Ready for Liftoff: Continuous Quality Improvement in Minnesota
After extensive planning, Minnesota’s child welfare agency is on the threshold of full, statewide implementation of its revamped continuous quality improvement (CQI) system.
The Minnesota Department of Human Services Child Safety and Permanency Division (CSPD) is a state-supervised, county-administered child welfare system. The CSPD CQI Section has piloted every component, and CQI champions from multiple areas across the CSP Division are poised to support the new process.
For years, Minnesota had been using a quality assurance process of revisiting the same county agencies a few years apart. Year after year, the reviews uncovered the same issues and areas needing improvement. While agencies executed program improvement plans and had short periods of change, meaningful changes weren’t sustained long term. It was clear that Minnesota’s method of assessing its child welfare work needed to change. Rather than telling the counties they just had to try harder—they were already working very hard—the state instead needed to examine system barriers and help the counties figure out how to work differently continuously over time.
Minnesota’s CQI Team brought a strong vision for the project, while the Center’s team started with a ground-zero assessment. After some frank and transparent conversations, the Center adjusted its team to better reflect the expertise necessary to meet CPSD’s needs and get the partnership off on a productive course. Munsterman describes the partnership, saying “We got some really good input and feedback from our consultants. So it wasn’t just, ‘Do what we want you to do and what we’re telling you.’ With their input, we’ve been able to continue to move through this process and have an excellent product in the end.”
“They’ve helped keep us sometimes grounded and sometimes elevated. They’re very good at keeping us focused, giving us other alternatives or ideas,” said Lori Munsterman, CQI Unit Manager.
The Center’s team of Tailored Services Liaison Jeremy Harvey, subject matter expert Cricket Mitchell, and Evaluation Coach Matt Davis really listened to the CQI team and supported their vision by providing core CQI teams and subteams shoulder-to-shoulder consultation, facilitation, and assessment. With the Center’s support, the CQI Team developed workgroups, co-created a theory of change and plans for implementation and training, assessed readiness, and piloted and refined the CQI process components. They have recruited and engaged CQI champions outside of the CQI Unit, making connections across the CPSD between Safety, Training, Foster Care, Indian Child Welfare, and African American Child Well-Being (AACWB) Units. CQI champions participate in subteams, learn about the CQI process, and contribute ideas about how their units will apply and benefit from the CQI process.
The Center’s consultants have been involved and available, identifying resources, tools, work plans, and templates for the team’s consideration so the team didn’t need to build a process from scratch. The Center brought training and technical assistance around things like developing the theory of change and how to code qualitative, narrative information for analysis, as well as specialized consultants for short-term help around the communication plan. Using the theory of change as a touchstone, the consultants guided CQI Team members to consider and amend some of their initial thinking. For example, the CQI Team originally planned to check the box of stakeholder feedback through a small CQI Advisory Council with one or two individuals to represent different populations of the community. Though it will take more work and coordination, the CQI Team now plans to engage larger community groups at different phases of the CQI process to share information and get more meaningful feedback before prioritizing what to tackle first.
“A lot of what we do is modeled after what the consultants do. They’ll sometimes teach us how to do something, and then we do it the first time with them. And then the next time without them. So, it was interesting to see the parallel between how we might function as a CQI Change Management Team and how they’ve provided us support along the way, and how that mirrors our work with families.”
As the work with the Center’s consultants progressed, the CQI Team has seen its own capacity grow to deliver shoulder-to-shoulder support to other units within CPSD. Recently, the CQI Change Management Team partnered with the newly-formed AACWB Unit to guide the development of a theory of change with causal pathways and an implementation workplan. Jennifer Droneck, Human Services program consultant for CSPD’s CQI Team, explained that “a lot of what we do is modeled after what the consultants do. They’ll sometimes teach us how to do something, and then we do it the first time with them. And then the next time without them. So, it was interesting to see the parallel between how we might function as a CQI Change Management Team and how they’ve provided us support along the way, and how that mirrors our work with families.”
Like so many organizations, Minnesota faces the challenge of sustaining efforts after leadership turnover. Munsterman, who managed the CQI Unit since the project’s inception, recently left the agency and Droneck has stepped into her shoes as CQI Manager. Given the foundations for sustainability the team has put into place, they are confident the CQI process will continue through the change. Along with the leadership team, staff, workgroup leads, and cross-area CQI champions have been heavily engaged in the design and piloting of the CQI process. Thinking and skill building across CSPD areas have shifted from quality assurance monitoring of years past to the ongoing, continuous process of identifying and addressing systemic barriers and influences. Droneck explained, “We did it through a pandemic. We all had to work remotely. The Center’s team couldn’t come in person anymore. We could have given up, just let it go back to what we did before, because that would have been really easy. I think we ended up seeing them more, bringing in their expertise more than we would have otherwise.” Summing it up, Droneck said, “We have all persevered, and we’re dedicated to lifting this off, and we’re still moving forward. It’s taken 4 years to get here, but this whole process has evolved as well. It will evolve as we move forward, too.”
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