Monitoring, evaluation and quality improvement
Monitoring, evaluation and quality improvement
This domain covers how services use data to improve, not just to comply.
Core concepts
- Outcome monitoring tracks functioning, goals, satisfaction, and safety, not only attendance.
- Feedback-informed practice routinely asks clients whether sessions helped and adjusts accordingly.
- Fidelity means delivering the model as intended while allowing cultural adaptation.
- PDSA (Plan-Do-Study-Act) cycles test small changes, measure results, and refine.
- Incident review focuses on system causes, not individual blame.
- Qualitative data-complaints, focus groups, peer feedback-reveal what numbers miss.
Worked example
No-shows rise. Plan: test reminder texts for two weeks with 20 clients. Do: send texts 48 hours before appointments. Study: compare the no-show rate with the prior two weeks and ask clients about timing. Act: adopt, adapt, or abandon. Reasoning: PDSA is iterative and low-burden; it uses a comparison rather than assuming causation.
Traps that cost marks
Measuring only attendance. Blaming clients for no-shows. Ignoring missing data. Treating satisfaction as the only outcome. Skipping baseline data. Making a large system change before testing it small.