BackgroundStrategies Supporting Large-scale Implementation of Evidence-Based Services

The goal of this article is to illustrate various strategies that the Hawaii Child Major systems reform has pervaded the Hawaii system of care for youth for Child Adolesc Psychiatric Clin N Am 14 (2005) 329–349more than a decade. Two federal lawsuits played important roles in promotingand Adolescent Mental Health Division (CAMHD) adopted to increase the use of empirical evidence to improve the quality of services and outcomes for youth. We operate from the premise that evidence-based decision making extends beyond the use of treatment outcome literature to inform decisions regarding treatment selection. We elaborate a list of common clinical decisions, discuss multiple evidence bases that may inform these decisions, and use a model of the phases of evidence to illustrate multiple quality improvement strategies used within the Hawaii system of care for youth. This article provides a broad overview to various quality initiatives for promoting evidence-based practices rather than in-depth discussion of any specific strategy