What is “Quality” ?
When we talk about Continuous Quality Improvement in a social service setting, what exactly are we trying to improve?
“Quality” can refer to so many aspects of a social service program or organization, and without a common understanding of what “quality” means, it’s hard to determine where exactly to apply an improvement process. Our team has sought to address this question of quality by drawing upon thorough research and experience to articulate six core domains that are critical to program quality for social service providers.
We developed these domains in the context of programs serving children and their families, but we find that they apply across most types of social services, though they may look slightly different based on the population served (for instance, “Family Engagement” could become “Student Engagement” in a school-based program). Within this quality framework, we designed a CQI Assessment to help social service programs identify strengths and areas for growth in each domain and measure progress towards quality improvement goals.*
Following is a brief overview of each quality domain. You can find far more about each through our CQI Resource Library for studies, reports, and other research from the field.
If you are curious about CQI but not sure where to begin, check out our Getting Started with Continuous Quality Improvement post.
Domains of Program Quality
Barriers exist that prevent some children and families from accessing programs and services. These barriers tend to be more prevalent among populations that have traditionally been less able to use existing services available, for a wide variety of reasons. These barriers to services tend to be more significant in low income neighborhoods; marginalized racial/ethnic, cultural, and immigrant groups; rural and remote areas; and non-traditional family structures. As a result, these groups tend to face more challenges and be less able to get the supports and services needed in a child’s early years.
Family engagement refers to the systematic inclusion of families in programs that promote children’s development and wellness, including the planning, development, implementation, and evaluation of program services. In family-centered programs, traditional parental roles as program helpers are transformed into creative roles in which families partner with staff to establish goals and make decisions related to the programs. Through active and dynamic forms of family engagement, families share power and responsibility with program staff which leads to improved parent/guardian-child and parent/guardian-program relationships, resulting in improved program efficacy.
Referrals & Partnerships
(nb: Here, “partners” refers to people and/or programs that your program relies on to deliver services and improve outcomes for children and families served.)
Families frequently fall through the cracks of social service systems because the connections between services are either absent or ineffective, or because needed services are missing altogether. Strong referral practices help ensure that families receive relevant, timely, and valuable connections from one program to others in a way that adequately addresses their needs. When managing partner relationships effectively, programs and organizations have close, communicative, and trusting connections with partners; and have put in place processes to sustain their partnerships and strengthen them over time. Programs with strong referrals and partnership management practices coordinate their services in order to ease access to services, reduce unnecessary duplication of effort, and produce a more effective and efficient social service system. Direct service providers that make effective referrals across programs and systems in the community can contribute significantly to meeting existing and projected needs in their communities.
Staff Support & Performance
Staff support is a critical component of organizational and program performance. When staff members feel supported professionally, personally and financially by their organization, they are better prepared and more motivated to perform and excel in their roles. Staff turnover, burnout, and lack of adequate support negatively impact service quality and a program’s ability to achieve its outcomes. Organizations and programs with strong staff support and performance practices prioritize staff supervision, development, and retention initiatives within the organization, as well as provide cultural competency training, with the aim of ensuring that staff have the support and preparation they need to deliver quality services.
Research shows that many children and families experience trauma from abuse/neglect, loss of a caregiver, economic struggles, lack of food, housing instability, and other life challenges. A trauma-informed program understands the actions and behaviors of a child in the context of what has happened to them and their family. A trauma informed approach realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist re-traumatization. This approach should be implemented in any type of service setting and is distinct from trauma-specific interventions or treatments designed specifically to address the consequences of trauma and to facilitate healing.
Use of Evidence
There is currently a growing movement around using evidence of effectiveness to spread what works and to avoid what does not work, thereby maximizing results from limited resources and increasing impact on people’s lives. This includes reviewing the best available research that already exists in your field, increasing evidence of effectiveness for your organization’s own work, and incorporating best practices.