Effective Action Planning and Implementation

 

Introductory Paragraph

After bringing stakeholders together, gathering and analyzing data, and identifying needs and priorities, the next step is for the coalition to collectively develop an action plan that addresses those identified needs, and then, support its implementation. Working together in close coordination during this process is as important as ever, so that all stakeholders have buy-in and are accountable. While the experience of communities varies, there are some common principles that consistently appear.

Key Information

Key Components to an Effective Action Plan
Substance misuse and substance use disorder are complex problems with numerous solutions across the continuum of care. What specific solutions are put into an action plan will vary widely, as will the approach different communities take. Some communities have a complex organizational structure to their coalition, which includes a planning section charged with the development and revision of an action plan. This section works closely with the data unit to provide status reports to the larger group and evaluate different initiatives within the plan. Most community coalitions have less structure where specific tasks, like creating an action plan, are done by the entire coalition or where all or most members provide input. Whatever the scope of the effort, there are some key components needed to develop an effective action plan. Communities should also note that action plans are living documents and they will need to be constantly reviewed and revised to address new realities and lessons learned along the way. Check out SAFE Project’s Community Playbook for an action plan template.

Setting Clear Strategies

When gaps and additional service needs are identified, the community coalition can begin to map out a set of actions and strategies to achieve desired outcomes. These outcomes first need to be agreed upon by the community coalition. From there, a set of action items can be added to achieve each intended outcome. Many community coalitions - especially those with a large number of members - will break into working groups or committees around each strategy or objective. Naturally, those members who are subject matter experts and work in specific fields can take the lead in developing a plan and outlining the details for that specific strategy. When formulating these plans, it is important that expectations are realistic and that the actions identified can be achieved. Even when action plans are revised due to changing data and lessons learned, achieving progress is important to keep participants energized and motivated so communities may consider planning for small and early wins first. Communities can use the strategies contained in the SAFE Solutions dashboard to help lead discussions on which strategies to implement within their community.

Identifying Members to Lead Implementation of Strategies

It is important for all participants to know what part of the action plan they are responsible for leading. This lays the groundwork of expectations between members and trust that each participant will carry out their portion of the plan. These responsibilities should be clearly spelled out in writing so there is no confusion or misunderstanding. Although a coalition member may be helping to coordinate the activities of members, it is the responsibility of each member to be accountable and help achieve progress. For example, coalition members not tasked with a specific strategy can still help to track milestones, maintain community momentum, and update key community stakeholders as progress is made.

Developing Short- and Long-Term Goals with Timelines

Once the group as a whole or sub-group agrees to an action plan, it is important to create timelines to complete each activity. As steps are taken to address both short- and longer-term goals, trust is built between the members working toward a common outcome. As with the actions themselves, the timelines need to be reasonable and achievable. Having a range of timelines helps keep members engaged and have a sense of accomplishment. Some coalitions will have short-term goals that can be achieved in 30 or 60 days, mid-term goals that are several months out, and long-term goals that can be expected to take a year or more.

Identifying Resources

Part of creating an achievable action plan is identifying and securing any financial and other resources that are necessary. There are a variety of funding sources that support planning and programs. Sources of funding include:

• Local or state government (grants or direct funding)
• Federal grants
• Funding through philanthropic organizations
• Support from the business/corporate community
• Funding from grassroots and direct fundraising campaigns and events

What is important is that the action plan develops steps to secure any needed financial resources. Without funding, community groups may be unable to meet their goals and objectives. More funding is not always feasible, so coalitions may need to consider alternate, innovative avenues.

Plan Implementation

As work begins on implementing the plan, a process begins whereby actions are taken, effectiveness is assessed, and modifications to the plan are made. The constant evaluation of progress is an ongoing effort. Often, goals are added and changed, and sometimes changes are made in those responsible for implementing parts of the plan. It is important to have the expectation from the start that almost nothing goes exactly as planned.

Tracking of Progress and Outcomes

Within an effective action plan, communities should identify and outline a series of performance indicators that align with their goal(s) and track progress. Shared accountability ensures that progress is being made towards achieving desired outcomes. The data can be used to report back to key stakeholders in the community on the progress that is being made, but it also can be used to revise any details related to the action plans as needed if strategies aren’t going as intended, so that all involved can collectively improve the desired outcomes.

Accountability and monitoring of progress are an ongoing process. As is the case with many aspects of community response, strategies and actions are constantly adjusted. Generally, the performance management process has four components:

• Identify Appropriate Performance Indicators - Determine agreed upon markers of achieving success.
• Conduct Performance Measurement - Leverage available data; collect new data to measure short-term and longer-term outcomes.
• Monitor and Report Performance Measurement Results - Share cross-sector performance management data, insights, challenges, and successes.
• Quality Improvement - Celebrate even small wins together, share what is working, and build on positive momentum to achieve continued progress. Use evidence of limited results or setbacks as learning opportunities that can be used to improve strategies and action plans.

Building a Culturally Competent Plan

Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients. A culturally competent healthcare organization seeks to understand the culture of the population served, recognizes the impact of cultural differences, fosters internal learning opportunities to improve cultural knowledge among care teams, and modifies patient care to meet the patient’s unique needs. Addressing the drug misuse and substance use disorder epidemic is a complex problem requiring a complex and coordinated set of solutions. Another critical factor to examine and plan for involves how to best serve diverse populations within a given community. Due to differences in language, culture, and experiences, communities addressing any public health issue must develop action plans that can achieve desired outcomes for all people within the community. A few guideposts for community groups looking to improve their response to substance misuse and SUD follow:

• Collect race, ethnicity, and language preference (REAL) data
• Identify and report disparities
• Offer culturally and linguistically competent care (i.e. interpretation services)
• Situate services in geographical areas that are easily accessible
• Develop culturally competent management programs
• Increase diversity and minority participation
• Involve the community in decision-making
• Train staff on sociocultural factors and recognition of personal biases
• Make cultural competency a priority

Relevant Research

• A summary of best practices in the planning domain can be found in "A guide to SAMHSA’s strategic prevention framework"

• One resource explicitly focused on implementation research is the National Implementation Research Network, which has public health implementation as one of its four focus themes.

• Although it is dated, Durlak and DuPre (2008) is worthy of review because it provides a meta-analysis of over 500 research findings on the implementation process.

Impactful Federal, State, and Local Policies

SAFE Solutions is an ever-growing platform.  Currently limited information is readily available for this section.  SAFE Project is dedicated to providing communities with the most relevant and innovative materials.  We will continue to regularly monitor and make updates accordingly with community input and subject matter expert collaboration.  Please check back soon.

Available Tools and Resources

• There are many resources that discuss how to improve cultural competence in the areas of substance use and mental health. SAMHSA has examined this issue in great detail.

• Typically, it will take a combination of several strategies to improve cultural competence. Therefore, it is important that there be as much input as possible when considering what needs to be done in a given community. SAFE Project’s resources for diverse populations provides links to a suite of resources for a varity of populations.

Promising Practices

SAFE Solutions is an ever-growing platform.  Currently limited information is readily available for this section.  SAFE Project is dedicated to providing communities with the most relevant and innovative materials.  We will continue to regularly monitor and make updates accordingly with community input and subject matter expert collaboration.  Please check back soon.