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FINE Newsletter, Volume V, Issue 3
Issue Topic: Creating a Culture of Continuous Improvement

Voices from the Field

Deborah J. Brown, Ph.D., is an organizational development and program evaluation specialist and a principal at the Brown Buckley Tucker consulting firm. She has worked as the external evaluator for Save the Children for the past seven years. In this article, she discusses the continuous improvement system used in one of Save the Children’s language development and preliteracy programs, Early Steps to School Success.


Continuous improvement and evaluation are vital to our work at Save the Children. At our program, we engage in continuous improvement because it encourages us to be innovative and to use our time and energy effectively and efficiently in our education, health, and resiliency programs. Continuous improvement allows us to be responsive when there is need for change. In order to ensure that we are continuously improving, we stress documentation and data use as two of the core competencies we cultivate with our staff; we put these on par with other competencies, such as child development, relationships with families, and community partnerships. I share a diagram with new staff that illustrates our parallel approach to continuous improvement and evaluation: Our Early Childhood Coordinators (ECCs) help families observe and “evaluate” their children while supervisors help Early Childhood Coordinators evaluate their own practice. These activities help staff members learn from day one that they are evaluators and that our program culture is a culture of inquiry.   


One of our education programs in which continuous improvement runs deep is Early Steps to School Success (ESSS). ESSS is Save the Children’s language development and preliteracy program for children and their families, beginning in the prenatal period and extending up through 5 years of age. ESSS serves more than 7,000 children and families in 113 programs in rural areas of the U.S. through free services that help fill the void left by the paucity of early childhood supports in rural parts of the country. ESSS staff members serve families through home visits and parent education groups, and they also participate in a book exchange program in which Early Childhood Coordinators supply them with a rotation of children’s books to encourage frequent reading, reading comprehension, and parent–child interaction. Funding for these services comes from Save the Children and a variety of state, local, and private sources.

To help ensure that ESSS is addressing the needs of the families we serve by decreasing risk factors and increasing resilience, we have developed a comprehensive and integrated knowledge management and continuous improvement system. We believe that having timely and relevant knowledge of what is currently happening in our ESSS program is essential to continuous program improvement. But creating real knowledge about organizational progress is about more than just stringing together pieces of “information.” It involves creating a culture of inquiry in which we (a) put together appropriate structures, (b) identify the right kinds and types of information that will shed light on ESSS’ progress, and (c) have actionable data that parents and staff use to problem solve and make decisions. 


ESSS has developed an organizational culture that expects and rewards inquiry, reflection, critique, and openness to change. Building relationships and encouraging learning are central to our work with families. The same practices and values are mirrored in our work with each other.

Appropriate structures. The following diagram (Figure 1), which we share with all new staff at orientation, depicts the process of inquiry we have embedded in our organizational culture and structure. Because information is readily and regularly shared, staff members have access to information about how they and the program as a whole are doing. Their active participation in continuous improvement is essential to our success, and they know that they are an integral part of decision making.

Figure 1. With the family at the center, information moves across all levels of the organization and is reported back to those who collect it. Our cycle is to plan activities across all program levels for all participants, including children and families, staff, and administrators. Such activities include staff development and improvement of program procedures. We carry out these plans, collect information about actions and results, and reflect on that information to make changes or enhancements for the next cycle.

We also have regular formal structures in place for reflection. One such structure is our annual planning meeting. Prior to the meeting, Program Specialists and other program leaders, such as the Evaluation Consultant, get together to review issues identified through data analysis as needing attention. Everyone is encouraged to suggest topics to cover. At the planning meeting, we use a structured planning process to discover what’s working well and what we’d like to change. We identify the barriers to address and the resources available for this process, and we then establish a work group to follow up on recommended action steps. Work groups at these meetings have created additional curriculum materials, improved protocols or written new ones, and developed an instrument and process to measure the increasing knowledge and competence of ECCs.

