Continuous Quality Improvement (CQI) Helps Jurisdictions Improve Performance  

How making CQI part of practice and culture can create lasting organizational change  

It can be difficult to know if child welfare interventions are improving outcomes for children and families. This is often because child welfare agencies lack a scientific process to measure the impact of their current services and make changes to improve performance.  

That’s where Continuous Quality Improvement (CQI) comes in. CQI is both a process and a support system that organizations use to identify problems they want to solve, identify strengths that work in their favor, and test and revise solutions that improve outcomes for children. 

It’s a cycle of problem solving in which members of an organization continuously apply the “Plan – Do – Study – Act” process. They plan by analyzing quality data to identify an area for growth and a tangible solution. Next, they test to see if the solution is effective. Then, they study the results. Finally, after assessing if the intervention made a positive difference, they act by continuing, changing, or discontinuing the solution.   

Examples of goals agencies set out to achieve with the CQI process are:   

  • Reduce the time it takes to place children in homes with kinship or foster families.   
  • Reduce the disproportionate number of Black children entering foster care.  
  • Place more children in family home settings compared to group home settings.  
  • Increase engagement in prevention services for families identified as being at risk of entering foster care. 

The CQI process is not a one-time fix for performance shortcomings. Agencies must wrap CQI into their organizational culture. They need to look for ways to better gather and analyze data and test new solutions to improve outcomes for children, youth, and families. A CQI culture includes family feedback and requires staff participation from all levels of an agency. When this organizational culture change happens, routinely assessing data and testing solutions becomes the norm.    

Chapin Hall works with agencies in jurisdictions across the country to implement CQI processes. We work together to identify outcomes and performance priorities to monitor. Then we determine how to assess performance, analyze and visualize data, facilitate meaning-making of findings, and report progress. Most importantly, Chapin Hall helps agencies build capacity to establish CQI processes and foster a data-driven, performance-oriented culture so they can continue this transformational work on their own. 

Using experience from previous work across the child welfare field, policy experts at Chapin Hall have guided several jurisdictions in creating organizational structures that integrate CQI into all they do. We have worked with states — including Tennessee, Florida, Texas, Maryland, Ohio, and Kentucky — as well as Alameda County and the city of San Francisco.   

Creating a CQI culture is increasingly important for public and private agencies as they implement evidence-based prevention services under the Family First Prevention Services Act. To receive funding reimbursement from the federal government for evidence-based prevention services, jurisdictions must formally evaluate services in their Title IV-E Prevention Plans. Alternatively, jurisdictions can secure an evaluation waiver for the services in their plan that the Title IV-E Prevention Services Clearinghouse rates as well-supported. To obtain an evaluation waiver, jurisdictions have to show they have a comprehensive and effective CQI strategy that ensures the evidence-based prevention services are properly implemented and that the strategy achieves the desired goals.  

Key CQI experts at Chapin Hall include Senior Research Fellow Fred Wulczyn, Senior Researcher Lily Alpert, Senior Policy Analyst Yolanda Green-Rogers, and Senior Policy Analyst Katie Rollins. 

If you are interested in learning more about CQI and the work being done at Chapin Hall, please contact any of the experts listed above.