Creating Change for Program and Service Improvement


As one of the largest providers of community-based health services and housing in New York State, Services for the Underserved (S:US) provides services to make sure every New Yorker has a home and can create a life of purpose. S:US values continuous quality improvement and engages in ongoing efforts to improve its services and internal practice.

S:US recently experienced a transition in leadership, including the creation of an Innovation and Quality (I&Q) Team with new staff tasked with working on S:US programs in partnership with senior leadership, program evaluation, and Quality Assurance (QA) Teams. This presented an opportunity to explore alternatives for enhancing the quality of S:US’s services and programs, focusing on the fundamental question: What model would be most effective for orienting the I&Q Team efforts and aligning I&Q with agency priorities?


S:US reached out to several consultants and organizations to help its quality improvement efforts and contracted with the NIATx Foundation as a consultant who could:

  • Directly apply continuous quality improvement (CQI) methods;
  • Offer familiarity with S:US’s program types and licensing bodies; and
  • Provide onsite, hands-on training and coaching.

NIATx worked with S:US to implement the learning collaborative model, focusing on 11 programs covering a wide range of service types (e.g., supportive housing, homeless services, clinic service, Assertive Community Treatment (ACT), care coordination). The learning collaborative approach provided S:US with a variety of methods for sharing innovative ideas to implement positive change.

Using this approach, NIATx consultants provided the following services:

  • Developed a plan to support the 11 identified programs, as well as the I&Q Team, with the ultimate objective to transfer the tools and implementation of the model from NIATx to the I&Q Team for ongoing sustainment.
  • Conducted a live meeting with executive leadership to engage and energize executive sponsorship for the I&Q Team’s improvement efforts.
  • Facilitated a Change Leader Academy (CLA) training with supervisors for the 11 programs to implement a structured, team-based approach to change management.
  • Engaged in ongoing monthly coaching for the I&Q Team on the NIATx approach and tools (e.g., walkthroughs, flow charts, nominal group technique) and how to effectively coach their 11 sites through the implementation process.
  • Developed and implemented change projects for the 11 programs.
  • Conducted a mid-project meeting to assess progress and will follow-up with a final meeting to evaluate lessons learned and celebrate results.


This project has a six-month timeframe. Over the first half of the project, members of the I&Q Team successfully learned the NIATx approach and have supported program use of the NIATx tools to begin implementing change. The program sites were encouraged to define their own improvement projects and to gather feedback from service recipients, according to the NIATx principal of understanding the customer. The nominal group technique has further helped the I&Q Team members and sites identify strategies for implementing these improvements.

As this project progresses, the program sites are beginning to incorporate NIATx’s plan-do-study-act (PDSA) change model, developing baseline data, implementing changes, and measuring the results of their efforts. The sites are clearly motivated to seek measurable improvements that enhance the collective experience of the people they serve.