Session: Integrating Research and Practice in Social Service Systems (Research that Promotes Sustainability and (re)Builds Strengths (January 15 - 18, 2009))

Social service systems are under increasing pressure to improve quality and accountability, as demonstrated by the growing emphasis on evidence-based practice (EBP), quality assurance and improvement (QA/I), and accreditation standards. The issue of quality in social service systems is of national significance. Measurement of processes and outcomes, quality improvement, and workforce capacity were three of the key priorities for strengthening the community mental health system as identified by the Institute of Medicine (2006) in their groundbreaking report, Improving the Quality of Health Care for Mental and Substance-Use Conditions.

Despite high motivation to strengthen social work practice and comply with these new standards, overburdened social service professionals and organizations may experience significant difficulties when they make changes that affect the organization and delivery of social services. As social service systems are complex, creating sustainable change requires attention to needs, strengths, and challenges throughout the organization. Some examples of where change may be felt include:

1. For individual workers, where QA/I and EBP may require re-training, limit worker autonomy and discretion, and/or increase documentation.

2. For staff teams, where QA/I and EBP may require additional meetings or trainings, change team composition, or alter relationships between team members.

3. For organizations, where QA/I and EBP may demand restructuring of data collection and reporting systems or require budget adjustments.

How do social service systems respond to these demands? In this symposium, three qualitative studies that explored QA/I and/or EBP in social service settings from worker and administrator perspectives will be presented. In the first paper, findings will be presented from interviews with 30 social service administrators and community representatives as part of an evaluation of the California Learning Collaborative, a nine-county community mental health quality improvement initiative. In the second paper, results of a study of 18 QA/I professionals regarding their role, duties, and challenges experienced will be discussed. In the third paper, findings from a study of 14 direct service providers' experiences in implementing four EBPs in a community mental health organization will be presented.

Successful QA/I and integration of EBPs is dependent on the ability of workers and organizations to adapt to, spread, and sustain change. This symposium will contribute to the literature in this area by exploring the change process within complex social service systems.