U.S. states and territories that receive grants from the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program are required to use continuous quality improvement (CQI) methods to improve program performance and participant outcomes. Yet awardees vary widely in their ability to plan, develop, and implement effective CQI systems.

The Maternal and Child Health Bureau’s Division of Home Visiting and Early Childhood Systems selected EDC to design and deliver technical assistance (TA) that builds awardees’ capacity to use CQI. The Home Visiting Performance Measurement and CQI Technical Assistance Center supported 56 states and territories in testing, refining, measuring, and sustaining improvements in home visiting practice and services.

Key Activities

  • Provided group and one-on-one TA to build awardees’ CQI capacity
  • Designed and delivered an eight-month CQI practicum experience to build participants’ knowledge and skills through a hands-on project
  • Developed “change packages” for awardees—documents that included a theory of change, summary of evidence-based practices, and tools that guided awardees in applying CQI to improve home visiting services


As a result of EDC’s support:

  • More than 95 percent of MIECHV awardees are now able to use CQI Plan-Do-Study-Act cycles to guide their work to improve services.
  • Almost 60 percent of MIECHV awardees use run charts, Pareto charts, and other analysis tools to examine and interpret data collected for improvement.
  • Nearly 80 percent of MIECHV awardees directly engage families in CQI processes and activities.

Learn More

U.S. Department of Health and Human Services, Heath Resources and Services Administration

James Bell Associates