Frontline Initiative Ethics

State-of-the-Art Definition:
Quality Assurance


Beth Knoblauch is a graduate student in Counseling and Student Personnel Psychology at the University of Minnesota, and is the assistant editor of FI. Beth has experience in both school and residential settings for people with developmental disabilities.

Quality assurance is a catch phrase that most of us have been hearing for awhile. But what exactly does it mean, especially for Direct Support Professionals (DSPs)? At a very basic level, it means that the quality of services we provide extends beyond the minimal level mandated by government or that which is required to stay in business.

The idea of Total Quality Management (TQM) is often associated with quality assurance. TQM means that the organization’s culture is defined by and supports the constant attainment of customer satisfaction through an integrated system of tools, techniques, and training. Many of the concepts of TQM are easily adapted for use in the Human Service Industry.

The main elements of TQM include —

  • Customer-driven quality. The people who receive supports drive our pursuit of quality of services. Feedback is sought from self-advocates and family members as to the quality of services. Goals and strategies are designed in response to this feedback.
  • Strong quality leadership. For TQM to be effective, quality service must be a central value of the organization, with top management having a deep long-term commitment to infusing the goal of quality in the organization’s mission, vision, and values.
  • Continuous improvement. This is often referred to as Continuous Quality Improvement (CQI), and can be defined as the activity of continually improving the process and systems that underlie the services we provide. The quality of services needs to be a continuous discussion, with new goals and strategies for continuous improvement evolving as the discussion progresses.
  • Action based on facts, data, and analysis. In TQM, the short-term fixes are converted into consideration of the long term. Instead of applying band-aids, the time is taken to gather information about how problems have been fixed successfully in the past. All problem-solving approaches are considered so that the best possible solution can be reached to achieve quality of service in the long term.
  • Employee involvement. Frontline employees are of central importance in the TQM process. Employees play crucial roles in the quality of service provided, with management serving these employees with support and training.

Through techniques of quality assurance such as TQM and CQI, all of the people within a system, especially the customers, are highly valued. In an effort to improve the product, data are collected, employees are empowered, and their opinions and those of the customers are sought and re-sought. In human services, the product is the supports that DSPs provide. The more effort that we put into quality assurance, the more we will see our efforts reflected in the quality of life experienced by the people who receive the valuable services provided by DSPs. 

  • Pettinelli, V. D., & Alloy, J. L. (1993). Human services management that works. Worthington, Ohio: IDS Publishing Corporation.

  • Sluyter, G. V., & Mukherjee, A. K. (1993). Total quality management: A paradigm for the ‘90s. Annandale, VA: National Association of Private Residential Resources.