Whether it is preparing an older sibling for the arrival of a new baby or potty training a toddler, Camille Carlson recognizes that everyone – whether they are aware of it or not – uses Continuous Quality Improvement (CQI) to improve everyday life. CQI is an invaluable reminder of the strength found in taking small, intentional steps. Therefore, it is important to break up the process into achievable goals – and celebrate the milestones along the way!

As Start Early Washington’s Quality Improvement and Innovation Manager, Camille Carlson’s approach to Continuous Quality Improvement (CQI) is instrumental in supporting home visiting services statewide. Through individual and group coaching, Camille guides professionals in the field toward providing the best possible services for children and families using tools to identify and test changes on a small scale. Together with CQI teams and Washington home visiting programs, Camille works to identify changes that result in significant improvements for the home visiting field, families and children, all part of Start Early Washington’s mission to create strong foundations necessary for more fulfilling work that continuously improves supports and resources available to families statewide.

A Beautiful Reminder

Camille uses her expertise to help home visiting programs deliver services relevant to the unique needs of the children and families they support. Her firsthand experience as a parent fuels her desire to improve systems of support for children, their families, and the teams of staff that serve them. Camille’s motivation for this work grew when she was pregnant with her second child. “During my pregnancy, I had the support of home visitors and supervisors at my fingertips. As I listened to home visiting professionals across the state discuss parent coaching and family observations, I started applying their valuable insight to navigate the changing dynamics of my life with two children. This process helped me gain confidence in my parenting skills, and it was a beautiful reminder that family is central to our work. I was overwhelmed by the support that was given to me and the confidence that it brought, which emphasized the importance of sharing such a positive experience with others.”

Connecting Data to Practice

Quality improvement is essential to providing successful home visiting services where staff collaboratively establish goals, reflect and create actionable steps for improvement. By adhering to a CQI process, home visiting programs can build strong relationships with families, make well-planned decisions and increase positive outcomes to achieve better support for children and families.

The ongoing, collaborative process draws on the expertise and experience of home visitors, supervisors, community partners and families. Although data points are a big part of CQI, Start Early Washington works toward cultivating a culture of continuous quality improvement rather than another set of requirements to check off for reports. “Since I’ve been in my role, we have seen an investment in a CQI culture. Teams have grown significantly, and we are beginning to see a sense of buy-in and excitement around the process.”

Camille shared her immense gratitude for the opportunity to work with and coach organizations that provide home visiting services to families across Washington state with the shared goal of creating positive change for the organizations and families that they serve, utilizing a CQI lens.

As the program analyst for Start Early Washington, Anna Contreras is always thinking about what works best to support the children and families that participate in Washington’s home visiting programs. She collects and analyzes a mixture of quantitative raw data as well as the often-overlooked qualitative feedback needed to truly improve and enrich the home visiting experience for children and families. This includes collating information gathered from numerous home visiting professionals across the state.

Anna has dedicated her professional career to understanding how relationship-based supports impact lifelong outcomes for young children and their families. She’s particularly interested in families grappling with adversities, such as migrant and seasonal farmworkers, immigrant communities and dual language learners. “My Latinx background not only identifies me but defines me. As a second-generation immigrant, I relate to the challenges of those who are growing and learning from their native culture while also adjusting to new societal norms and navigating American culture.”

Anna’s commitment to improving the home visiting experience and creating more equitable and inclusive systems that recognize and respect diversity begins with her mother. Home visiting has been part of Anna’s life since the day she was born. Anna’s mother received home visiting services in Washington state when she was pregnant with Anna, a support that was not provided for Anna’s siblings. Because of this experience, her mother was better connected to her community’s resources and felt more comfortable talking through the various roadblocks she was experiencing. In addition, her home visitor helped her better understand the services and supports available to her. They were a trusted partner to nurture and support Anna’s healthy development. This was especially important to Anna’s mother because she didn’t have her mom (Anna’s abuela) near at the time.

Recalling her personal experiences and her experience helping her parents navigate data collection and other complex information, Anna finds it essential to create inclusive forms and dashboards for the home visiting support team.

Anna also shared the importance of considering the impact on the person collecting information. “When creating forms, we consider the impact on the staff asking the questions — such as, what does the answer mean for the respondent? How is this information going to be utilized? What are the unintended consequences for the person sharing the information? People must feel comfortable enough to share this information. They also want to ensure that necessary changes will follow and that they are not wasting their time answering another set of questions; it is hard to be vulnerable, especially when you are unsure of what will happen next with the information provided.”

Whether it’s a first-time parent connecting with a home visitor or staff sharing their experiences with each other, trust and respect are vital to collecting meaningful information. Relationship-building is foundational to Start Early Washington’s work and a key ingredient to affecting meaningful change.

