Continuous Quality Improvement

For an agency to measure performance, there must be a process in place to benchmark the progress towards stated goals and to change course in a specific area to enhance performance. The Continuous Quality Improvement (CQI) process is a mechanism of the overall Change Management process. In the CQI process, quantitative and qualitative data are key guiding principles. Once processed (collected, analyzed, shared), these data guide and improve practice and contribute to advanced learning on agency administration, policy development and program implementation.

A core process an agency can use to guide quality improvement activities in the Change Management process is the DAPIM model. This process defines an agency problem, assesses the current situation to identify strengths and gaps and identify root causes, plans a course of action, implements activities to execute the action plan and make improvements and establishes mechanisms for continued monitoring and evaluation.

Another resource to agencies in this area is the National Child Welfare Resource Center on Organizational Improvement. The Resource center provides research, training, technical assistance and evaluation to State and Tribal child welfare organizations in a number of areas, including strategic planning and quality assurance and improvement.

An information management plan will only come to life once structures are established for producing and disseminating the information and for establishing the feedback loops to accommodate changing information needs and changing program conditions over time. Following is an example regarding increasing exits to permanency to demonstrate the cycle of continuous quality improvement.

Vignette: An agency builds a new information management system that generates useful reports to caseworkers. Supervisors and caseworkers hold team meeting to review the reports and to identify barriers to achieving the target goals. The leadership team meets with the supervisors and program administrations to receive update reports on the barriers/gaps identified. Although useful and valuable information is being shared, the agency’s performance is not improving and there is no evidence of increased exits to permanency. The information management plan assumed that if leadership staff understood the barriers, they would be able to revise agency policies/procedures to assist caseworkers in increasing exits to permanency. However, in this case, the barriers are located outside of the purview of the leadership staff – and have been identified as a court issue related to scheduling of TPR hearings. This is illustrative of the problem in the CQI process when a root cause analysis is not conducted after the gap was identified.

In that case, the information management plan needs to be adjusted to include court personnel on the case review teams. The assumptions about the ability of leadership to affect the needed change were not correct, therefore, the improvements in agency performance did not materialize. By periodically reassessing assumptions, adjustments to the strategy can be made proactively and in a timely manner.

What could have been done to increase the likelihood of success?

Assure that caseworkers and their supervisors were receiving the report in a timely manner.
Train caseworkers and supervisors in using the report.
Require supervisors to include review of the report on their monthly team meeting agenda.
Set up monthly meetings with supervisors and leadership staff to discuss common barriers to permanency and the action steps that are needed or are being implemented to overcome the barriers.
Examine data on exits to permanency on a monthly (rather than semi-annual) basis.
Track data at the systemic level, but also at office, unit and worker levels. In this example, individual workers or frontline supervisors may have identified the issue readily.
Share information on progress with supervisors and frontline staff on a monthly basis to celebrate progress and learn from challenges.
Inform the Executive Team outside of the committee on a regular basis of the priority (increase exits to permanency), the processes and the progress.

< Back to Information Management Strategy Section

Additional Sections:

Leadership Vision for Managing Information
Organizational Commitment
Purpose and Objectives
Environmental Scan - Needs Assessment
Policy Development Framework
Monitoring and Evaluation