Additional Resources

Below are listed numerous resource references that provide additional information and guidance to child welfare practitioners, particularly at the management level, on a variety of aspects regarding continuous quality improvement (CQI). The resources are grouped under four broad headings:

  • CQI Concepts and Implementation
  • Data Quality, Decision-Making, and Processes
  • Leadership
  • Systems Change

CQI Concepts and Implementation

  • A Framework for Quality Assurance in Child Welfare, (2002), National Child Welfare Resource Center for Organizational Improvement, retrieved from LINK. This framework of quality assurance (QA) systems is based on examples from existing State systems, requirements from Federal legislation, Child Welfare research, and national QA standards. There is a discussion of the difference between QA and CQI, and details are provided of the five main steps of the QA framework, including State examples for each step.
  • Continuous Quality Improvement, Child Welfare Information Gateway, retrieved from LINK. This article provides an overview of CQI, including planning and implementation. Additionally, State examples are provided.
  • Continuous Quality Improvement in Title IV-B and IV-E Programs, (2012), Administration for Children and Families Information Memorandum 12-07, retrieved from LINK. This Information Memorandum (IM) provides information that State child welfare agencies can use to establish and maintain CQI systems. It also provides information on claiming allowable Federal financial participation costs for CQI systems.
  • Dedhia, N., (2008), Continuous Improvement Requires a Quality Culture, retrieved from LINK. The article describes in detail the culture needed in organizations to set the stage for implementing and sustaining continuous quality improvement.
  • Dever, A., Public Health Practice and Continuous Quality Improvement, Improving Outcomes in Public Health Practice: Strategy and Methods [chapter and book], information retrieved from LINK. This chapter defines CQI in health care settings and, in chart form, clearly delineates in detail the differences between quality control/assurance and CQI, and “conventional thinking” and “CQI thinking.”
  • Getting Ready for CQI: A Webinar for Child Welfare Agency Directors and Administrators, (2013), North Carolina Department of Health and Human Services, Division of Social Services, Child Protective Services, retrieved from LINK; accompanying handouts, including a pre-implementation data gathering tool, are retrieved from LINK. This webinar presents a panel discussion of the North Carolina agency’s efforts to implement its CQI program, focusing on the four key areas of readiness, including agency climate and engagement of partners.
  • Introduction to CQI History, (2004), Loyola Medicine and Illinois Department of Public Health, retrieved from LINK. This article provides a history of CQI, presents the “Plan, Do, Study, Act” methodology and “14 points” to creative management, and discusses institutional barriers to implementation in the emergency medical services field.
  • Juran and Deming, Prism Consultancy, retrieved from LINK. The article discusses CQI in the context of the work of the early pioneers of the process, Dr. J.M. Juran and Dr. W. Edwards Deming, and compares and contrasts the work of the two. Many interesting concepts are discussed, including “Rules of the Road” for overcoming employee fear of change when establishing a CQI culture.
  • Kaizan, a Model for Continuous Improvement, Aberdeenshire Council, Northeast Scotland, paper presented at International Leading Practices Symposium, Queensland, Australia, May 2008, retrieved from LINK (note: to open this file, please paste the complete link into your browser window). This paper provides an overview of improvements made in the services of a Scottish [regional governing] Council, using the Kaizan [Japanese] model of CQI. It highlights the employee contributions and combined benefits of measurable performance improvements and culture change. The article charts the Council’s CQI planning and implementation activities from 2004 to 2008 and notes that the Council’s project earned a European Excellence award.
  • McKay, M., First CQI Projects in Family Support, Mount Sinai School of Medicine, New York, New York, retrieved from LINK. This PowerPoint presentation discusses principles involved in the “Plan, Do, Check, Act” steps of CQI as applied to support for youth and families in the psychiatric setting. CQI actions for individual staff members are stressed.
  • QI 101, Loyola University Health System, retrieved from LINK. This site, in an auxiliary paper, provides a history of quality improvement, illustrated by the concepts of early CQI pioneers Joseph Juran, Philip Crosby, and W. Edwards Deming, and discusses barriers to effective CQI implementation. Additionally, the site discusses the importance of CQI and provides links to numerous other resources that recount the history, tools, and techniques developed and used in CQI.
  • Quality Improvement in Social Care, Healthcare Quality Improvement Partnership [of the United Kingdom], retrieved from LINK. This site proposes that social care [social services] systems in the U.K. should implement systematic CQI systems that mirror those of health care, and it provides a discussion of the cycles of CQI.
  • Sollecito, W., and Johnson, J., (2012), The Global Evolution of Continuous Quality Improvement: From Japanese Manufacturing to Global Health Services, retrieved from LINK. The article posits that CQI, used very successfully in other industries, remains a critical need for much of the Nation’s health care field. Detail is provided about the “evolution of the quality movement,” beginning with the Japanese auto industry in 1950.
  • Sperber, K., CQI 101: Building and Sustaining an Effective Infrastructure, retrieved from LINK. This PowerPoint presentation provides information on the formation of a CQI system from beginning to end, stressing the major components that make up each step of the system; short- and long-term benefits of a CQI program are clearly stated.
  • Tout, K., Isner, T., and Zaslow, M., (2011), Coaching for Quality Improvement: Lessons Learned from Quality Rating and Improvement Systems, retrieved from LINK. This research brief summarizes the results of a full research study done to determine whether coaching and mentoring in Quality Rating and Improvement Systems [QRIS] in early childhood settings resulted in more positive outcomes for both practitioners and children. The brief concludes with an overview of implications for coaching in QRIS early childhood settings.
  • Using CQI to Improve Child Welfare Practice, (2005), National Child Welfare Resource Center for Organizational Improvement, retrieved from LINK. This article provides a discussion of the results of a meeting of 28 national child welfare CQI experts who were brought together to develop a framework for the implementation of CQI in child welfare agencies; the article includes information on establishing a CQI-receptive culture.
  • What is Continuous Quality Improvement?, National Resource Center for Community-Based Child Abuse Prevention, retrieved from LINK. The article explains the “Plan, Do, Study, Act,” model of CQI and also discusses the differences between evidence-informed practice, evidence-based practice, and evidence-based programs.
  • Wulczyn, F., Chapin Hall, (2007), Monitoring Child Welfare Programs: Performance Improvement in a CQI Context, Center for Children at the University of Chicago, retrieved from LINK. The authors explain the major steps involved in a CQI program, discuss the cycle of improvement, and provide examples to clearly explain each step.

