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  • Approaches to Quality Improvement

Approaches to Quality Improvement

Resources in this section describe methods for designing and implementing quality assurance approaches that have been successfully applied to child welfare and related fields, including State and local examples.

  • Continuous Quality Improvement (CQI) tools
  • Lessons learned through quality improvement efforts
  • Continuous Quality Improvement (CQI) committees

Child and Family Services Review/Continuous Quality Improvement Processes During the COVID-19 Pandemic 
U.S. Department of Health and Human Services, Administration for Children and Families, Children's Bureau (2020)
Offers tips and resources on how to prepare State reviewers to conduct Child and Family Services Reviews during the COVID-19 pandemic. The resource also provides information on training staff and reviewers remotely and conducting remote interviews.  

Focused CQI Services: A Guide for Agencies (PDF - 314 KB) 
Capacity Building Center for States (2016)
Presents a framework and recommendations for child welfare agencies seeking to assess the capacity of the continuous quality improvement systems. The resource helps State, Tribal, and other child welfare agency leaders prioritize areas that need attention and take action to bring about meaningful change. 

The National Quality Improvement Center on Tailored Services, Placement Stability, and Permanency for Lesbian, Gay, Bisexual, Transgender, Questioning, and Two-Spirit Children and Youth in Foster Care (QIC-LGBTQ2S) 
Works to develop best practices and programs for child welfare agencies to improve outcomes for children and youth in foster care who identify as LGBTQ2S. The organization works to identify, implement, and evaluate evidence-based or evidence-informed interventions that serve the unique needs of these children and youth. 

National Quality Improvement Center on the Representation of Children in the Child Welfare System
Collects, develops, and communicates knowledge on child representation, including on methods of representing children, the role of the child's legal representative, and how legal representation for the child might best be delivered. The center provides links to webinars, reports, and other resources.

Quality Improvement Center for Adoption & Guardianship Support and Preservation
Works to ensure child welfare agencies provide a continuum of services to children and families beginning with the first entry into the child welfare system and continuing after adoption or guardianship has been finalized. The organization created a permanency continuum framework to guide families and children through the transition from foster care into permanency and to help families maintain stability and well-being after adoption or guardianship is achieved.

Quality Improvement Center for Workforce Development 
Selects, implements, evaluates, and disseminates knowledge about innovative and promising workforce improvement strategies to address child welfare workforce challenges and improve child and family outcomes. The website shares tools and resources on delivering workforce interventions in child welfare. 

Quality Improvement Center on Domestic Violence in Child Welfare  
Works to improve child welfare collaboration with domestic violence services to help families experiencing domestic violence. The website offers resources on its research-based approach along with information on how child welfare systems, domestic violence programs, and other partners can engage people who use violence and work to strengthen protective factors for families. 

Strengthening Families and Continuous Quality Improvement [Webinar]
Center for the Study of Social Policy (2018) 
Offers a webinar featuring tools and resources related to strengthening families and how they can be used to help child welfare programs engage in continuous quality improvement for family engagement efforts. 

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State and local examples

Better Decisions for Better Results: How Two Counties Are Improving the Quality and Consistency of Child Protection Investigations 
Annie E. Casey Foundation (2019) 
Explores the principals of continuous quality improvement (CQI) and describes how county agencies in Ohio and Colorado applied CQI to improve their decision-making and create better outcomes for children and families. 

Child Welfare Program Improvement 
California Department of Social Services 
Shares information on how the California Department of Social Services uses a continuous quality Improvement (CQI) model to develop, evaluate, and refine its policies and programs. The website explains the shift to using a CQI approach. 

Continuous Quality Improvement (PDF - 1,112 KB) 
New Jersey Department of Children and Families (2017) 
Provides information on the New Jersey Department of Children and Families' use of continuous quality improvement (CQI) to improve services. The website defines CQI, lists the goals of CQI, and outlines five stages of CQI. 

Continuous Quality Improvement for Home Visiting Programs 
Washington State Department of Children, Youth, & Families (2019)
Explores how home visiting programs in Washington have been working on continuous quality improvement (CQI) and have developed CQI projects. The website links to the department's website, which provides additional information on data collection and CQI.

Family Home Visiting Continuous Quality Improvement (CQI) Toolkit (PDF - 1,021 KB)
Minnesota Department of Health (2020)
Explains the continuous quality improvement (CQI) system being used by the Minnesota Department of Health's Family Home Visiting program to build capacity and improve outcomes. The toolkit defines CQI and reviews how to start a CQI project, how to form a CQI team, how to choose a CQI method, and more.

How Did Washington, D.C. Develop Its Approach to Meaningful Continuous Quality Improvement?
Casey Family Programs (2020)
Examines continuous quality improvement strategies used by Washington D.C.'s Child and Family Services Agency to help shift from a focus on foster care to a focus on supporting families and preventing entry into out-of-home care. The article reviews the agency's approach, changes that were made, four pillars of performance, self-assessment tools, building capacity for change, and more. 

Wisconsin Child Welfare Continuous Quality Improvement System 
Wisconsin Department of Children and Families
Outlines Wisconsin's use of continuous quality improvement in the child welfare system to gain an understanding of what affects performance and improve practices, processes, and outcomes.

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Spotlight On

Data-Driven Decision Making and Continuous Quality Improvement 

National Child Welfare Workforce Institute

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