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September 2013Vol. 14, No. 7Promoting CQI: The NRC on Organizational Improvement

By Peter Watson, Director, National Child Welfare Resource Center for Organizational Improvement

There is a growing consensus in the child welfare field that we need to incorporate the ongoing use of reliable data and information into our management, supervision, and practice. Over the past 20 years, the child welfare field has dramatically expanded data collection and analyses focused on practice and outcomes. Most States leveraged Federal funds to develop comprehensive, automated data systems, and most also implemented qualitative case review processes. As a result, child welfare agencies now have access to numerous reports from various quantitative and qualitative data sources that can help track critical outcomes and related practice. Nevertheless, most agencies also struggle with how to effectively use the enormous amount of information. Continuous Quality Improvement (CQI) offers a way forward that addresses this challenge.

The concepts of CQI are couched in the learning organization literature, with "learning organizations" described as open to change, supportive of adaptation and continuous improvement, and willing to address important organizational challenges.1The Children's Bureau (CB) has long promoted and supported CQI approaches and principles in child welfare. As part of its Training and Technical Assistance (T&TA) Network, CB funds the National Child Welfare Resource Center for Organizational Improvement (NRCOI) that has worked for the past decade to help child welfare agencies define and implement CQI approaches. In a 2002 framework, the NRCOI identified five key processes in the quality assurance (QA) cycle that are still widely cited:

  • Adopt outcomes and standards
  • Embed QA throughout the agency
  • Gather data
  • Analyze data
  • Use information to make improvements

In 2005, the NRCOI and Casey Family Programs convened a diverse panel of experts and child welfare stakeholders to refine this model and promote a practical CQI framework and approach. This framework informs the NRCOI's work with States and defines CQI in child welfare as:

the complete process of identifying, describing, and analyzing strengths and problems and then testing, implementing, learning from and revising solutions. It relies on an organizational culture that is proactive and supports continuous learning. CQI is firmly grounded in the overall mission, vision and values of the agency. Perhaps most importantly, it is dependent upon the active inclusion and participation of staff at all levels of the agency, children, youth, families, and stakeholders throughout the process.

The NRCOI's training and technical assistance (T&TA) has supported multiple States in developing and refining their CQI systems in recent years. We continue to offer a range of resources and services that can assist child welfare agencies in their CQI development efforts, including the following:

  • Short- and long-term T&TA for State child welfare agencies. This includes facilitated CQI assessment and action planning sessions focused on the CQI functional components described in CB's Information Memorandum; CQI skills training and coaching; CQI leadership coaching; qualitative review process development and implementation; and other topics.
  • A CQI research project site that presents the results of a 2012 survey on State CQI systems. The project site includes descriptions of 26 State CQI systems, topical summaries of State approaches to key CQI functions, and other CQI resources agencies can use to explore different CQI models and approaches.
  • An active CQI Peer Network composed of professional CQI staff from State and local child welfare agencies across the country. The NRCOI facilitates quarterly webinars focused on issues of interest to CQI Peer Network members, sends out information requests in response to needs among members, and posts CQI resources and materials.
  • The NRCOI Child Welfare Matters newsletter that often includes a "CQI Corner" column. The most recent issue focused on "Leading Adaptively in Child Welfare" and includes the column "Exercising Leadership in CQI" that links adaptive leadership techniques to CQI activities.

We are currently developing a series of CQI working papers focused on key aspects of CQI systems in child welfare. The NRCOI first developed draft papers for use in a national CQI Working Meeting convened in August 2012. These papers will soon be revised and posted on the NRCOI website.

As jurisdictions continue to refine their CQI systems, with much of the work focused on better using CQI results to drive systemic change, the NRCOI will continue to develop, gather, and share resources and provide targeted T&TA to assist the child welfare field in this critical work.

1 Behn, Robert D. (2006) Performance leadership: 11 better practices that can ratchet up performance. Retrieved from http://www.businessofgovernment.org/report/Behn-PerformanceLeadership

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