Quality Assurance - Teaching the Elephant to Dance

Susan Hanson

Helpline of Delaware and Morrow Counties

11 West Franklin

Delaware, Ohio 43015

In his book, "Teaching the Elephant to Dance," James A. Belasco says organizations are like elephants, slow to change. But in life, change is inevitable and in business, change is vital. This is true for non-profits as well. Funders and the general public are increasingly looking toward non-profits to be able to demonstrate results in the form of outcomes. The Quality Assurance process is critical to improving not only service delivery, but in determining whether services are making a difference. The road to excellence can be a difficult one, as organizations can tend to resist change and self-examination. The key is not only developing a meaningful and effective quality assurance process that is tied directly into process as well as results, but to have the buy in of stakeholders. This can make the difference between an organization being "stuck" and having an organizational culture that inspires creativity, values quality, and continually works toward improvement and results.

The purpose of the Quality Assurance Process is to provide a means to evaluate appropriateness and efficiency of services by insuring the delivery of high quality services. It is to provide a means to identify and resolve problems in order to pursue continuous quality improvement. QA provides a means for reviewing and evaluating qualifications and skills of those engaged in delivery and management of services. And it provides a means for dissemination of information regarding the quality of services and the effort and practices the agency uses to insure that quality.

Developing a quality assurance plan is a process that involves representatives of the major stakeholders in the organization. It includes both administrative and program areas and standardized tools that can be utilized to audit activities annually and on an ongoing basis. A good plan incorporates the organization's mission, objectives of QA activity, scope of the various services and outcome monitors, requirements of regulatory bodies, details regarding QA committee membership and process, plans for community participation and measuring community impact, administrative procedures, issues around confidentiality and records security, how QA information will be disseminated, and how QA activities will be evaluated.

Outcomes are a key piece of the QA process. Although it looks at internal organizational process and how to improve that, it also must look at service outcomes or results of service provision. There are a variety of outcomes models available. One example is the logic model which looks at outcomes coming from a linear process of inputs(program resources), activities(what the program does with the resources), outputs(the direct products of program activities such as number of classes taught), and ultimately, outcomes(the benefits for the participants). This model looks at a variety of steps including choosing outcomes, specifying outcome indicators, collecting data on your indicators, analyzing and reporting your findings, and evaluate and improve your system of outcome measurement and then use your findings to determine program effectiveness and need for improvement.

Moving an organization toward valuing self-examination and change can be daunting and sometimes even threatening. To be effective, it requires ownership at all levels. One of the most critical components for developing that sense ownership and empowerment is participation. Having consumers, staff, volunteers, and board somehow investing in this process can make it less threatening. Promoting the belief that "we are all in this together" can help to create a vital, meaningful process that leads to actual change.

Quality Assurance is a critical marketing tool for non-profits in this increasingly competitive funding environment. Funders and other stakeholders are looking for excellence and results. Being able to demonstrate that we are truly making an impact will make the difference in being able to survive in this coming century.