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Quality Improvement Cycle

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Nationwide Health and Disability Consumer Advocacy Service Quality Improvement Cycle

Quality Improvement Approach

The model used by the Nationwide Health and Disability Advocacy Service is one that works towards achieving excellence.  

It includes processes for effective communication and monitoring; a defined level of commitment required of health and disability advocates; established processes for the linguistic and cultural challenges that includes recognition of cultural and ethnic values; strategies that provide relevant, accurate, and timely information that maximise the value and benefits of the service being provided. This will be achieved through the implementation of continuous quality improvement systems, the basis of which is the simple quality improvement cycle outlined below.

Say what we do - Do what we say -  Prove It - Improve it
IIn the pursuit of quality improvements the objectives are to: foster a receptive organisational culture where there is consultation with consumers about the development, delivery and review of the service that takes into account regional variations; provide services that are delivered in a consistent manner regardless of where in the country the service is accessed from; deliver the service with sensitivity, courtesy and the least possible delay; provide accessible offices in local communities and facilitate easy access to the service for those who would find it difficult or impossible to access.

Advocacy personnel are expected to provide a quality service. This involves compliance with the Advocacy Code of Practice: model evidence-based best practice in carrying out their role; take personal responsibility for the service they provide; ensure they act with integrity, honesty and professionalism; respect the privacy, dignity, religious and cultural beliefs of consumers; regularly critique their own performance and that of the service as a whole to identify any opportunities to enhance and improve the service.

Model for Specific Improvements


Plan (change or test) - Do (carry out plan) - 

Study (summarise analysis + learnings) -  Act (determine action)

•    Identify opportunity for improvement
•    Select the people/team
•    Study the current situation
•    Analyse the reasons for the current situation
•    Develop an improvement approach

•    Provide information about the plan to those most affected
•    Ensure a favourable environment
•    Implement the improvement

•    Collate the data
•    Analyse the results
•    Share the results

•    Standardise the improvement
•    Provide training and information about the benefits
•    Continue to collect data to monitor the sustainability of the improvement                                                                                                                    

Focus of providing a quality consumer-centered advocacy service


To implement the philosophy, service models, government strategies, advocacy guidelines, operating guidelines to ensure a nationally consistent and high quality consumer-centred advocacy service.


  • To strengthen the national focus and identity by using the national logo on all information and signage
  • To work collaboratively together at all levels to achieve a cohesive national approach that takes into account variations in regional need
  • In collaboration with Whanau, Hapu, Iwi, develop a Māori partnership model of practice for advocacy as part of implementing the Māori  cultural competencies.
  • To increase access to advocacy services for people with disabilities as well as those who assist and support them.


To ensure consistent application of advocacy service contracts, guidelines and consumer-centred services through the professionalism, competence and commitment of advocates and those who support them.


  • To provide performance objectives for the advocacy workforce that encourages best practice, a good work ethic, accountability and fair division of the workload.
  • Integration of core, disability, Māori  and cultural competencies through all levels of the service including governance, service delivery, HR, performance management etc
  • Routinely use the new DVD demonstrating best practice advocacy for in-house orientation and training purposes
  • To strengthen the understanding and use of strength-based practice through the input of in-house trainers.


To provide flexible, responsive and innovative advocacy services that meet the diverse range of needs within all communities of consumers, within an environment of collaborative planning and monitoring.


  • To participate in an independent evaluation of services organised by the Director of Advocacy, to review how the service is meeting the needs of consumers.
  • To identify research opportunities for national analysis of the data collected by advocates.
  • To explore ways to engage with consumers and local consumer organisations so they have regular opportunities to provide comments on service performance
  • To promote the broader use of the resolution agreement, including for right 10 complaints to providers.
  • To actively promote regular advocacy rural visits to improve access to consumers in remote communities


To develop and implement systems that support the work of advocacy organisations, advocates and the Director of Advocacy and ensure processes for continuous quality improvement are in place.


  • To review, update and report on support systems (eg recruitment/induction, performance management, professional development, supervision, and governance roles) that demonstrate an empowerment, strengths-based approach.
  • To ensure there are effective systems for timely reporting on referrals to advocacy from the Commissioner
  • To ensure effective systems for timely reporting on contractual requirements
  • To ensure timely action(s) on agreed activities.
  • To achieve consistent standardised reporting so accurate national, regional and local analysis can be achieved.
  • To use the approved forms and templates to achieve a consistent and professional approach.


To increase awareness of the role of advocacy and the benefits of early resolution, so that consumers are willing to exercise their rights, and providers implement practices and processes that enable compliance with the Code of Rights.


  • To strengthen the range of approved education and training resources to better reflect the various audiences and topics of interest.
  • Improve the familiarity with the resources by introducing each new education resource at regional training events.
  • To identify education and resource development areas where HDC and Advocacy can work collaboratively on joint ventures.
  • To continue to develop and utilise the advocacy section of the web site to provide information and showcase advocacy.
  • To develop education and networking plans that are inclusive of and tailored to the specific needs of Māori  and Pacific people as well as refugee and migrant communities.


To participate in maintaining a positive internal culture and working environment. Establish and/or maintain professional linkages to, and liaison with, HDC staff, govt. departments, community organisations, providers, professional bodies and other relevant agencies.


  • To build professional relationships with providers through the provision of useful, respectful, strength-based feedback about consumer views and experiences of their service to increase the focus on quality improvement and providing consumer-centered services
  • To actively promote and gather stories of great care
  • To strengthen networking links to and engagement with consumer and community-based organisations.
  • To explore joint venture opportunities (regional and national)  
  • To actively participate in the ongoing monitoring and implementation of the HDC strategic plan

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