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Continuous Quality Improvement

What is CQI?

Continuous Quality Improvement is a process to ensure programs are systematically and intentionally improving services and increasing positive outcomes for the families they serve. CQI is a cyclical, data-driven process; it is proactive, not reactive. A CQI environment is one in which data is collected and used to makes positive changes—even when things are going well—rather than waiting for something to go wrong and then fixing it. CQI is an ongoing process that involves the Plan, Do, Study, Act cycle.


What is the Plan, Do, Study Act Cycle? 

Plan arrow_tailed_tiny_right Plan evidence-informed or evidence-based programs and practices that meet the needs and desires of a targeted population

  • This includes development of a logic
  • model and hiring and training staff that “fit” the requirements of the service model.
  • Good planning means consumers are involved in each step of the process.

Do arrow_tailed_tiny_right
Provide the services as intended

  • Document activities; monitor *fidelity
  • Provide ongoing staff supervision and support
  • Collect data

checkmark._16_black Formally, through evaluation activities, focus groups, needs assessments,  self-assessment, and peer review

checkmark._16_black Informally, through self-reflection, feedback from consumers, staff, funders and other stakeholders.

Study arrow_tailed_tiny_right Learn from the data.

  • Review and analyze data

checkmark._16_black Formally, through staff supervision, full staff meetings, board meetings, and

checkmark._16_black Informally, through daily discussions with staff and participants; self-assessment of job performance, observation of day-to-day participant progress and satisfaction.

Act arrow_tailed_tiny_right Adjust practices based on findings

  • Make decisions on how to improve practices

checkmark._16_black Formally, by adopting new practices, programs, policies and procedures based on findings, and

checkmark._16_black Informally, by making personal adjustments to improve job performance

  • Implement the decisions
  • Repeat steps 1-4

What resources does FRIENDS offer for promoting CQI?

The Peer Review Self-Assessment Tool
This tool includes a large section on CQI.

The Evaluation Toolkit
This toolkit  provides numerous resources for programs in planning and conducting evaluations

Online training on CQI
This training takes the learner step-by-step through the CQI process. CEUS can be earned by taking this and other FRIENDS on-line training courses

Some terms referenced above or related to the topic of CQI:

Evidence-Based Practices- These are approaches to prevention or treatment that are validated by some form of documented scientific evidence. This could be findings established through scientific research, such as controlled clinical studies, but other methods of establishing evidence are valid as well. There are different types of evidence based practices; these include “supported” or “well supported,” based on the strength of the research design.

Evidence-Based Programs- Evidence-based programs use a defined curriculum or set of services that, when implemented with fidelity as a whole, have been validated by some form of documented scientific evidence. Different types of evidence-based programs include “supported” or “well-supported,” based on the strength of the research design.

Evidence-Informed Practices- Evidence-informed practices use the best available research and practice knowledge to guide program design and implementation within context. This informed practice allows for innovation and incorporates the lessons learned from the existing research literature.

For more details related to evidence-based and evidence-informed programs and practices, visit the Evidence-Based Practice Section of the site.

Fidelity- Fidelity to a model means the services provided are faithful to the core components of a curriculum or program as specified by the model developer(s).

To learn more about fidelity to a model and its critical relationship to effective services, visit the National Implementation Research Network (NIRN) website at http://www.fpg.unc.edu/~nirn/default.cfm.

Logic Model-  A logic model is a program map. It is a simple, logical illustration of what the program does, why the program does it, and how observers will know if the program is successful. There is a wide variety of logic-model formats, but most have the same key components including the anticipated outcomes of program and the services provided to achieve the outcomes.

For more information, go to the Logic Model section of the FRIENDS Evaluation Toolkit or the FRIENDS Logic Model Builder housed on the Child Welfare Information Gateway Site.

Quality Assurance (QA)-  This term refers to ensuring that services and products efficiently and reliably satisfy consumer needs. It has a strong emphasis on identifying and providing services most likely to achieve targeted outcomes and consumer satisfaction, and in monitoring whether or not the services were provided.

Quality Improvement (QI)- This term refers to activities for evaluating services and for ensuring that the necessary resources and supports are in place to facilitate ongoing enhancements and improvement. It stresses the use of data in making decisions for program improvement. The National Child Welfare Resource Center for Quality Improvement (http://muskie.usm.maine.edu/helpkids/)  describes QI as a system ”. . .  that supports a child welfare agency’s values, vision and mission through ongoing data and information collection and analysis and the regular use of QI results to make decisions, improve practice and achieve better outcomes for children and families.”

For more perspectives on Quality Assurance and Quality Improvement, visit the following websites: