Questioning and thinking reflectively are of critical importance in implementing a continuous quality improvement (CQI) system, as is a thorough understanding of the continuous learning atmosphere instilled through CQI. Management and administration, including unit supervisors, should constantly reinforce with staff that there are always better ways to do things. They should not only encourage staff to question the status quo, but also reward curiosity, creativity, and bold thinking. Staff at every level should be constantly encouraged to seek ways to improve their own performance, independent of agency requirements.
A continuous learning environment will:
- Provide openness and transparency about agency activities, goals, and performance
- Promote the free sharing of information at all levels to increase knowledge
- Encourage and enable questioning, feedback, and recommendations/input from all strata of staff to all levels of administration
- Minimize bureaucratic controls that hinder implementation of improvements and better practices
- Promote ownership and involvement in new practices and processes
- Recognize and reward creative thinking
- Encourage analysis and learning from mistakes and failures
- Engage staff in “sense making” or reasoning about case practices and CQI activities
- Foster understanding of, and pride in, the learning culture
- Promote trust in leadership
As succinctly described by Michael Fullen in his 2004 article, Systems Thinkers in Action: Moving beyond the standards plateau, “A learning organization is a place where people are continually discovering how they create their reality and how they can change it.” A focus on continuous learning, combined with the commitment and involvement of staff at all levels to collaboratively examine and improve practice, will engender excitement for improving the status quo and encourage a CQI-rich environment to emerge.
Once a learning culture has been created within the agency and a comprehensive continuous quality improvement system set in motion, there must be unwavering commitment on the part of agency administrators, teams, and individual staff members to maintain the process. It may be easier to sustain interest and activity among external stakeholders and consumers, at least initially, as they may view anticipated changes more enthusiastically than do some staff who are dealing with the loss of established roles and ways of doing things. Maintaining an institutional improvement path is sometimes more daunting and time-consuming than the initial task of gaining staff enthusiasm and support, but it can be done.
In developing an environment that identifies and sustains needed change, it is particularly critical to convert small individual and project successes by field personnel into sustained performance. Ultimately, the success or failure of the enterprise will likely hinge on the degree to which leadership engages its frontline staff in the CQI activities. It may take months for new processes to feel routine and for consumers and staff to perceive the benefits of change initiatives and an integrated CQI system. Regardless, the temptation to move away from a continuous improvement mindset must be avoided. The focus should be on consistently encouraging employee buy-in and enthusiasm for meaningful change and its rewards.