Continuous Quality Improvement Framework

Indicators are the specific and measurable ways that show whether people are on track for achieving intended outcomes.  Indicators provide evidence that a service or program is – or is not – achieving its desired results.  For example, proficiency in geometry skills is one indicator that a high school student is on track to graduate.

Family engagement refers to the systematic inclusion of families in programs that promote children’s development and wellness including the planning, development, 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.

As different functions of human services become fragmented or siloed into distinct service categories, families are falling through the cracks of the system because the connections between services are either absent or problematic, or needed services are missing all together. As a result, direct service providers are encouraged to coordinate their services with one another under the assumption that collaborative activity can facilitate 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 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 families, especially children, may experience trauma from economic struggles, lack of food, housing instability, and other life challenges.  A program that is trauma-informed 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.

There is 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 evidence that already exists in your field, increasing the evidence of effectiveness for your organization’s own work, and incorporating best practices.

A clearly articulated hypothesis is essential to anchor a program’s performance measurement efforts by defining what will be measured and why. A program’s hypothesis should rest on sound logic and clear assumptions explaining how and why its activities address a need and produce the outcomes it aims to achieve.

A strong measurement system helps to ensure that performance data is readily available and used to support continuous improvement and to report out to key stakeholders. Measurement systems include staff time, processes, and tools to collect, store, analyze, report, and learn from performance data on an ongoing basis.

Program leaders complete an online assessment that focuses on three areas:

– Life Outcomes and Indicators

– Domains of Program Quality

– Performance Measurement Capacity

The results of the assessment are the foundation for ongoing collaboration between program staff and Root Cause CQI coaches.

Root Cause coaches review CQI Assessment results with program staff and together they identify opportunities for strengthening their practice.

Root Cause coaches and supports program leaders and staff in implementing Continuous Quality Improvement cycles to that strengthen program capacity in priority areas.  The cycle follows a Plan / Do / Study / Act (PDSA) model and can be repeated as often as the program chooses to focus on various areas of the CQI Assessment.

Programs retake the assessment to gauge how their capacity has improved after an appropriate amount of time has passed since PDSA cycles have been completed.  Successfully building and sustaining a CQI practice depends on creating a culture that fosters learning and a spirit of inquiry. Programs that excel collect and use data in ways that go beyond compliance with funder requirements or other external performance standards, and create time and space for staff to develop skills that support CQI practices.