Karun K. Singh is a professor of teaching at Rutgers School of Social Work. His teaching, research, and scholarly interests focus on multidisciplinary nonprofit and public human services management, collaborative strategic planning, fundraising and marketing, social entrepreneurship, and microaggressions prevention. He is the co-chair of the New Jersey and the New York City Chapters of the Network for Social Work Management (NSWM). He also serves as an editorial advisory board member of Human Service Organizations: Management, Leadership, & Governance, currently the only social work journal focused on improving the capacity and performance of human service and health care organizations worldwide through high-level research. Dr. Singh teaches advanced-level courses in the Management and Policy (MAP) specialization such as Management, Practice, and Theory, Program Development and Strategic Planning, and Fundraising and Marketing, as well as Diversity and Oppression, a foundation-level course. He is a Faculty Affiliate, Center for Leadership and Management.
Tell us about one specific article or dissemination effort that relates to IIDEA (Inclusion, Intersectionality, Diversity, Equity, and Advancement) that you’ve worked on recently.
I had an article published recently (Singh, 2022) on quality assurance in a new academic resource, the Oxford Encyclopedia of Macro Social Work (OEMSW). OEMSW is an annotated, peer-reviewed, online research encyclopedia of macro social work. The article is based in part on a conference paper I co-presented with two MAP alumni mentees of mine at the NSWM conference in 2021, Singh, Bader, & De La Cruz, 2021.
Quality assurance (QA) is a widely accepted management function that is intended to ensure that services provided to consumers meet agreed-upon standards. Standards come from professional organizations, evidence-based practices, and public policies that specify outcomes for consumers. QA systems consist of measurement, comparison of findings to standards, and feedback to practitioners and managers. It is useful to think of assurance not as a guarantee, but as increasing the probability that the social work transactions will achieve intended results with consumers. There is emerging, but limited, research that indicates QA can be an effective strategy for improving outcomes for consumers. However, a caveat is that one of the major challenges limiting QA’s effectiveness is the lack of sufficient data collected on race and ethnicity, resulting in disparities in the delivery of prevention and treatment services and the achievement of optimal health and human service client outcomes. Another significant problem is the need for overcoming barriers due to structural bias in organizations processing information via their QA systems.
Why did you conduct this study?
OEMSW is the first online research encyclopedia focusing exclusively on macro social work theory, research, and practice. I wrote this article because I was invited by the editors of this new compendium, Dr. Terry Mizrahi and Dr. Darlyne Bailey, to submit a research-based entry on QA. They have known me for many years as a leader in the MAP specialization at Rutgers.
How does it connect with the principles of IIDEA?
Management techniques should be held to the same standards as direct social work practices in terms of demonstrating their effectiveness. This is easier said than done with respect to QA systems, given that they are complex. Due to their complexity in terms of both design and implementation, it is often difficult to state with certainty that they are more than moderately effective across all organizational and service settings. However, despite this uncertainty, a considerable number of recent investigations linking multiple evidence-based practices, strategic frameworks, experience-validated tools, and research-informed methodologies have demonstrated the promise of a high level of QA effectiveness in a wide variety of social work and health care contexts (see, for example, Bradshaw et al., 2016; Hogue et al., 2013; Myszewski & Sinha, 2018; Sedlar et al., 2015; Seidl & Newhouse, 2012; Wandersman et al., 2012). By referring readers to these studies, one can see that in my article I go into a more in-depth exploration that describes the benefits of implementing QA programs, such as the assurance that all clients will receive the same quality of evidence-based services, thereby reducing disparities in diversity, equity, and inclusion (DEI) care provision and increasing outcomes’ effectiveness across different population groups. Also, it highlights opportunities for social work managers to establish frameworks, a form of standardization and best practices to improve the practice of QA in social services.
What are the implications of your work for social policy, practice, or research?
In the last two decades or so, agency executives (as well as researchers and other health and human services system stakeholders) have focused on DEI practice and policy issues, as well as the deployment of modern technological advances in terms of how they impact data-driven decision making and the delivery of services to service recipients (Alberti et al., 2013; Mutha et al., 2012). For example, racial and ethnic disparities have been observed in the health status and health outcomes of Medicare beneficiaries because of poor historical data collection practices. To improve the accuracy of race and ethnicity data, researchers have deployed new techniques such as algorithm imputation, geocoding, and surname analysis (Filice & Joynt, 2017). These techniques can be utilized in combination with older approaches to reducing health care inequities like the advocacy-oriented report card approach (Smith, 1998). Of practical significance is the large number of toolkits that have been developed recently to assist in tackling organizational structural DEI challenges in order to improve the quality of information processed by QA systems (Tellez, 2021).
