Three-headed hydras do not want to hear crazy-talk about assessing, planning, action and evaluation.

The continuous quality improvement process sets your projects up for success. Or you can follow the whims of three-headed hydras.

Dominic Cappello

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“TERMS OF SURVIVAL” SERIES

This twenty-part series introduces you to twenty key terms used in a local mobilizing process that you and your community will require to survive and thrive during colliding crises. The articles will reference the three-headed hydras of apathy, envy and fear, those people in positions of power who are fighting to keep a broken status quo.

Concept 8: continuous quality improvement (CQI)

CQI is my most favored model for quality improvement when working in the public sector with the goal of getting to results. Many people have invented various forms of quality improvement but if you scratch the service of most of them, you will see that improving a system or solving challenges comes down to four skills: assessing, planning, acting and evaluating. That’s CQI. Radically simple stuff.

How do we begin to define CQI?

CQI is the framework that is guiding all action teams in the 100% Community initiative to ensure the ten vital services for surviving and thriving. Every initiative participant on an action team, each team focused on one of the ten services for surviving and thriving, should have a good understanding of the CQI framework. With some projects the problem identified may be a lack of quality on the part of a particular agency. If this is the case, the action teams may propose to the agency leadership that CQI may be used to address the agency’s challenges.

Action teams may discover in the assessment process that it’s not the quality (or lack of quality) of an organization that’s the problem, instead it may be that there is not an organization to provide the service in a particular community. CQI can guide solutions in this case.

Four Key Components of CQI

The key components of the CQI cycle that we use are assess, plan, act and evaluate.

Assess: Using data, a change agent or action team will identify the magnitude of a challenge, the capacity of local organizations to address a challenge.

Plan: After analyzing data, a change agent or action team will build a measurable plan. This planning starts with researching evidence-informed solutions (to problems associated with lack of timely access to vital services or services lacking user-friendliness). We recommend using a planning tool called a logic model that identifies the goal, inputs/partners needed, activities and measurable outcomes.

Act: Implement plan, working with strategic partnerships, with measurable short term, intermediate and long-term outcomes.

Evaluate: Monitor progress with all stakeholders.

Each of these four components of CQI, or phases, comes with a set of questions to ensure that the change agent or action team is using data to support the improvement process every step of the way.

CQI is a Team Process

CQI cannot operate in a vacuum. Objectives, goals, and implementation are shared responsibilities and activities. When the team shares an understanding of the process, the team can move forward as one. When an action team works together, CQI is fully supported.

Quality Data and the CQI process

We need quality data that is accurate and timely in order to assess a challenge. Data need to be current and analyzed with care to support the entire CQI process. Our action teams focused on the surviving and thriving services will be in contact with a wide variety of agencies providing specific services. Data will need to guide all attempts at improvement.

Who Wants CQI and Who Doesn’t

State and local stakeholders, including elected leaders, have a wide range of reactions to both CQI and a data-driven process. Data, used correctly, will show where systems aren’t working or don’t exist where they should. Many people want this information in the fields of health, safety, education and economic development — and across the public sector. There are also those who prefer to use hunches or opinions to guide work, rather than data.

POSITIVE RESPONSES TO CQI

  • Opens up all aspects of work to possible improvement
  • Frees up ways of thinking about work (we’ve never done it that way before)
  • Reframes the idea of failure and turns it into an experiment.
  • Makes it a process of discovery and adaptation
  • Allows for growth and encourages growth
  • Helps to keep priorities upfront
  • Can change the culture of the office/organization
  • Improves organizational accountability
  • Refines service delivery process
  • Supports flexibility when services need to change
  • Enhances information management, client tracking and documentation
  • Lends itself to design of new programs and program components
  • Allows creative/innovative solutions

NEGATIVE AND DISRUPTIVE RESPONSES TO CQI

  • People may feel threatened by CQI and use of data to assess their work, leading to fears of being judged.
  • People feel a sense of loss as the old way of making decisions (by hunch, or idea of a higher up) is traded in for a data-driven process.
  • It spotlights processes, services or products that aren’t working, and this may shine light on ineffective investments and investors.
  • It may show how certain populations are experiencing social adversity, injustices and health, education and opportunity disparities.

A whim-free zone

CQI will set all your projects up for success. The alternative is following hunches, guesswork or some three-headed hydra’s whim. We don’t have the luxury to follow whims in an era of pandemics and economic disruptions. Not when services for survival are needed.

See 100% Community, Chapter 29: Continuous Quality Improvement Guides Us with Data

The future is what we make it. Join the evolution.

Please excuse any typos as I construct an article at 3am on only one cup of Joe. These stories are mine and mine alone. I do not represent any organization here. If one of my illustrations looks like a real human or three-headed hydra, that’s total coincidence. Words and images ©Dominic Cappello but share with everyone you know. Questions? Answers await you here: www.tenvitalservices.org

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Dominic Cappello

A NY Times bestselling author, social justice activist, Oprah guest, co-author of Attack of the Three-Headed Hydras, 100% Community and Anna, Age Eight.