“As a first-generation college student, relationship-building was important to me. Feeling seen and heard was fundamental to my growth and development, and therefore I carry that experience in my work today.” Feeling accepted, safe and connected to a community of support helped push Anna past moments of self-doubt and projected her toward future success in her home life, career and beyond.

The Subtle Differences

Data showcasing the subtle differences in home visiting provider experiences and the depth of variation between the family dynamics they support helps inform the resources and learning opportunities needed for the home visiting field as well as the various elements required to support the children and families they partner with. In addition, such data-driven insights are vital to maintaining an inclusive and collaborative decision-making process for system improvements.

Anna primarily works with Start Early Washington’s home visiting team to improve home visiting services and outcomes for children and their families in Washington state. Anna works closely with the home visiting team to assess customized coaching and mentoring offered to home visiting programs. Similarly, she evaluates how Start Early Washington can best support comprehensive learning opportunities, transparent data collection and thoughtful analysis.

For example, surveys are designed to answer questions such as: Does the home visiting field have the professional development opportunities they need to grow their skills? What additional support is needed for home visitors to feel confident in their role? How can Start Early Washington help home visiting professionals achieve individual and programmatic goals? These questions and more help to ultimately measure how we can support positive system changes —such as gains in knowledge, better time management, improved staff retention and the creation of better family engagement protocols.

Qualitative feedback helps Anna understand the story of home visiting in our state, connecting the necessary data points to improve system outcomes and inform policymakers. Data allows us to see how and when priorities shift for programs, and feedback and discussion help us understand what success and challenges look like for home visiting programs and the families they work with. Qualitative feedback from our home visiting team helps uncover trends in discussions, typically hidden among quantitative numbers alone. This data complements ongoing performance monitoring to ensure continuous quality improvement for home visiting professionals statewide.

Anna’s work strengthens home visiting programs by showcasing the power of relationship-based work, reinforcing the deep connections and trust between home visitors and families. Recognizing the unique identities, heritages, cultures and human emotions while celebrating differences and bolstering representation validates and supports an environment of inclusion for the entire home visiting system.

Trust Is Pivotal

While data is critical to support a high-quality system, trust is pivotal to accessing quality information and rich feedback. Some things for home visiting teams to consider when collecting data:

• Use simplified language; the frame of information is important.
• Are questions clear enough to capture the needed information?
• Do all parties understand how the data collected will inform the home visiting system?
• Does the reader understand their rights and role in responding to the questions?

Co-Creative Learning Opportunities for Home Visiting Professionals

Start Early Washington facilitates learning opportunities as well as unstructured co-creative opportunities for home visiting professionals statewide to build knowledge, seek mentorship, connect and decompress with others in the field experiencing similar situations. Together, they work through obstacles and celebrate successes; since 2020, Start Early Washington’s work has reached nearly 8,235 children and families. Our approach to supporting the home visiting field includes mindfulness practices, reflection, sharing experiences and knowledge that builds trust in a strengths-based learning environment.

A growing concern for the early childhood field is how to best support parents and families in nurturing their young children’s healthy development. Educators and leaders are eager to help families gain the knowledge and tools they need to effectively engage in their children’s learning.

Technology-based interventions hold great promise for reaching and communicating with families. These interventions are relatively low-cost, scalable, and accessible for parents who use their mobile phones for communication and information seeking. Technology-based interventions can also reinforce the learning and community building of on-the-ground family support programs. But this promise can only hold true if the technology products are designed to reach parents and communicate what they want to know.

In the last few years, a number of tech-based family engagement platforms and tools designed to guide parents have emerged, including apps like Vroom, Let’s Play, and Kinedu, video tools like Ready Rosie, texting programs such as Text4Baby and Ready4K, podcasts, and word-tracking wearables like LENA and Starling. As awareness about early childhood development increases, more technology players (non-profit and for-profit) are likely to enter this space.

At The Early Learning Lab (The Lab), we have spent the past year surveying early childhood technology tools, learning how various products and programs are being implemented and evaluated, and identifying best technology practices for early childhood family engagement.

Whether you are an entrepreneur developing a new early learning tech product, a school administrator trying to find an effective family-engagement tool, or a parent-support program operator looking to add a digital component to your program, The Lab sees the following 10 design elements as critical to the impact of any early learning parent engagement tool:

All in all, no one product is going to have all 10 of these elements. But this list can serve as a useful guide for developers and a wish list for people who are evaluating and purchasing technology products for parent engagement. Technology holds great promise for reaching large numbers of families and helping us achieve the goal of kindergarten readiness for all, but only if the products we develop and use are designed for impact.