for Organizational Improvement
A service of the Children's Bureau, a member of the T/TA Network
- QI Corner • QI Links • QI Resources and Publications • Quality Improvement Systems
The Critical Role of Stakeholders
in Continuous Quality Improvement (CQI) (Fall, 2005)
My work with state, county and local child welfare agencies over the past
four years has convinced me that involving internal and external stakeholders
in QI activities bears enormous dividends. Internal stake-holders—staff
from throughout the agency—must be involved to make CQI a transformative
and ongoing agency approach to the work rather than merely a specific
initiative undertaken by a specialized unit. External stakeholders—including
children, youth, parents, caregivers, contracted providers and other community
partners—bring different and valuable perspectives to the process.
They serve as conduits to the larger community, often helping child welfare
agencies communicate more effectively about their strengths and engaging
the community in efforts to make systemic improvements.
Earlier this year, the NRCOI partnered with Casey Family Programs to develop a new Framework for Continuous Quality Improvement (CQI). We convened a meeting of national child welfare experts who represented a multitude of perspectives: public child welfare administrators, supervisors, workers and QI staff; constituents served by child welfare agencies, including caregivers and young people; child welfare researchers and academics; and child welfare policymakers. These national experts created a framework to help child welfare agencies develop and implement CQI systems. (You can download the entire CQI Framework.)
One critical element that emerged almost immediately is the need to involve stakeholders. The message from our national experts was clear and unambiguous: continuous quality improvement will not be successful unless agencies actively involve internal and external stakeholders at all stages of the process. For example, one of the framework’s seven underlying principles focuses on internal and external stakeholders:
CQI is dependent upon the meaningful and active engagement of staff at all levels, children, youth, families, and stakeholders (e.g., caregivers, other public entities, community partners, contracted providers, and courts).
In addition, all of the CQI Framework’s six key components include specific details about involving stakeholders in the implementation of comprehensive CQI systems. Stakeholders should participate in the development of outcomes and indicators, receive training in key CQI skills, assist in the collection and analyses of data and information about agency practices and outcomes, and, finally, make targeted recommendations for improvements as a result of these analyses.
The form of stakeholder involvement may vary across agencies, but some typical approaches related to CQI include the following:
- Stakeholders serve on local, regional and state CQI teams that review data and information and recommend programmatic and practice improvements.
- Stakeholders participate as case reviewers on CQI review teams.
- Stakeholders take part in periodic agency strategic planning activities.
- Stakeholders serve on agency advisory boards.
- Stakeholders serve on CQI advisory boards convened to help develop,implement and oversee CQI initiatives.
Child welfare staff understand intuitively they cannot work with families in isolation given the often immense challenges involved. They must engage other government and community systems to help families access the range of services and assistance they need. In the same way, true CQI initiatives focused on improving outcomes for children and families must actively engage the full range of internal and external stake-holders involved in the work to have any hope of success.
Other QI Corner Topics:
Quality Improvement T/TA
Planned for 2005 (Spring 2005)
Use Your PIP to Help Transform
QA to QI (Winter, 2004)
Child Welfare Leadership and Quality Assurance
(Spring, 2003)
Developing and piloting qualitative case review
systems (Winter, 2003)
