The Basic CQI Cycle
CQI is a method for problem solving that has been applied across fields for nearly a century. As a result, there are a number of different models that describe the CQI process. All of them, however, boil down to the same four fundamental phases: Plan, Do, Study, Act. In a child welfare context, these stages unfold as follows:
- Plan. The CQI cycle begins when the agency establishes baseline performance on the outcome of interest and identifies an intervention that is expected to improve that outcome. Among other considerations, the choice/design of the intervention should be supported by research evidence that demonstrates its effectiveness. At the very least, the intervention must be grounded in a theory of change that clarifies the process by which the intervention is expected to produce an improvement in the outcome.
- Do. Implementing a new intervention requires the agency to invest in three major areas: the quality of services to be delivered, the processes by which they are delivered, and the capacity of the agency to deliver them with fidelity. Quality and process refer to the “what” and “how” of intervention. Capacity investments are the resources that the agency will allocate to ensure that the intervention is implemented according to process and quality standards.
- Study. Over the course of the implementation period, the agency conducts process evaluation to monitor the extent to which the intervention is being implemented with fidelity to its design. After an established performance period, the agency measures the outcome of interest again to determine whether the intervention has had its intended effect.
- Act. Finally, the agency uses findings from the process and outcome evaluations to make decisions about its future investments. At this stage, the agency must answer a number of questions: To what extent does the original performance problem still exist? Does the degree of progress made toward the target outcome support the theory of change underlying the intervention? Are adjustments to the intervention (i.e., the agency’s process, quality, and capacity investments) required? The answers to these questions may lead the agency to continue with the selected intervention, modify the intervention, or revisit the original conceptualization of the problem. From there the cycle begins again.
In future posts, we’ll talk more about the major principles underlying CQI, the analytic and decision making tasks involved at each stage, and the structural, functional, and human capital resources required to develop capacity for high-quality, sustainable CQI systems in child welfare.