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Continuous Quality Improvement (CQI)

Continuous Quality Improvement (CQI), sometimes referred to as Performance and Quality Improvement (PQI), is a process of creating an environment in which management and workers strive to create constantly improving quality.

Continuous Quality Improvement (CQI) is:

  • A theory-based management system that looks at processes/outcomes
  • Culture change
  • Client-centered philosophy
  • Tools to help quantify what we do
  • A search for common causes of variation
  • Driven by data
  • System, process and client feedback
  • Shared success
  • Long-term approach


What are the key elements of Continuous Quality Improvement?

  • Accountability
  • Driven by good management...not crisis
  • Driven by input from all levels of staff and stakeholders
  • Teamwork
  • Continuous review of progress


What are the internal and external benefits of Continuous Quality Improvement?

  • Improved accountability
  • Improved staff morale
  • Refined service delivery process
  • Flexibility to meet service need changes
  • Enhances information management, client tracking & documentation
  • Means to determine & track program integrity and effectiveness 
  • Lends itself to design of new programs & program components
  • Allows creative/innovative solutions


What are the goals of Continuous Quality Improvement?

  •  Guide quality operations
  • Ensure safe environment & high quality of services
  • Meet external standards and regulations
  • Assist agency programs and services to meet annual goals & objectives


Who is involved in Continuous Quality Improvement?

  • Persons & families served
  • Employees, volunteers & consultants
  • Members of advisory boards
  • Consumer advocates
  • All levels of agency staff


What is the Continuous Quality Improvement team structure?

The Department of Children & Family Services/Office of Community Services' Continuous Quality Improvement process involves two levels of teams. There is a state level Continuous Quality Improvement team and a Continuous Quality Improvement team in each region statewide. The teams include staff from all levels within the agency representing all programmatic service areas as well as community stakeholders.


What are Continuous Quality Improvement team roles? 

  • Chair/Facilitator - facilitates Continuous Quality Improvement meetings, champions the Continuous Quality Improvement process and coordinates input and feedback to staff.
  • Scribe - takes detailed meeting minutes, schedules meeting room.
  • Member - participates in review of issues referred to the Continuous Quality Improvement team; provides feedback to peers, stakeholders and consumers. 


What are the steps in the Continuous Quality Improvement process?

  • Step 1 Identify a need/issue/problem and develop a problem statement
  • Step 2 Define the current situation - break down problem into component parts, identify major problem areas, develop a target improvement goal
  • Step 3 Analyze the problem - identify the root causes of the problem and use charts and diagrams as needed.
  • Step 4 Develop an action plan - outline ways to correct the root causes of the problem, specific actions to be taken, identify who, what, when and where 
  • Step 5 Look at the results - confirm that the problem and its root causes have decreased, identify if the target has been met and display results in graphic format before and after the change
  • Step 6 Start over - go back to the first step and use the same process for the next problem


Who is the Council on Accreditation (COA)?

The Council on Accreditation is an international, independent, not-for-profit, child and family service and behavioral healthcare accrediting organization. It was founded in 1977 by the Child Welfare League of America and Family Service (now the Alliance for Children and Families). Originally known as an accrediting body for family and children's agencies, the Council On Accreditation currently accredits 38 different service areas and over 60 types of programs. Among the service areas are substance abuse treatment, adult day care, services for the homeless, foster care, and inter-country adoption. 

In addition to standards for private social service and behavioral health care organizations, the Council on Accreditation has developed separate business lines for public agencies, networks and lead management entities, opioid treatment programs, employee assistance programs,  and financial management/debt counseling services. 

The Council on Accreditation views accreditation as a catalyst for change that builds on an organization's strengths and helps it achieve better results in all areas. 

For more information on the Council on Accreditation, please visit their website at

Accreditation Information and Reports

What are the Council on Accreditation Public Agency-Performance and Quality Improvement (PA-PQI) 8th edition standards?1: LEADERSHIP ENDORSEMENT OF QUALITY AND PERFORMANCE VALUES

  • The organization's leadership promotes a culture that values service quality and continual efforts by the full agency, its partners, and contractors to achieve strong performance, program goals, and positive results for service recipients.


  • The infrastructure that supports performance and quality improvement is sufficient to identify organization-wide issues, implement solutions that improve overall productivity and promote accessible, effective services in all regions and sites.  


  • An inclusive approach to establishing measured performance goals and client outcomes, indicators, and sources of data ensures broad-based support for useful performance and outcomes measurement.

The Performance and Quality Improvement plan describes how valid, reliable data will be obtained and used on a regular basis to advance monitoring of actual versus desired:

  1.  functioning of operations, that influence the organization's capacity to deliver services;
  2. quality of service delivery;
  3. program results;
  4. client satisfaction; and
  5. client outcomes.


  • Reports, with findings based on improvement efforts, are issued periodically to personnel throughout the agency and provide information useful for improving programs and practice.


  • Staff and stakeholders receive training and support that increases their capacity to participate in, conduct, and sustain performance and quality improvement activities. 

For more information on the Public Agency-Performance and Quality Improvement Standards or any other Council on Accreditation 8th edition standards, please visit their website at 

Customer Satisfaction surveys


Continuous Quality Improvement Reports

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