This paper describes the CQI (Continuous Quality Improvement) process of collecting and analyzing field level qualitative data in an ongoing cycle. This data can be used to guide decision-making for effective emergency response. When medical and community components are integrated from the earliest stages of the disaster, it allows for true collaboration and supports the CQI process to be responsive to evolving data. Our CQI process identified and addressed gaps in communication and coordination, problems with strategy implementation and, on a conceptual level, gaps in the disaster response model. The 2015 Ebola crisis in Sierra Leone provided a case study demonstrating improved effectiveness when a CQI approach is implemented in the Humanitarian Setting, equally in terms of reducing disease spread, and in meeting the broader needs of the population served.

Structured processes to improve the quality and impact of clinical and translational research are a required element of the Clinical and Translational Sciences Awards (CTSA) program and are central to awardees’ strategic management efforts. Quality improvement is often assumed to be an ordinary consequence of evaluation programs, in which standardized metrics are tabulated and reported externally. Yet evaluation programs may not actually be very effective at driving quality improvement: required metrics may lack direct relevance; they lack incentive to improve on areas of relative strength; and the validity of inter-site comparability may be limited. In this article, we describe how we convened leaders at our CTSA hub in an iterative planning process to improve the quality of our CTSA program by intentionally focusing on how data collection activities can primarily advance continuous quality improvement (CQI) rather than strictly serve as evaluative tools. We describe our CQI process, which consists of three key components: (1) Logic models outlining goals and associated mechanisms; (2) relevant metrics to evaluate performance improvement opportunities; and (3) an interconnected and collaborative CQI framework that defines actions and timelines to enhance performance.

This article describes the clinical supervision of Multisystemic Therapy (MST), which takes place in the context of a quality assurance and quality improvement system that is used to support the transport and implementation of MST nationally and internationally. Information is provided about the assumptions, objectives, structure, process, and content of MST supervision; training and support provided to supervisors; methods used to measure adherence to the supervision model; and, findings supporting linkages between supervision, therapist adherence, and youth outcomes. MST supervision is considered in the context of recent efforts to identify empirically supported approaches to supervision and of recent developments in implementation research.