Fidelity review and action-plan guide EBP implementation process

—by Paul M. Kubek and Matthew K. Weiland

Editor's note: This article first appeared in print as a sidebar on page 16 of the Fall 2007 issue of SAMI Matters newsletter, a publication of the Center for EBPs at Case.

The fidelity review (or assessment) provides a formal mechanism for independent evaluation of evidence-based practices (EBPs), such as Integrated Dual Disorder Treatment (IDDT) and Supported Employment (SE). The fidelity review is not an audit or accreditation process. It is strictly a quality-improvement process that provides program managers and implementation teams with information about an organization's progress with EBP implementation. This information informs decisions about next steps. Research demonstrates that IDDT and SE programs which maintain fidelity to each model achieve the best results. Optimally, organizations engage in an external fidelity review process at least once per year. The fidelity review and fidelity action-plan create a continuous quality-improvement process—a cycle of planning, implementation, evaluation, and service enhancement.

In Ohio, fidelity reviews are conducted onsite at the organization by a team that has been trained to conduct the reviews. The team often consists of representatives from the Center for Evidence-Based Practices at Case Western Reserve University, the Ohio Department of Mental Health, the Ohio Department of Alcohol and Drug Addiction Services, and representatives from peer IDDT and SE initiatives throughout the state. The Center for EBPs does not recommend that organizations perform their own fidelity reviews. The experiences of Ohio organizations have demonstrated that external fidelity reviewers provide an objective perspective that is more helpful for future service enhancements.

Fidelity Scale

The fidelity action-plan outlines next steps in the journey toward reaching and sustaining high fidelity and improved outcomes.

The fidelity scale is an evaluation instrument that is designed to measure the degree to which programs administer services according to each EBPs organizational characteristics (components) and treatment characteristics. Obtain the IDDT fidelity scale and SE fidelity scale

Fidelity Review Process

For more information about the fidelity-review process, consult the Implementing IDDT booklet

Fidelity Action Plan

The fidelity action plan is created by each organization's implementation steering committee in consultation with technical-assistance providers (consultants and trainers). The plan addresses all areas of each fidelity scale. It outlines next steps in the journey toward reaching and sustaining high fidelity and improved outcomes. 

Paul M. Kubek, MA, is director of communications at the Center for Evidence-Based Practices at Case Western Reserve University. Matthew K. Weiland, MA, is senior writer and producer.