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This guide outlines some of the options for developing and implementing a Continuous Quality Improvement Plan. The main topics covered are:
Continuous Quality Improvement (CQI) is both a philosophy and a method of management that ensures specified standards of quality are met and are being continuously improved. A CQI Plan is a detailed program of improvement resulting from activities that may include but not be limited to internal reviews, internal or external assessments, service user feedback, complaints and other service delivery initiatives.[1]
A CQI Plan is your organisation’s roadmap for improving services, processes, capacity and outcomes. It guides your organisation and its clients, partners, key stakeholders and the Board through the process of monitoring and using data to improve outcomes as part of everyday practice. A CQI Plan allows you to track progress towards planned quality improvements and document what has and has not worked in achieving them.
The most common model used in Quality Management is the PDCA Model: plan→ do→ check→ act cycle. The main steps are:
Plan – identify the result or outcome to be achieved or improved and define what you will do to achieve this
Do – implement the Plan, taking small, controlled steps
Check – evaluate the results and document data on the steps taken and results. Has there been an improvement? If so, why, if not, why not?
Act – take action to standardise or embed the improvements into everyday operations.
Plan
Do
Check
Act
The PDCA Model is a straightforward and systematic method of quality improvement. There are tools available that complement the model, and other quality improvement models and software programs that can also be applied. Choose the method for CQI that is right for your organisation. You may find it useful to review The Smartsheet Company’s overview of CQI methods and tools at:
https://www.smartsheet.com/continuous-quality-improvement
The previous section looked at the approach for a single quality improvement initiative using the PDCA quality improvement model. In this section, we broaden the CQI perspective to look at some strategies for developing a whole, organisation-wide CQI Plan.
The key steps in building a CQI Plan for an organisation are:
You may find it helpful to establish a working group to develop your organisation’s CQI Plan. This is a great opportunity to include client representation, a cross-section of staff at different levels in the organisation and Board representation, since quality is everybody’s business.
The foundation of the CQI approach is a set of principles for quality management and improvement. The eight principles underlying the ASES are:
Develop your organisation’s CQI principles by considering:
Although you may wish to improve many areas in your organisation it is important to be realistic about what is achievable. The CQI approach is based on embedding small, incremental steps that build to large-scale, positive change over time.
For each of the eight ASES Standards start with some ‘broad brushstrokes’ of the key areas for improvement over a three-year period.
Consider:
It can be helpful to use a 3-year matrix (sample below) to guide your development of strategic improvements. Although you don’t need to have improvement action against every Standard, starting off with a table listing all the Standards helps to visualise the ASES framework and to decide the greatest priorities for the next three years.
Three-year strategic improvement matrix sample for one Standard
Time frame → | Year 1 | Year 2 | Year 3 |
ASES Standard ↓ | |||
1 Planning:
Strategic planning |
A CQI governance model sets out the roles and responsibilities, the monitoring and reporting and the overall resourcing of CQI within the organisation.
Consider the following questions when developing your governance model.
Once your organisation has identified draft priorities for improvement you can compile a document for consultation with stakeholders. This describes why the draft priorities were chosen, and how they align with the state priorities for the NSW Specialist Homelessness Program and your organisation’s strategic directions.
The document should also confirm that there are no initiatives planned by other organisations (e.g., DCJ or Homelessness NSW) that address the issues identified.
After consultation and feedback the draft can be revised and submitted for approval using your organisation’s decision-making procedure and instrument of delegations.
Using the PDCA Model apply the steps to each individual improvement project and also identify any specific project governance and consultation arrangements that apply to it.
An individual improvement plan typically includes the following information.
Regular monitoring and updating of your organisational CQI Plan will help to keep quality improvement alive in your organisation.
Consider an annual review of the CQI Plan each year in conjunction with developing your Operational (or Business) Plan, to make sure there is alignment between the two.
Celebrate successes with your CQI Plan, no matter how small. Sharing concrete results helps to keep staff motivated and engaged with the quality improvement process.
[1] Based on the South Australia. Dept. for Communities and Social Inclusion (now the Department of Human Services), Australian Service Excellence Standards: A road map to an excellent organisation, Third Edition, version 7, 2019, p. 82.