2001 Finding Better Ways Conference Presentation Recap
Employee Retention Through CQI
Silvio John Orlando and Margaret Murray
Optimist Youth Homes and Family Services
Los Angeles, CA
In two recent publications, Alwon & Reitz (2000a, 2000b) have addressed issues related to employee retention. They cite strong evidence supporting the importance of open and honest communication, relationships, partnerships, and empowerment of staff. The staff of our agency could not agree more and have focused our efforts in these areas on our Continuous Quality Improvement (CQI) program as the cornerstone to reinforce these vital factors.
Optimist Youth Homes and Family Services (OYHFS), like many residential treatment centers, began serving at-risk children at the turn of the century. Since that time the small six bed home has grown to a large multi-service agency serving over 500 children and their families each day. The agency provides diverse programs including intensive residential services with a mental health component, community-based group homes, a non-public school, independent living programs, day treatment services, a county-wide foster family agency, and adoption services. With tremendous program growth, however, many of the administrative infrastructure needs for program support were left unmet. Two years ago the executive director, who had been in place for over 31 years, retired and a new executive was selected. One of the main goals of the new administration was to achieve national accreditation through C.O.A., which was seen as an opportunity to help drive needed program and administrative changes. The addition of an emphasis on CQI would mean not only more accountability but also would allow for increased staff involvement in the running of the organization, which heretofore had been run primarily from the top down. In addition it would enhance communication, create partnerships, and empower line staff through a systematic approach towards program implementation, budget review, performance improvement, and contract compliance. By involving staff and creating an atmosphere of ownership it was hoped that staff would feel more satisfied and remain with the agency.
The CQI Program
The CQI program at OYHFS begins at the staff level with ten Quality Management subcommittees. These include groups made up of staff at all levels across all programs that plan, review, and improve performance in the following areas: record reviews; clinical performance; resource allocation; personnel practices; staff development; outcome measures; food services; programs and audits; safety and infection control, and landscape and campus beautification. Each sub-committee has two co-chairs who in turn sit on the agency wide Quality Management Committee. It is to this committee that all recommendations are made and actions are taken. This overall QM committee becomes the conduit for information sharing as well. This process avoids the common pitfalls of smaller groups in many agencies that labor over tasks only to meet frustration when there is no follow up, thereby negating not only their hard work but the entire process as well.
Top management must promote staff involvement in the CQI process. This means starting on day one with new staff orientation. In addition, time needs to be afforded for staff to participate in the various activities and management must role model by participating themselves. To reinforce the importance of this function the Director of Quality Management in our agency reports directly to the Executive Director. This also means a change of mind set for top management. If the process is to succeed, freedom to make decisions has to be afforded to those involved in the CQI process. Not all decisions need to rise to the top, nor does every top manager need to be involved. Exceptions of course might be in certain fiscal areas or any issue contradicting licensing or regulatory bodies.
The success our staff is enjoying is based on the fact that they feel empowered in examining the areas of agency performance, service delivery, and performance improvement. In one short year they have examined trends and made improvements or new initiatives in the following areas: client injuries; medication protocols; food services; client and referring worker satisfaction surveys; tuition assistance programs; social events for staff; environmental beautification; post-discharge follow-up protocols; an automated clinical record system; planned space requirements during major construction; and a detailed staff survey regarding all aspects of the agency. At the end of the program year each committee reviewed their work through a formal evaluation process laid out by our Director of Quality Management, and subsequently set forth their goals for the following year. As mentioned, the committees themselves did the majority of the work. In some agencies the Quality Management department is totally responsible for the activities associated with those functions. In our agency that department coordinates the work of the agency staff and ensures that it gets done. In our view this difference leads to more staff involvement, understanding, empowerment, and satisfaction.
The bottom line is that staff satisfaction will lead to better retention. It is our premise that true involvement in a meaningful CQI process will lead to better staff satisfaction. If top management supports a "bottom up" management style based on grassroots energy this can lead in fact to more effective management processes. The total staff ownership for the process as outlined will lead to a commitment to the agency. But it is results that count in the long run. In our case after one short year turnover is down 6%. A few more years of this continued success will hopefully lead us out of the crisis that we, like many, face regarding workforce issues in our field.
- Alwon, F., & Reitz, A. (2000a). The workforce crisis in child welfare: An Issue brief. Washington, DC: CWLA Press.
- Alwon, F., & Reitz, A. (2000b). Empty chairs. Children's Voice, 9(6) (November, 2000), 35-37.
Silvio John Orlando, ACSW
Optimist Youth Homes and Family Services
6957 N. Figueroa Street, Box 1076
Los Angeles, CA 90041-1076
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