Defining CQI and Building a CQI Framework

Continuous quality improvement (CQI) is the complete process of identifying, describing, and analyzing strengths and problems and then testing, implementing, learning from, and revising solutions. CQI relies on a proactive organizational and/or system culture that supports continuous learning; it must be firmly grounded in the overall mission, vision, and values of a child welfare agency or system. Perhaps most important, CQI depends upon the active inclusion and participation of staff at all levels of the agency/system, children, youth, families, and stakeholders throughout the process (Using CQI to Improve Child Welfare Practice, 2005).

More simply defined, CQI is an organization-wide system that involves the identification, dissemination, and measurement of best practices, as well as enhancement of processes and systems, to improve overall agency functioning and ensure more positive outcomes.

A key principle of CQI is that those who are closest to the work are the true experts in the field. Consumers, such as parents, children, and youth, and external stakeholders, such as courts, Tribes, and service providers, have much to contribute from completely different perspectives and should be incorporated by agency leaders into all phases of the CQI process. Youth, birth parents, and foster parents should be assigned to working CQI teams or committees to ensure a holistic perspective.

Some State child welfare agencies are very open and transparent, and fully involve stakeholders, families, and youth in their assessments and strategic planning activities, including their Child and Family Services Plan and Program Improvement Plan assessment and feedback. Consumers and stakeholders are made to feel such a part of these agencies that when an agency celebrates its successes, the stakeholders and families feel a special pride and that they, too, have succeeded.

This section discusses the activities that make up a well-functioning CQI system, focusing on the importance of aligning CQI with an agency's mission, values, vision, and practice. It also outlines distinct differences between quality assurance (QA) and CQI activities, and discusses the critical importance of integrating staff, external stakeholders, and consumers into CQI processes. Finally, it defines and explains the development of outcomes and measures of success that should be used to realistically measure the results and outcomes of the CQI initiative's various components and determine whether improvements are needed to improve practice and processes. It also stresses the importance of using measures as a “bridge” to connect data and intended outcomes.