The Continuous Improvement (CI) Process
Beyond change planning, effective change management relies on having in place a formal process of
continuous improvement (CI). As a result, the priorities established in the change plan lead to
efforts that actually make the priorities within the plan happen. CI efforts also reinforce the
agency’s practice model and overall readiness for change, as they embody the principles and values
of empowerment, learning by doing, innovation, and inclusion.
An effective formal CI process includes three tiers of organization: sponsor groups, continuous
improvement teams, and working committees. Sponsor groups charter and authorize specific projects
and initiatives and provide ongoing oversight for these efforts. Continuous improvement teams
actually manage the CI process, while working committees may be formed to tackle the most complex
assignments that the continuous improvement teams generate, such as designing or revamping a
service, process, program or practice.
An effective CI process is systematic and includes the following general steps a continuous
improvement team should follow for making improvements to areas of priority for the agency:
The DAPIM™ Model and Root Cause Analysis
APHSA developed a model that illustrates this CI process as an ongoing cycle or “flywheel” that
moves through five general stages of Defining, Assessing, Planning, Implementing and Monitoring
(linking back to the previous steps). In its experience supporting agency CI efforts, APHSA finds
that agencies often “jump” from identifying a gap to developing solutions, without taking the time
needed to understand the root causes for why a gap exists. Effective root cause analysis typically
requires “peeling the onion” of a gap one to three times before arriving at its root cause and related general remedy.
The DAPIM™ Model and Performance Improvement Plans (PIPs)
Agency PIPs typically define the CFSR-based performance standards, measure current agency
performance against those standards, and list a set of actions for addressing any current gaps
between these standards and measures. When using the DAPIMTM flywheel technique, agencies enhance
their standard PIPs by also identifying the root causes for their gaps, developing implementation
plans that are more targeted and sequenced over time, and establishing mechanisms for monitoring
for follow through, impact, lessons learned, and adjustments to make. This is in line with the best
intentions of the CFSR and PIP process.
Other Key Processes for Effective Change Management
Data Collection and Analysis
At both the micro change plan level and within targeted continuous improvement efforts, processes
must be in place that yield three types of data to support them: environmental scanning and
baseline assessment; monitoring agency performance and impact on children and families; and
communicating with staff and stakeholders. Characteristics of these data include:
Determining the priorities for continuous improvement efforts is an ongoing role of senior-level
sponsors of CI within the context of an unfolding strategic and change plan cycle. This role
requires applying the CI process to the strategic and change plan efforts themselves, identifying
strengths and gaps within them and establishing new or adjusted initiatives and chartering new or
amended CI teams.
When the continuous improvement process is open and inclusive of all levels of the organization,
stakeholders and partners, the result is more buy-in and commitment versus resistance or confusion,
and more innovative and realistic tactics and initiatives.
Effective agencies use comprehensive communication mechanisms to keep those it serves, staff and
stakeholders informed and build understanding, buy-in and participation.
Celebrating Progress and Taking Risks
It takes a lot of energy and passion to sustain change efforts, and teamwork and collaboration are
essential to maintaining this energy and passion. And there are risks in attempts to innovate and collaborate resulting in
failures, mistakes and frustrations. At times, agencies become risk averse, preferring to do things
within strict compliance boundaries (e.g., placement in licensed homes) instead of taking measured
risks in the best interests of children, youth and families (e.g., placement with relatives).
Well-designed methods and activities to frequently recognize and reinforce the strengths of the
agency and the progress being made by both individuals and teams are essential to maintaining that
energy and tolerating that risk. Recognition programs should stimulate healthy, fun competition and
promote individual and team goals. These programs should at the same time emphasize that
appropriate risk-taking and related failures are constructive learning experiences- indeed, the
primary means for generating important new insights and making important course corrections.
Developing staff capacity and capabilities in alignment with change planning and continuous
improvement priorities requires effective methods for professional development. Staff capacity must
be built to support desired outcomes such as recognizing disparities or appropriately engaging
families. Leadership and supervisory development programs should be built around change and
continuous improvement efforts themselves, versus employing abstract or conceptual curricular
approaches. All staff should understand, buy into, and internalize the critical thinking steps used
in the agency’s continuous improvement process.
Performance Management and Other HR Programs
Evaluations and individual or team development plans are most powerful when they are explicitly
linked to the strategy and change plan. Processes and methods that supervisors use must be
objective, consistent, constructive, and collaborative with those who need to improve their
performance. Hiring and promotions should be based on those positively reacting to the culture of
change vs. those that resist in non-constructive ways. These same principles apply to programs,
functions and individuals within the agency, as well as when establishing and managing contracts with private providers