Ensure Organizational Capacity to Support Complex Service Delivery

Outcome

Externalizing Behavior

Intervention Family

Effective Implementation

Ensure Organizational Capacity to Support Complex Service Delivery

Service delivery complexity is a combination of different settings (e.g., classroom, home, community setting), different types of delivery personnel (e.g., teachers, laypeople, program specialists) and different formats (e.g., group, one-on-one, self-directed). The more of these elements a program has, the more complex and challenging it can be to implement with quality and consistency. However, many health and human services programs for youth are intentionally complex, due to factors such as the constellation of needs of populations of interest, community context, and funding requirements. Moreover, many programs for youth are multidimensional, reinforcing content in multiple spheres of a child’s life – home, school, and community – and with multiple people who influence that child – caregivers, teachers, and peers. Because service delivery complexity can be desirable, it is crucial for programs that involve multiple settings, formats, or delivery personnel to have the capacity to ensure they are well implemented.

By organizational capacity, we mean “the range of capabilities, knowledge, and resources that nonprofits need to be effective.”2 There are many different dimensions of organizational capacity – here are four common dimensions, but you may have your own favorite framework for defining organizational capacity:

  • Leadership – the active involvement of leadership in providing direction, creating a positive climate, and inspiring others to achieve the organization’s mission.
  • Operational – the people, skills, competencies, space, funding, partnerships, technology, etc. necessary to carry out the organization’s activities.
  • Management – policies, systems, and procedures that provide structure and support the delivery of services. For example, training and supervision, continuous quality improvement (CQI), decision-making structures, and policies that guide service delivery.
  • Adaptive – the ability to respond to changing circumstances within and outside the organization.
EXAMPLES OF HIGH COMPLEXITY PROGRAMS
  • A day treatment program for children exhibiting disruptive behavior provided a daily 2.5 hour block of special education, a 3-hour block of psychotherapy, and weekly family therapy. Though conducted in a single setting, the intervention was delivered by multiple types of providers such as teachers, psychologists, a social worker, and child care workers. In addition, each component of the program required a different format: group special education, one-on-one psychotherapy, and child-parent dyads with a provider for family therapy.
  • A program designed to reduce inattention, impulsivity, and improve motivation among 2nd – 4th graders was implemented in a school-based setting and a home setting. At school, classroom teachers used positive reinforcement techniques to reinforce desired behaviors, coupled with parental praise for positive teacher reports. At home, parents consulted with therapists and implemented behavior modification and tutoring, and children received individual counseling from the therapist.
2 Grantmakers for Effective Organizations (2015). Strengthening Nonprofit Capacity. Washington, DC: Author.