Quality Rating and Improvement Systems

1

• Quality Rating and Improvement Systems
• Presentation to ECICQRIS Pilot Implementation
  Meeting
• January 10, 2008
• Gerrit Westervelt, Ph.D.The Build Initiative

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What is the Build Initiative?

• Multi-state partnership of funders, agencies,
  policymakers and NPOs
• Created by the Early Childhood Funders
  Collaborative (ECFC)
• Supports state leaders who make policy, provide
  services and advocate for children 0-5
• Goal youngest children are safe, healthy, eager
  to learn and ready to succeed

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State Early Childhood Development System
Early care and education opportunities in
nurturing environments where children can learn
what they need to succeed in school and life.
Comprehensive health services that meet
childrens vision, hearing, nutrition,
behavioral, and oral health as well as medical
health needs.
Early Learning
Health, Mental Health and Nutrition
Family Support
Early identification, assessment and appropriate
services for children with special health care
needs, disabilities, or developmental delays
Special Needs/ Early Intervention
Economic and parenting supports to ensure
children have nurturing and stable relationships
with caring adults.
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What are Quality Rating and Improvement Systems
(QRIS)?

• A key component of a comprehensive early
  childhood system
• Tools that assess, monitor, improve, and
  succinctly communicate levels of early childhood
  program quality to providers, parents,
  policymakers and funders.

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Common QRIS Elements

• Tiered program standards (state licensing is
  often the baseline, national accreditation is the
  ceiling)
• For providers, serve as a quality improvement and
  monitoring measure, and enable them to access
  quality improvement coaching and support
• Help parents select quality child care and
  ultimately change child care purchasing patterns
• Are linked to differential child care
  reimbursement strategies (e.g. tiered subsidy
  reimbursement)
• Provide an accountability measure to child care
  funders
• (adapted from NCCIC, 2005)

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QRIS The National Landscape

• Currently 14 states and DC implementing QRIS with
  these common measurement elements many more in
  pilot stage
• Environmental Assessment (92)
• Early Childhood Environment Rating Scale (67)
• Parent Involvement (75)
• Staff Professional Development/Business Practices
  (100)
• Program Accreditation (67)
• Parent Satisfaction (42)
• Licensing Status (100)
• (adapted from The RAND Corporation, 2005)
• Many QRIS require a program to be licensed to
  participate, others give points for being
  licensed, while others give points for compliance
  history.

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Lessons Learned Five Key Areas

• Provider Outreach
• Measuring Quality
• Delivery Infrastructure
• Quality Improvement
• Evaluation

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Lessons Learned Provider Outreach

• Provide incentives for participation (e.g.,
  mini-grants for materials, or staff bonuses)
• Explain your measures and processes, early and
  often. Be Transparent!
• Enlist the support of key providers (e.g. local
  association leaders) to get rated and promote the
  process
• Provide personal consultations on the rating
  results
• If possible, do not publish first year results
  without permission public accountability can be
  a real barrier to participation in the early years

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Lessons Learned Measuring Quality

• Self-assessment measures can be very problematic
• Ensure that your learning environment measure is
  aligned with desired child outcomes
• A classroom sampling approach to the learning
  environment may be a cost effective approach
• Professional development is very challenging to
  measure accurately resources are needed to
  review transcripts and arrive at a reliable score

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Lessons Learned Measuring Quality

• Ratios/group sizes are dynamic throughout the
  day multiple time samples should be collected
• Staffing patterns are not an accurate proxy for
  actual counts) classroom ratio sampling does not
  provide accurate representation
• Licensing compliance is usually not a good proxy
  for aspects of structural quality (e.g. ratios)
  or process quality (e.g. health and safety)
• Resist linking high stakes to QRIS results until
  after pilot work has been completed

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Lessons Learned Delivery Infrastructure

• Involve licensing officials in QRIS development
  process to promote future collaboration
• Classroom observation measures need solid
  infrastructure to support inter-rater reliability
• Seasoned practitioners sometimes find getting
  reliable more challenging than those newer to the
  field
• Local or regional delivery system as you scale
  up?
• Develop web based data collection technology

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Lessons Learned Quality Improvement

• Quality Improvement is a relatively new field and
  many states have been working to
• Develop coaching and training professional
  standards that have associated educational
  requirements and proficiencies
• Develop training institutes to support these new
  professionals in their mentoring and technical
  assistance skills

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Lessons Learned Quality Improvement

• Provide personal debriefing on rating results
• Do not assume that directors can translate the
  results to classroom staff
• Involve coaches in consultations and assure that
  coaches understand the measures and rating
  process
• Assure that raters do not use an expert
  approach to consultation, but can
• Translate results/standards into practice
• Engage providers in a problem-solving approach to
  developing a QI plan to address areas for
  improvement

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Lessons Learned Quality Improvement

• In-classroom mentoring is particularly helpful
  for low quality programs
• Involve directors in mentoring process to build
  leadership skills
• Director-level coaching is helpful, esp. for
  higher quality programs
• Lower quality programs need more guidance in
  prioritizing QI spending

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Lessons Learned Quality Improvement

• Facilitated director groups and home provider
  peer groups appear to be a cost-effective QI
  strategy
• Formal scholarships appear to be more effective
  when staff have been in the program for at least
  3 years (and under 10) and when programs are not
  at a very low quality level
• Process and structural quality improve at
  different rates and require different resources
• Consider measuring process quality (e.g, Learning
  Environment) for all programs at outset

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Lessons Learned Evaluation

• Formative evaluations to improve QRIS measures
  and processes can be very useful QRIS will
  change as lessons are learned
• Collect as much data as feasible work with an
  evaluator during the initial stages of QRIS
  development
• Collect consistent data on QI interventions, in
  order to
• Show how quality has improved over time
• Understand which interventions work for which
  types of programs
• Hold off on child outcome studies until AFTER a
  few years of pilot work

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Michigans Opportunities

• Piloting several different QRIS and understanding
  what works in different contexts
• Creating a statewide QRIS based on best practices
• Establishing model communities that are able to
  train new communities
• Availability of QI funding to enhance quality and
  encourage programs to participate
• Assessment and QI expertise at High/Scope

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Michigans Challenges

• Developing and implementing QRIS without stable
  funding sources
• Different QRIS hard to compare results
• Building local capacity to do ratings and QI
• Developing multiple databases and technology
  platforms
• Local preferences may make the consensus QRIS
  harder to create than you think

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The Build Initiative

• For more information, visit www.buildinitiative.or
  gContact Gerrit Westervelt, Ph.D.
• Executive Director
• gwestervelt_at_buildinitiative.org
• 303-929-5011