Implementation and Sustainability

Training upwards of 5,000 clinicians to become reliable raters of the CAFAS is only the first step in changing practice and in supporting the use of CAFAS in the province. This is very much a capacity building initiative and will take time to build momentum.

We know from research in the field of organizational change that certain factors are necessary for the attainment of change within organizations. This includes (I) strong and innovative leadership, (ii) organizational readiness and openness to change, and (iii) effective use of resources.

Similarly, research has identified several factors expected to hinder change, including, (I) resistance to measurement, (ii) lack of trust in the goals of the initiative and intended uses of data, (iii) fear of change, (iv) lack of skilled & experienced staff, (iv) resistance from other agencies - fear of disturbing alliances, (v) fear of losing funding, (vi) confusion regarding the goals of the initiative.

We have developed implementation support strategies based on this knowledge.

Support activities include the following:

CAFAS Reliability Training

CAFAS Software Training: Since the summer of 2002, CAFAS trainers have been conducting software training.

Regional "Community of Practice" Meetings: Implementation success is dependent upon the perceived and actualized clinical utility of the CAFAS. Through regional meetings, agencies will have the opportunity to come together to discuss the challenges and successes they have experienced in using the CAFAS, and in this way learn how CAFAS use can benefit practice. Link to the schedule for a view of regional meeting dates in your area.

Individual Consultation: The CAFAS in Ontario team are available to assist you with agency-specific issues. We can be reached by telephone or by email, and if possible, we can schedule a person-to-person visit. The following people will be able to assist you:

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General Inquiries and Booking for Training dates/Assistance with Rating CAFAS:
  Karen Fennell
  416-813-7168 or karen.fennell@sickkids.ca
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Technical Assistance with Software:
   Cristina Vlad
   416-813-7654 ext. 2623 or cristina.vlad@sickkids.ca
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Implementation Issues:
  Dr. Melanie Barwick
  416-813-1085 or melanie.barwick@sickkids.ca
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Data Exporting and Data Analyses
   Cristina Vlad
   416-813-7654 ext. 2623 or cristina.vlad@sickkids.ca

   Behnaz Shirazi
   416-813-7654 ext. 2023 or behnaz.shirazi@sickkids.ca
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CAFAS Wiki: We invite you to be part of our Communi-CAFAS wiki - a collaborative endeavour in which you can take part in shaping the future of CAFAS, share your experiences and expertise and learn from others in a supportive environment.  Please click here to require access to the wiki and to be part of the CAFAS on-going updates and the development process.

Sustainability Strategy: We are involved in several activities that will help to build a CAFAS culture and support the continued use of this tool in Ontario:

Training of College Instructors, teaching social work, Psychology, child and youth care

Development of Guidelines for CAFAS Rating of First Nations Children and Youth

Translation of the CAFAS tool and software into French

Invited presentations to other groups and/or sectors in Ontario (i.e., Ministry of Education; Boards of Education; Canadian Association of Pediatric Health Centres; CAPHC)

Development of a Best Practices Guide for Use of CAFAS in Clinical Practice in Ontario

Coordinated and Participatory Decision-Making: CAFAS Leads meet with MCYS on an ongoing basis to review progress and make joint decisions. The CAFAS Team meets quarterly with the CAFAS in Ontario Advisory Committee to review progress and receive important feedback and input from the CMH field of service providers.