused on the staff integration and sharing of knowledge. It was interesting to see the range of knowledge and experience we could share even within our small APIF team. In order to learn more about the practice areas that staff wanted to develop, we conducted a survey within the service region and selected areas for improvement from the results. Topics included learning more on nutrition, stress and sensory issues, as well as developing the range of community activities we could offer.
From our meetings, we identified a specific need for ‘community mapping’ within our area. We knew that both our staff and supported persons had a significant knowledge of opportunities and resources in the community which could be valuable to others when selecting day trips or planning an activity. As a team we created a Community Mapping form which we called ‘Source Explore’, which is now accessible on Source, our staff intranet.
With the use of this resource, staff are able to upload reviews of cafes, museums, castles and general places of interest which all Scottish Autism staff can access. This can be useful when planning a day trip or holiday for those we support as reviews can be searched by type of activity or area. It is also a great tool to use if our autistic individuals have a favourite place but would potentially benefit from new environments and experiences – this tool also offers the opportunity for individuals to review places they have visited and share their own experiences. This gives a valuable insight as it allows supported persons the opportunity to make clear what they really thought about the places they have visited with staff. In the future we hope that this can be made available to all carers, support workers and families of autistic persons.
Dawkins, S., Tian, A.W., Newman, A., and Martin, A. (2017). Psychological ownership: A review and research agenda. J. Organ. Behav. 38, 163–183.