Developing and Implementing a Practice Model at Nexus

How one private agency, working with Chapin Hall, is improving services to youth and families

Nexus practice model

Nexus Youth and Family Solutions (Nexus) is a private agency that is working with Chapin Hall to implement a practice model to make a meaningful impact on the quality of services for youth and families.

Nexus provides individualized mental health services for youth with emotional and behavioral issues in outpatient, home-based, community, and residential care programs. Its programs, spread across five states, seek to provide “the right care at the right time in the right way.” The Nexus Practice Model provides an organizing framework and communicates the agency’s overall approach, translating the values and principles into practice behaviors and strategies for the workforce across each site.

The Nexus practice model development process began with a workforce survey and a commitment by the senior management team to the design process. The mission and cornerstone values were engrained in the culture of the sites and those components remain as pillars of the model.

Mission: Strengthening lives, families, and communities through our cornerstone values

Cornerstone Values: Honesty, responsibility, courage, care, and concern

Guiding Principles:

  1. Values-oriented
  2. Relationship-based
  3. Individualized and strength-focused
  4. Culturally responsive
  5. Trauma-informed
  6. Family-driven
  7. Youth-guided
  8. Skill- and competency-based
  9. Evidence-informed
  10. Outcomes-driven

Passionate about the importance of having metrics and measures for each guiding principle, Chapin Hall and Nexus engaged in a review of functional assessment tools that could align with the practice model. Nexus selected the Child & Adolescent Needs & Strengths (CANS) — a person-centered, information integration strategy whose underlying philosophy is aligned with Nexus’ guiding principles — and engaged sites in a process to ensure redundant tools were phased out.

With the practice model fully developed and the assessment tools aligned, Nexus continues to engage in a comprehensive implementation plan that includes:

  • Human Resources: aligning job postings, interviewing tools, and performance evaluations;
  • Clinical Division: aligning the internal clinical auditing process and creating staff, youth, and family surveys to measure fidelity to the practice model;
  • Communications: creating visuals, posters, and updating the website;
  • Training: embedding the practice model in all new hire trainings, creating a curriculum template to demonstrate alignment between all future topics and the practice model, and implementing a CANS super-user program to support the workforce’s reliable use of the tool;
  • Policy: developing the comprehensive assessment and practice model policy and procedures;
  • Information Technology: creating a CANS data management system with user and administrator reports; and
  • CQI: identifying all data sources with which to measure and monitor fidelity to the practice model, assessing the progress and penetration of the CANS/TCOM into practice, and exploring development of clinical acuity algorithms using the CANS.

This work at Chapin Hall is led by Policy Fellows Jennifer O’Brien and April Fernando, and Senior Policy Analyst Mike Stiehl. Contact Jennifer O’Brien for more information about our work related to developing and implementing the Nexus Practice Model, and April Fernando about her work related to the CANS.