At EDC, we value the development and delivery of high-impact interventions that improve critical services for children, families, and communities. Working closely with partner organizations, private foundations, and federal agencies, we use data to rapidly develop and implement improvements that lead to sustainable change. We do this work by actively integrating Continuous Quality Improvement (CQI) methods.
What Is CQI?
CQI is the “process of identifying, describing, and analyzing strengths and problems and then testing, implementing, learning from, and revising solutions. More simply, one can describe CQI as an ongoing cycle of collecting data and using it to make decisions to gradually improve program processes.”1
These methods enable us to do the following:
- Identify gaps in implementation
- Develop strategies for filling those gaps
- Support the use of rapid testing to assess effectiveness of innovations and interventions
- Monitor the sustainability of changes
- Scale tested interventions to a broader audience
Why Is CQI Effective?
Our use of CQI to improve services for the most vulnerable families involves not just what we do, but how we do it. We work with education, health, and human services programs to bring them up to speed on CQI basics, such as the following:
- Identify gaps for improvement
- Set aims that are SMART (specific, measurable, achievable, realistic, and timely)
- Identify the achievements needed to meet the SMART aims
- Develop measures to monitor improvement over time
Our approach is distinctive because we:
- Understand the learning curve for CQI
- Promote inquiry and data use as a cost-effective, efficient way to sustain gains
- Prepare groups to teach others in their organizations, building their capacity
- Create state-of the-art resources
- Help groups document strategies, share successes, use peer coaching, and build lasting systems
- Develop documentation across topics critical to early childhood and health, including:
- Maternal depression screening, referral, access to services, and symptom improvement
- Healthy relationships and screening for intimate partner violence, safety planning, and linkage to services
- Developmental surveillance, screening, referral, and timely linkage to services
- Positive guidance and reduction of corporal punishment in pre-K classrooms
EDC brings expertise in a wide array of CQI methods and models, including the following:
- Institute for Healthcare Improvement Breakthrough Series
- Model for Improvement
- Collective Impact Framework
- LEAN Six Sigma
- Carnegie Model for Improvement
- Rapid-Cycle Evaluation
CQI is central to long-term change due to its cost-effectiveness, efficiency, scale, and equitable access to quality care for all. It is a critical process for the individuals, communities, and nations that we work with, enabling them to participate in the work to improve their programs.
EDC’s approach is proven to be effective. For example, in our work with the Home Visiting Collaborative Improvement and Innovation Network (HV CoIIN), our experts are building the capacity of home visiting staff to use the Institute for Healthcare Improvement Breakthrough Series (“Plan-Do-Study-Act”) to strengthen the services they provide to families. Following are some examples of our impact:
- Reduced stigma and broadened access for families to quality evidence-based treatment for maternal depression.HV CoIIN teams improved maternal depression screening rates to 96%, acceptance of referral to treatment to 72%, and receipt of treatment to 66%—well above national averages.
- Increased exclusive breastfeeding. HV CoIIN teams saw a 45% increase in home visitors trained in infant feeding and lactation, which improved breastfeeding support to mothers and families. Improved intention to breastfeed rose to 65%, with the initiation of breastfeeding at 61%, leading to exclusive breastfeeding rates of 14%.
- Improved developmental surveillance, screening, and timely linkage to services. HV CoIIN teams reported 96% of home visitors doing developmental surveillance on every home and 88% of children screened in a timely way for developmental risk (an increase of 18%), with 83% of these children getting the supports they needed (an increase of 16%).
Interested in learning more about our Continuous Quality Improvement services? Please contact us.
Mary Mackrain, Project Director
- Heising-Simons Foundation
- James Bell Associates
- The Ounce of Prevention Fund
- U.S. Agency for International Development
- U.S. Department of Health & Human Services, Office of Head Start
- Health Resources & Services Administration
- ZERO TO THREE
Articles and Briefs Authored by EDC Staff
- HV CoIIN: Implementing Quality Improvement to Achieve Breakthrough Change
- A Primer for Continuous Improvement in Schools and Districts
- “National Quality Improvement Initiative in Home Visiting Services Improves Breastfeeding Initiative and Duration,” Academic Pediatrics (2018)
- Partnering with Families in Continuous Quality Improvement Brief (2017)
Resources Developed by EDC
Partner Publications Spotlighting EDC’s CQI Work
- Research for Results: The Power of Home Visiting, by the Association of State and Tribal Home Visiting Initiatives
- Parenting Matters: Supporting Parents of Children Ages 0–8, by the National Academies of Sciences, Engineering, and Medicine
- Assessing the Effectiveness of Technical Assistance, published by Mathematica and ASPE.
1U.S. Department of Health and Human Services, Office of Adolescent Health. (n.d.). Continuous quality improvement: Part 1: Basics for pregnancy assistance fund programs. Retrieved from https://www.hhs.gov/ash/oah/sites/default/files/cqi-intro.pdf