Transformational Collaborative Outcomes Management (TCOM) is an international phenomenon, with implementations in all populated continents (sorry, Antarctica). Recently, I had the opportunity to visit Milan, Italy, where a local collaborative of stakeholders (including the local municipal body), are implementing a sophisticated multi-level CANS initiative to transform youth outcomes.
Under the stewardship of Drs. Antonella Costantino & Stefano Benzoni, the “CANS for Italy” project has been in place for several years, and they have already developed their own form, various means of visualizing their data, and have professionals using the tool across Milan. Starting Fall 2019, they are going to ramp up this implementation by universally adopting Community Data Roundtable’s DataPool application to capture their CANS information, and make it amenable to visualization and analysis. Automating this process will have significant implications – ensuring better data quality, as well as making the whole CANS process more disciplined, and thus effective. This is a wonderful opportunity for me, since I am junky for human services systems, and I love to see how other places do the work of caring for the most vulnerable, and assuring a well-functioning society. So I asked some of the local stakeholders to take me around, show me their system, and help me understand where CANS are scored, and the work of caring that the CANS are helping to accomplish. My getting a sense for the “boots on the ground” helps us better tailor our software, and ensure it is a helpful tool in care work, and not a bottleneck!
So on May 23rd (while still relatively jet lagged!) Antonella Costantino M.D. and Alessandro Chinello Ph.D. drove me around Milan to various levels of care, so I had a sense for the kind of work that is done in Milan’s child caring system, and to meet the staff and consumers that make the system vibrant and caring.
Some of what I saw is quite similar to what we have in the United States and Canada: Intensive one-on-one programs for children with developmental delays, psychotherapy groups for self-harming teens, residential placements for families from fragile homes, and home-based care for children leaving the hospital. As we walked around and saw their nice facilities, I imagined the various algorithms that could describe the services we were looking at. I considered that while the kernel of such algorithms would be similar to what we have in the United States, Italy’s unique program would also have unique triggers for programs, and unique outcomes expectations. I am excited to get to the point where we have credible data so that we compare, say, a partial hospital in Italy with one in Idaho. The growth of TCOM systems has much to offer.
One of the very interesting things about Italy’s implementation, is the sophistication of the research they are doing with their TCOM data. One particular project that I found powerful, is spearheaded by Dr. Costantino, and attends to the crisis of unaccompanied minor immigrants coming to Italy from war-torn nations across the Mediterranean. Like the United States, Italy is facing a wave of displaced people, sometimes unaccompanied children. Through CANS, Italy is learning more about this population so they can provide the best care. One of their interesting findings, is though this population has a lot of trauma (which is expected), they actually are not more disposed to criminality, which is a talking point on the Italian political stage. Milanese researchers are hoping that this data that shows that unaccompanied migrant children are NOT more likely to be criminally involved, and are actually less likely to be such than Italian youth, can be used to help officials set up programs to help these children, instead of treating them like a problem. I am hoping their work can lead to some similar research on our immigrant population, so we can begin to address this global problem with compassion.
In conclusion, I will keep everyone abreast of TCOM developments in Italy. There is a unique and vibrant culture developing here, and they are now using what I humbly declare to be the most sophisticated software in the industry for TCOM implementation. I hope to show off the progress we’re making as time moves forward, so that the entire TCOM community can benefit from their advancements.
Dinner with friends in Italy
Constantino and Chinello at a teen service provider.
Constantino and a program supervisor (serving a great cup of espresso!)
