Staff use ten self-assessment guides containing several trigger questions. The guides are based on the clients' rights and providers' needs framework. In larger sites, they break up into teams assessing the services they provide according to one or two guides each. The client interviews were developed to increase the service providers' understanding of the client perspective. The self-assessment guides and client interviews provide staff with information to identify problems related to the service delivery process and to develop an action plan .
Staff identify and state the problems and their root causes, as well as appropriate solutions.
The action plan also contains information on assignments of staff to take responsibility for given actions, and dates by when actions will be completed. Finally, the institutionalization of COPE requires the establishment of a COPE committee. Some organizations have vested this responsibility with already existing committees or teams. As suggested, any type of quality improvement is a long-term process. To nurture this process, it is important to ensure site follow-up and management support.