Jumping Into the Deep End

Envision being thrown into the deep end with limited swimming skills.  Imagine the feelings that come along with this – overwhelmed, confused, frightened, and frustrated….all emotions that I’ve experienced as I assume my new role as Deputy Commissioner in a state Child Welfare System. I’m intelligent, motivated, and energetic, but are these traits, combined with my desire to impact positive change enough? Transitioning into this position has required me to hit the ground running and essentially learn as I go.  

The limited formal training has been supplemented with book recommendations - “read this, it will help.” And some of the recommendations are helpful, but not a perfect substitute for the learning that comes from collaboration and conversation with other professionals.  This transition has led me to wonder what training is available to really prepare child welfare workers, foster parents and leaders in child welfare for the difficult, ever-changing and multifaceted work that they do. Are there guides to best practice and how to achieve the high standards that we know are key to success in this complex field? There are experts and sound, step-by-step approaches in fields like aviation and healthcare, but when it comes to child welfare, there are not nearly as many clear approaches to enhancing organizational performance. 

In child welfare, a robust continuous quality improvement system is critical to ensure that we are consistently improving services and supports for children and families, as well as to make sure that we are making the most effective use of our resources.  Undeniably, child welfare systems contain a multitude of challenges and complexities. We must strive to adequately assess and measure our practice to ensure that our work is continuously improving.

Moving forward in my role, I plan to help enable others to act, shadow other industry quality improvement experts &  leaders, and working to develop a stronger understanding of core practices that drive our outcome metrics.  I believe success include

1. Ongoing cultural shifts

  • The culture of the child welfare system must embrace continuous learning. Staff must believe that we are all responsible for improving quality and in as much, work towards being more proactive at all levels of the system.
  • Bring hope, energy and the idea of being proactive with strengthening practices that might have drifted away from quality.

2. Assisting and aligning with the development and implementation of a culture of safety

  • Work towards building safe and supported staff with the hope of demonstrating greater buy-in and contribution if their learning environment is more proactive and engaging.

3. Enhancing communication feedback loops.

4. Working with my peers to make timely decisions and prioritize, track and adjust projects routinely.

  • Inspire shared accountability over blame
  • Follow through on commitments

5. Regular review and use of data with a communicated understanding of why this is important at all levels.

While “jumping into the deep end” isn’t always the best strategy, it does provide the opportunity to learn quickly. However, with the addition of a strong support system, one can thoughtfully plan next steps and take time to get familiar with best practice, while moving steadily forward and using data to make meaningful organizational change.  

 


 

Is the scene safe?

It may seem odd, but my journey to child welfare started in an ambulance. Specifically, in the back of an ambulance where, in my 20s, I worked as a paramedic. This is where I first became interested in things like the effects of trauma exposure, mental health crisis, and the complexity of our care delivery systems. It’s also where I learned the importance of teams, teamwork, and team culture.

Culture has been described in a variety of different ways. But one idea that’s common to all definitions is that culture is what we teach. An organization’s culture lives and breathes in the way it approaches problem solving. It gets passed down as we train (formally and informally) our new professionals.

In Emergency Medical Services (EMS) culture, there is a simple problem solving approach to safety that gets taught and passed down.  EMTs and paramedics are expected to ask “is the scene safe” before attempting a rescue.  The obvious reason for this moment to pause and take stock is that if it’s not safe you and your team will be at risk. If, for example, in the classic example of a noxious gas poisoning you run recklessly to the aid of a group of unconscious citizens without realizing that the room they are in is filled with poisonous gases you will quickly be overcome… and dead.

The genius of scene safety is in how it works on two levels. It is, in fact, a simple memory tool to help you stay safe. But, it’s also a tool used to connect you with your team and instill a sense of shared responsibility. The power of scene safety is that when it’s taught to new first-responders the emphasis is not on how it protects the individual but on how it protects the team. If I rush into the burning building and get myself trapped, I have put my entire team at risk because now I need to be rescued. So, everyone on my team now has the responsibility of rescuing me added to their need to render care to the original victims.

In child welfare, we know our professionals are expected to work in any number of unsafe “scenes.” Entering a poorly lit home, interviewing and engaging with violent men, and driving late into the night are routine events.  But, they also put themselves at risk when they heroically push beyond the limits shared by all us humans.  An equally pervasive but more insidious threat to health and well-being comes from chronic stress, exposure to trauma, and fatigue from long and unpredictable work hours.

We spend a lot of time talking about our professionals' personal safety and “hero behavior” in our system. In our culture heroes are celebrated, but they may actually make our care delivery system less safe.  Our professionals routinely put concern for vulnerable children and families ahead of concern for their personal safety.  And, importantly, they do this without an awareness for how their heroism puts their team at risk. What we find too often is that contrary to a culture that promotes scene safety we have a culture that promotes individual heroism. In fact, we very likely select for it and reward it in the Social Services. 

Professionals in child welfare have limits that have nothing to do with their passion, commitment, or preparation. When we’re tired, stressed, and unfortunately, affected by secondary trauma, we’re less effective. In child welfare, less effectiveness means less safety.

Imagine the power of intentionally questioning the safety of our situation. If I pick up my third severe child abuse case this week, is it safe for me to take a fourth? Is it safe for my team to have me at less than 100%? Is it safe for the child I’m charged to protect if my physical and emotional reserves are stretched beyond the breaking point?

Child welfare should embrace scene safety.  How often do our professionals put themselves at risk? how often are they asked to push beyond their capacity? How often are they asked to make impossible decisions? How often do we - their team - pause to take stock and question if it’s safe?