Breakthrough Series Collaborative
The Institute for Healthcare Improvement (IHI) and the Associates in Process Improvement (API) developed the Breakthrough Series Collaborative (BSC) methodology in 1995. In 2000, Casey Family Programs (CFP) joined with IHI to learn the Breakthrough Series Collaborative methodology by sponsoring a Breakthrough Series Collaborative on “Improving Health Care for Children in Foster Care.” Casey Family Programs has sponsored a total of seven internal BSCs on child welfare issues such as kinship care and disproportionally. They currently have five partnerships with external organizations conducting BSCs on a range of child welfare issues.
From 2008 to 2009, the Center for Juvenile Justice Reform (CJJR) and Casey Family Programs partnered to conduct the Juvenile Justice and Child Welfare Integration BSC, which has several unique components that vary from previous and current BSCs. It was the first and only BSC to involve the juvenile justice system as a concentrated area of focus and it was only the second BSC that formally worked to integrate two systems. Lastly, the incorporation of a Certificate Program as a foundation for each team’s work was a new component as well.
The following seven teams were selected to implement the Juvenile Justice and Child Welfare Integration BSC:
- Baltimore, Maryland
- Denver, Colorado
- Georgetown County, South Carolina
- King County, Washington
- Los Angeles County, California
- Miami-Dade, Florida
- Sioux City, Iowa Woodbury County Juvenile Court Services
For almost 30 years, various researchers have been studying the effects of child abuse and neglect on subsequent delinquent behavior. Studies show that child abuse and neglect increased a juvenile’s risk of arrest for nonviolent crime by 55 percent and the risk of arrest for violent crime by 96 percent. This population of at-risk youth is commonly referred to as Crossover Youth. Additionally, research has shown that collaboration among systems is the most efficient and effective way to serve crossover youth and improve their outcomes.
Although a multi-system approach is considered to be best practice, it presents significant challenges including time and resources. While these challenges are very real, jurisdictions that have gone down the collaborative path have found tremendous value in sharing and working together and that, in the end, it is more effective—both from a cost and outcome perspective—than going it alone.
In the Certificate Program portion of the BSC, which was held in July of 2008, public juvenile justice, child welfare and other agency leaders from seven jurisdictions around the country were joined with national experts to exchange knowledge, information, strategies, challenges and successes around systems integration. The learning during the Certificate Program was linked to the Change Package.
After the participants completed the Certificate Program, they returned home to their jurisdictions to begin the Breakthrough Series Collaborative. They began initiating strategies to target the many factors that contribute to poor outcomes for youth known to both juvenile justice and child welfare. Each small test of change, also know as a PDSA (Plan-Do-Study-Adjust), had a direct correlation to the Change Package to ensure that communities were addressing specific areas of practice and policy where it was found that change lead to improved outcomes.
The seven teams selected to participate accomplished this by various means that include:
- Created environments in which strategies could be developed and tested in their jurisdiction
- Joined with a cadre of peers from across the country that was working toward solutions
- Created and sustained partnerships to advance the work; and
- Disseminated lessons learned.
The work of the Breakthrough Series Collaborative is rooted in the key foundational principles, found in the Change Package. There are ten key principles/values, which are then translated into practice through six component areas:
Measurable Systems of Agency/Interagency, Court and Community Accountability
Active Engagement of Family and Youth in Planning and Decision Making
Integrated System of Information Compilation and Sharing
Shared Approach to Prevention, Identification, Assessment and Case Plan Development Within and Across Systems
Shared Case Management, Decision Making, and Community Service Utilization
Effective Use of Blended Resources
For more information about the principles and components of the Change Package, please click here.
Director, Center for Juvenile Justice Reform, Georgetown University at McCourt School of Public Policy
Laura Burney Nissen
MSW, National Program Director, Reclaiming Futures; Associate Professor, School of Social Work, Portland State University
Research Associate Professor, Georgetown University, Health Policy Institute
Professor, California State University Kate Kraft, Senior Partner, Wholonomy Consulting
Consultant Lyman Legters, Senior Director, Casey Family Programs Michael Sanders, Consultant for Annie E. Casey Foundation
Director of Child Welfare-Juvenile Justice Systems Integration, Child Welfare League of America
Director, Juvenile Justice Division and Senior Consultant, Child Welfare League of America
The Juvenile Justice and Child Welfare Breakthrough Series Collaborative Final Report provides more information on the BSC and lessons learned.
Subsequently, CJJR developed the Crossover Youth Practice Model based off the lessons learned during the BSC.