What is the value of this work? Why is it important?
One of the significant advantages of developing and implementing a QA system is that it helps an agency to be focused on its service mission and, thereby, to remain consumer-oriented across time. The concept of QA shares basic compatibility with human service and social work values. Increasingly, as part of enhanced strategic management initiatives, human service and health care leaders are routinely deploying QA techniques as part of continuous quality improvement and program monitoring efforts to drive the overall strategic planning (Bryson, 2018) and program design (Kettner et al., 2017) practices of their organizations (Golensky & Hager, 2020).
References
Alberti, P.M., Bonham, A.C., & Kirch, D.G. (2013). Making equity a value in value-based health care. Academic Medicine, 88(11), 1619-1623.
Bradshaw, K.M., Donohue, B., Fayeghi, J., Lee, T., Wilks, C.R., & Ross, B. (2016). Evaluation of a standardized method of quality assurance in mental health records: A pilot study. Research on Social Work Practice, 26(6), 686-692.
Bryson, J.M. (2018). Strategic planning for public and nonprofit organizations: A guide to strengthening and sustaining organizational achievement (5th ed.). Jossey-Bass.
Filice, C.E., & Joynt, K.E. (2017). Examining race and ethnicity information in Medicare administrative data. Medical Care, 55(12), e170-e176.
Golensky, M., & Hager, M. (2020). Strategic leadership and management in nonprofit organizations: Theory and practice (2nd ed.). Oxford University Press.
Hogue, A., Ozechowski, T.J., Robbins, M.S., & Waldron, H.B. (2013). Making fidelity an intramural game: Localizing quality assurance procedures to promote sustainability of evidence-based practices in usual care. Clinical Psychology: Science and Practice, 20(1), 60-77.
Kettner, P.M., Moroney, R., & Martin, L.L. (2017). Designing and managing programs: An effectiveness-based approach (5th ed.). Sage Publications.
Mutha, S., Marks, A., Bau, I., & Regenstein, M. (2012). Bringing equity into quality improvement: An overview of the field and opportunities ahead. Center for the Health Professions: University of San Francisco.
Myszewski, J.M., & Sinha, M.N. (2018). A model for measuring effectiveness of quality management practices in health care. Leadership in Health Services, 31(3), 310-325.
Sedlar, G., Bruns, E.J., Walker, S.C., Kerns, S., & Negrete, A. (2015). Developing a quality assurance system for multiple evidence based practices in a statewide service improvement initiative. Administration and Policy in Mental Health, 44(1), 29-41.
Seidl, K.L., & Newhouse, R.P. (2012). The intersection of evidence-based practice with 5 quality improvement methodologies. The Journal of Nursing Administration, 42(6), 299-304.
Singh, K.K. (2022). Quality assurance. In T. Mizrahi and D. Bailey (Eds.). Oxford Encyclopedia of Macro Social Work. Oxford University Press. OEMSW is an annotated, peer-reviewed, online research encyclopedia of macro social work.
Singh, K.K, Bader, R., & De La Cruz, B.M. (2021). Quality assurance frameworks and measurement tools for social work managers. Paper presented at the Network for Social Work Management Conference (https://socialworkmanager.org/programs/annual-management-conference/).
Smith, D.B. (1998). Addressing racial inequities in health care: Civil rights monitoring and report cards. Journal of Health Politics, Policy, and Law, 23(1), 75-105.
Tellez, T. (2021). Diversity, equity, and inclusion (DEI) organizational assessment tools: A resource guide. Institute for Racial and Economic Equity: Brandeis University.
Wandersman, A., Chien, V.H., & Katz, J. (2012). Toward an evidence-based system for innovation support for implementing innovations with quality: Tools, training, technical assistance, and quality assurance/quality improvement. American Journal of Community Psychology, 50(3-4), 445-459.
This story was created in partnership with Rutgers School of Social Work's Inclusion, Intersectionality, Diversity, Equity, and Advancement (IIDEA) Committee in support of our commitment to diversity, equity, and inclusion.
