Research and Evaluation Projects

Quality Assurance / Continuous Quality Improvement

The Maryland’s Quality Assurance (QA) or Continuous Quality Improvement (CQI) Process was revised in 2011 based on findings from RYC research.  The QA/CQI Process is designed to assess and evaluate the practices and policies of the Local Department of Social Services based on the child welfare indicators of children’s safety, well-being, and permanence.  The new QA/CQI Process currently assesses five program assignments within the child welfare system: The five program assignments are:

  • Investigations
  • In-Home Services
  • Out of Home Services
  • Adoptions
  • Resources Homes

The QA/CQI Process determines gaps among services, sets expected performance and outcomes, and identifies actual performance and outcomes. In collaboration with Maryland’s Department of Human Resources (DHR), each jurisdiction completes the QA/CQI process every three years. The CQI Process is composed of three main parts:

  • LDSS Self-Assessment
  • DHR/SSA Quality Assessment (QA) Review
  • Continuous Quality Improvement Plan (CIP)

The QA Process also uses the Results Accountability (RA) framework to report and track data on selected Child Welfare indicators.  The framework is structured around these four questions:
How well did we do?
How well did we do it?
Is anyone better off?
The “Story behind the data”
LDSS Self-Assessment: Each jurisdiction completes a self-assessment on their agency prior to the on-site review.  This report is data driven and requires six different sections:

  • Description of the Jurisdiction
  • Description of the LDSS
  • Stakeholder Focus/Work Groups
  • Result Of the Citizen’s Review Board for Children (CRBC) Review
  • Analysis of CQI Indicator Data and designation of Areas of Strength and Areas Needing Improvement.
  • Additional Areas of Discussion

The self-assessment needs to be approved by DHR before the on- site visit can occur.

DHR/SSA Quality Assessment (QA) Review: Prior to the onsite visit, a case review is conduct on a random sample of 30 cases, 10 cases from each program assignments (In-Home, Out of Home, CPS).  During the four day on-site review, case related and stakeholder interviews are conducted.  Both qualitative and quantitative data from the interviews are used in the On-Site Report. 

Continuous Quality Improvement Plan (CIP):  Based on data from the Results Accountability indicators, the Self-Assessment and the On-Site Report, the jurisdiction’ strengths and areas needing improvement (ANI) are identified.   Once identified, a Continuous Quality Improvement Plan (CIP) is compiled to show how the jurisdiction will maintain their strengths or improve on their ANIs.  Once the CIP is approved by DHR, continuous 6 month monitoring occurs for each jurisdiction.  

Ahn, H., Esaki, N., Gregory, G., Melz, H., O'Connor, J., & Shaw, T.V. (December 2010). Quality Assurance Processes in Maryland Child Welfare. 4th Annual Child Welfare Accountability Report. Baltimore, MD: Ruth H. Young Center for Families and Children at the University of Maryland School of Social Work.

DePanfilis, D., Esaki, N., Gregory, G., Hayward., A.R., Shaw, T.V. (December 2009). Quailty Assurance Processes in Maryland Child Welfare. 3rd Annual Child Welfare Accountablilty Report. Baltimore, MD: Ruth H. Young Center for Families and Children at the University of Maryland School of Social Work.