Vol. 14, No. 1 October 2012
In Pursuit of Better Outcomes: Putting CQI in North Carolina's Child Welfare Toolbox
In recent years, the federal Children’s Bureau and many practitioners have embraced the concept of using outcome measurement to help child welfare agencies make a difference in families’ lives.
At the same time, there has been a growing awareness that in order to help families in the most effective and sustainable way, we need to apply strategies and tools that have not always been seen as part of the traditional social work toolbox.
Continuous Quality Improvement is one of the most important of these “non-traditional” social work tools.
What is it?
In an outcomes-focused agency, staff and community partners use a standard model to analyze data, develop goals and action steps, and track progress. The figure below depicts the 4-step CQI process model North Carolina has adopted.
North Carolina's CQI Model
REAP is CQI
Focus on Implementation
Years of research tell us that there are specific implementation drivers that determine whether a new model will be successfully adopted and make a difference in agency outcomes (Fixsen et al., 2009). Staff training and supervision, leadership, and effective community partnerships are all implementation drivers.
Promoting a “Learning Culture” in Pilot Counties
For example, agency leadership and culture are critical factors in successful change efforts. In particular, agencies with a “learning culture” are most likely to be successful in implementing new approaches. A learning culture is one which values curiosity and critical thinking, and which empowers all staff—management to front-line workers—to be leaders and innovators.
Implementation science also tells us that to improve outcomes, front-line staff must develop new skills and approaches (Fixsen et al., 2009). That’s why supervisors are a key intervention point for CQI efforts—they’re the ones responsible for continually assessing and developing workers’ skills.
To support supervisors and REAP implementation, in pilot counties North Carolina is focusing on building coaching skills and other supervisory competencies.
CQI and the CFSR
Fortunately, because of REAP, North Carolina is well positioned to show progress in this area. With training and support from federal, state, and county resources, even data-shy child welfare practitioners can add CQI to their toolkit for helping families.
National Implementation Research Network. (2012). Implementation defined. Chapel Hill, NC: FPG Child Development Institute, UNC-CH. http://bit.ly/PwTEAg
Watson, P. (2005). Using CQI to improve child welfare practice: A framework for implementation. Portland, ME: Casey Family Programs and NCROI. http://bit.ly/T2qFuw