The right kinds and types of information. As depicted in the diagram, our process of inquiry begins with and is centered on the family and is based on the right kinds and types of information flowing through our organization. The process starts when parents complete the Ages and Stages Questionnaires (ASQ). Parents use their expert knowledge of their children to complete the ASQ―responding to items about development such as communication, gross and fine motor skills, problem solving, and personal–social. Parents discuss the results with their ECC, and, in consultation with the ECC, plan ways to support the next steps in their children’s development. In between home visits, parents continue to observe their children. Parents use the Family Planning and Reflection form to report the number of times they read with their children, record their children’s new accomplishments, and make note of their children’s needs and interests. The ECC also administers the Peabody Picture Vocabulary Test (vocabulary assessment) to each child and shares the meaning of the scores with parents. Finally, the ECC provides parents with guidance about how they can continue supporting their children’s language development and communication skills as they transition from the home visiting component into the 3–5-year-old component. This component includes a continuation of the book exchange and the parent education groups, and also provides a structured and supported transition to kindergarten.

Actionable data. When Regional Program Specialists identify a site-specific or program-wide issue, they work with ECCs to gather knowledge about the concern, discuss possible barriers to improvement, and identify ways to address the issue. We use data to problem solve and make decisions. The following are several examples of how our staff members have used data to improve the way we serve children and families.

  • A monthly summary report identified a child whose ASQ scores indicated some developmental delays, yet there were no notes of referrals to Early Intervention (EI) in the child’s files. Further investigation revealed that the ECC had talked with the parents about a referral, but the parents were resistant to the idea of EI services and feared that they would be judged as bad parents. The ECC and supervisors talked and came up with an approach to help parents understand more about the way the EI agency works. After the ECC and supervisors discussed these issues with the parents, the parents were reassured that the agency was not judging them and willingly participated in the EI agency’s evaluation to determine their child’s eligibility for services.
  • An ECC was having difficulty with recruiting and enrolling families, which resulted in her program being underenrolled. Her data also showed that she had not made any community contacts. Working with her supervisor, she learned to overcome her shyness about reaching out to community partners and started to make important community contacts. When the partners learned more about her and the program, referrals and enrollment picked up.
  • Our program model calls for home visiting to end when a child is 3 years old, and for work to continue through partnerships with local preschool programs. After children “age out” of the home visiting component of our program, ESSS continues to serve families with take-home book bags, literacy activities in the preschool classroom, parent/child groups, and a well-planned process for transition to school. To our surprise, we found that many children were exiting ESSS entirely at 3 years of age instead of transitioning to the 3–5 component. Background research led us to understand that many communities did not offer a group preschool experience for 3-year-olds; Head Start or school-based programs served mostly 4-year-olds. We therefore took steps to increase our focus on supporting the transition into the preschool experience for 3-year-olds through libraries, child care centers, and play groups.

The way we collect, report on, and use data gives us information that we use for program planning, funders, and staff development. It gives our organization the capacity to leverage, improve, and refine programming to meet goals and targets for supporting young children and their families. It also gives on-the-ground staff information about how they and the organization as a whole are doing, and provides us all a basis for change if needed.

Save the Children's Early Steps to School Success (ESSS) Roles and Responsibilities

Early Childhood Coordinators (ECCs) are paraprofessional home visitors who provide parents with age-appropriate activities for their children, help parents monitor their children’s developmental progress, and offer parents suggestions on how to interact with their young children to promote early literacy and language learning. Regional Program Specialists serve as supervisors of the ECCs, and teach, mentor, observe, and coach them.

The Program Specialist is the on-the-ground staff member who provides technical and management assistance to ensure the effective coordination, implementation, and monitoring of early childhood education programming.

Our Data Manager compiles monthly summary reports of local data and sends them to site supervisors and ECCs. The timely information about enrollment, retention, numbers of services delivered, and reminders for services due contained in these reports helps leadership identify areas where ECCs are excelling and where they might be encountering challenges

Click here to access other articles and resources in this FINE Newsletter, "Creating a Culture of Continuous Improvement."

This resource is part of the September 2013 FINE Newsletter. The FINE Newsletter shares the newest and best family involvement research and resources from Harvard Family Research Project and other field leaders. To access the archives of past issues, please visit

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