Data Quality, Decision-Making, and Processes

  • Adams, C., Crowe, P., Neely, A., The Performance Prism in Action, retrieved from LINK. The authors illustrate the practical application of a new measurement framework for companies, used extensively in the United Kingdom, called The Performance Prism; they address the limitations of traditional measurement frameworks, presenting their model that has extensive stakeholder involvement.
  • Carrilio, T., (2008), Accountability, Evidence, and the Use of Information Systems in Social Service Programs, Journal of Social Work, April, Volume 8, retrieved from LINK. This article discusses the importance of social workers accurately documenting service activities and outcomes, particularly with the advent of evidence-based practices; further, it describes a “multiple case study” of social workers’ use of computers and data systems.
  • Chapman, A., [report presenter], (2005), Principles of Data Quality, Global Biodiversity Information Facility, Copenhagen, Denmark, retrieved from LINK. This paper highlights the importance of data quality in various occupations, but as specifically geared to primary species occurrence and environmental assessment; the importance and necessity of data quality and proper documentation in business, medicine, and other fields is emphasized.
  • Developing a Plan for Outcome Measurement, Strengthening Nonprofits – A Capacity Builder’s Resource Library, retrieved from LINK. This e-learning module discusses and provides suggestions for clarifying goals, assembling a planning team, developing outcomes, crafting logic models, and devising performance measures; additionally, more Web sites are suggested for further learning.
  • Dietrich, R., (2010), Data-based Decision Making Cultures; Four Assumptions, Association for Positive Behavior Support, retrieved from LINK. This presentation describes four assumptions necessary for data-based decision making to be effective, and explores the truthfulness of the assumptions. Additionally, discussion is provided of how decisions based on data are becoming increasingly regarded as an ethical obligation by some helping professions.
  • Ensuring Quality in Contracted Child Welfare Services, (2008), U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, retrieved from LINK. This article describes ways that public child welfare agencies can better monitor quality and outcomes within the State agency’s quality assurance/improvement system through contracts with service providers.
  • Fayyad, U., (2002), Datamation, Drilling Down with a Data Mining Pioneer, retrieved from LINK. The author defines drilling down/data mining and provides guidelines and tips for mining data.
  • From Data to Decisions II, Partnership for Public Service, IBM Center for the Business of Government (October 2012), retrieved from LINK. This publication discusses in detail an analytics approach to managing organizations, which allows for the unearthing of hidden problems, monitoring of progress, measuring of performance, and providing of a vision for what should be done better. Clearly described steps are articulated to help agencies begin to use data as a major component in moving forward and measuring progress.
  • Gwet, K., (2012), Handbook of Inter-Rater Reliability, Third Edition: The Definitive Guide to Measuring the Extent of Agreement Among Multiple Raters, retrieved from LINK. This information serves as a handbook for researchers, practitioners, teachers, and students, and provides, for both researchers and non-researchers, well-organized and readable materials on inter-rater reliability.
  • Liddy, C., Wiems, M., and Hogg, W., (2011), Methods to Achieve High Interrater Reliability in Data Collection from Primary Care Medical Records, Annals of Family Medicine, retrieved from LINK. This article deals with inter-rater reliability in the medical setting and makes recommendations for increasing reliability.
  • Reveal, E., and Helfgott, K., (2012), Putting the Pieces Together: Guidebook for Fact-Based Decision Making to Improve Outcomes for Children and Families, Washington, DC: Technical Assistance Partnership for Child and Family Mental Health, retrieved from LINK. This article presents helpful guidance to human services agencies/employees that are just beginning their “managing by data” journey to those who are already in a data-driven culture, with the goal of achieving better outcomes for children and families.


