Quality Management and Improvement
Enhancing the effectiveness and impact of your organisation’s activities often requires a lot of energy and careful trying-out of different things, which may involve a bit of experimentation. A structured way to approach this is through quality management—a process generally understood as comprising three related elements.
The first of these is outcome-focused evaluation. This approach provides a clear framework for assessing how your activities have influenced individuals or groups. Often developed in response to funder requirements, it involves determining whether the intended outcomes have been achieved and whether the planned outputs were delivered. Further information can be found on the evaluation page.
The next element is quality assurance, which examines the functioning of the organisation as a whole. It includes processes such as planning, monitoring, performance measurement, and evaluation—outcome focused evaluation included. If your organisation is large and enters into contracts or service level agreements, many of these elements may already be described and measured.
Lastly, quality improvement refers to the organisation’s ongoing commitment to and ambition for enhancing the care, support, or services it provides. Priorities may shift depending on the organisation’s stage of development, but common areas include volunteer management, governance, reducing waiting times for services to start, and internal focusses such as staff performance reviews. At times, improvement efforts may focus on making more effective use of existing resources – getting better at what you do already.
This article mainly addresses quality assurance and quality improvement. For more on outcome focused evaluation, please refer to the main evaluation page.
Quality assurance
Manchester Community Central describes quality assurance as:
“a way for your organisation to make sure that it is always striving to do the best it can for its service users, members, volunteers and funders. A quality assurance system is a way of checking, through continuous monitoring and evaluation of your performance and through the collection of evidence, that your organisation is continuously improving what it does and how it does it.
"Quality assurance can also be a way of measuring what your organisation does against other organisations doing similar work or against set, recognised standards. The systems of checking your organisation’s quality are ongoing processes to help you ensure that you are always meeting the new standards that are continually being developed.”
Quality assurance in the third sector involves using systematic approaches to ensure services meet expected standards and improve overall effectiveness. It encompasses various activities from self-assessment to external accreditation and helps organisations demonstrate accountability and continuous improvement.
Outcomes-focused evaluation is distinct from Quality Assurance in its emphasis on measuring the impact and effectiveness of services in achieving their desired outcomes. While Quality Assurance concentrates on ensuring that processes, standards, and outputs consistently meet predefined quality criteria, outcomes-focused evaluation examines whether those efforts lead to tangible, meaningful results for the target audience or community. In essence, Quality Assurance ensures that the "how" is maintained to a high standard, whereas outcomes-focused evaluation analyses the "what" in terms of achieved impacts.
Key elements of quality assurance
- Planning: this involves setting clear standards and expectations for the organisation’s work
- Monitoring: (including outcome monitoring) involves regularly tracking your performance against your organisations standards and expectations (or those of an external monitor)
- Evaluation: requires you to assess the effectiveness of programmes and activities (including outcome monitoring)
- Improvement: involves making changes based upon these evaluations to enhance performance
Quality improvement
NHS Scotland’s NHS Education for Scotland (NES) provides a which shows the stages of an improvement initiative or project, stating that “in reality, your journey is unlikely to be linear – you move backward and forward and will likely need to work on different aspects at the same time throughout your project. This is accompanied by a video.
They define 6 stages and 3 key elements as follows:
Six stages:
- Creating conditions: build will and conditions for change
- Understanding systems: understand current systems and opportunities for improvement
- Developing aims: develop aim and change theory
- Testing changes: identify specific change ideas, test and refine using PDSA (Plan, Do, Study, Analyse)
- Implement: implement and sustain where tested
- Spread: share learning and spread where relevant
Three key elements:
- Leadership and teams: make sure that you have the right people involved and get buy in early
- Project management and communication: is especially important at the beginning of the project but should continue throughout the improvement project
- Measurement: is core to your improvement journey. It demonstrates how your changes have lead to improvement and allows you to track your progress
PDSA (Plan, Do, Study, Act)
The PDSA Cycle—short for Plan-Do-Study-Act—is a structured, iterative method used to test and implement changes that lead to continuous improvement in processes, products, or services. It’s widely used in healthcare, education, business, and other fields where quality improvement is essential.
The Four Stages of the PDSA Cycle
| Stage | Description |
|---|---|
| Plan | Identify a goal or problem, develop a hypothesis or change idea, and plan how to test it. Define success metrics and predict outcomes |
| Do | Implement the plan on a small scale. Collect data and document any problems or unexpected observations |
| Study | Analyse the data and compare the results to your predictions. Reflect on what was learned |
| Act | Decide whether to adopt, adapt, or abandon the change. Use the insights to refine the approach and begin the cycle again if needed |
Why Use PDSA?
- Encourages evidence-based decision-making
- Supports small-scale testing before full implementation
- Promotes team learning and reflection
- Drives continuous improvement through iteration
Quality assurance frameworks in the UK
Trusted Standard (formerly PQASSO) and delivered by NCVO is a comprehensive quality assurance system designed for charities and voluntary organisations.
Investors in People is a quality framework for employers, people management and employee wellbeing.
ISO 9001 is a quality management system supported by the British Standards Institute (BSI) https://www.bsigroup.com/en-GB/
Further resources and links
NHS Scotland NHS Education Scotland (NES) – Quality Improvement Zone