  • Collin-Camargo, C., McBeath, B., and Ensign, K., (2011), Privatization and Performance-Based Contracting in Child Welfare: Recent Trends and Implications for Social Service Administrators, Administration in Social Work, 35:494–516, Volume 35, Issue 5, retrieved from LINK. The authors review information about privatization and performance-based contracting to reveal themes around key management tasks and competencies within these settings. These themes are then considered in light of existing literature, and implications for administrative practice are discussed.
  • Exploring Five Core Leadership Capacities: Engaging in Courageous Conversations, Ontario Ministry of Education Leadership Strategy Bulletin, Winter 2009/10, retrieved from LINK. The article defines, as one core component of desired leadership capacities, “courageous conversations” in organizations, and discusses in depth the need and benefits to organizational change and health from having such conversations.
  • Heifetz, R. A., Linsky, M., & Grashow, A., (2009), The Practice of Adaptive Leadership, Boston, Massachusetts: Harvard Business Press, with information [review] retrieved from LINK. According to the reviewer, the authors define authentic leadership as “the practice of mobilizing people to tackle tough challenges and thrive,” with the crux of adaptive leadership practice being that if a system is faulty, it must be analyzed, diagnosed, and remedied by taking risks and challenging the status quo to provoke change. Each of the book’s five sections takes the reader through the steps involved in learning/adopting adaptive leadership practices.
  • Lichtenstein, B., and Plowman, D., (2009), The leadership of emergence: A complex systems leadership theory of emergence at successive organizational levels, retrieved from LINK. The authors describe “complexity science” and how it reframes leadership by focusing on the dynamic interactions between individuals and how those interactions can result in “emergent outcomes.” An analysis of three empirical studies takes place, leading to development of a “Leadership of Emergence.”

Systems Change

  • Connor, D., (1993) [book updated 2006], Managing at the Speed of Change, with information retrieved from LINK [overview presented by Vinson, J., (June 2010)]. The book helps agency leaders learn how to orchestrate transitions vital to their organizations’ success; the dynamics of change are explored and, rather than focusing on what to change, the goal of the book is to show readers how to change.
  • Franks, R., Implementation Science: What Do We Know, and Where Do We Go from Here?, Connecticut Center for Effective Practice, retrieved from LINK. This presentation provides an overview of implementation science and discusses different implementation science theories, such as those of (1) Simpson, (2) Greenhalgh, Robert, Macfarlane, Bate, and Kyriakidou, and (3) the National Implementation Research Network. The steps and stages of implementation are discussed, as well as the importance of having an implementation framework when making practice and process changes.
  • Fullen, M., (2004), Systems Thinkers in Action: Moving beyond the standards plateau, retrieved from LINK. The article intends to promote debate, within and beyond the teaching profession, on how the nature of leadership in any major field increasingly must recognize that sustained improvement, via continuous quality improvement and capacity building, is not possible in systems unless they are constantly moving forward.
  • Leading Fearless Change!, (2013), Russell Consulting, retrieved from LINK. This presentation posits a “natural” model of how people respond to change, actions to assist others during the emotional journey through change, the origins of resistance, and how to deal with resisters.
  • Positioning Public Child Welfare Guidance [PPCWG] Reflective Thinking Guides [on topics such as Strategic Partnerships, Change Management, Strategy, and many more], retrieved from LINK. The guides offer practical suggestions, including many hypothetical questions that agencies/leaders should ask themselves in close examination and to better know how to move forward with forming partnerships, planning strategies, and managing by data.
  • Wandersman, A., Chien, V., and Katz, J., (2011), Toward An Evidence-Based System for Innovation Support (Tools, Training, Technical Assistance, Quality Improvement/Quality Assurance) for Implementing Innovations with Quality to Achieve Desired Outcomes, University of South Carolina, retrieved from LINK. This paper provides theory, research, and action for evidence-based innovation systems, with the major goal of improving the practice of evidence-based support to build capacity to implement quality innovations