Continuous Quality Improvement Change Packages

Change packages are evidence-informed collections of actionable ideas that are known to produce a desired result in a process or system. They help break down large continuous quality improvement (CQI) projects into smaller, more manageable pieces.

The Early Childhood Systems Technical Assistance and Coordination Center, funded by the Health Resources and Services Administration, developed these resources to support systems change efforts of state prenatal-to-three (P-3) awardees and their community partners. They may also be useful for other maternal and early childhood organizations, including those in home visiting, early care and education, family and social supports, income assistance and basic needs, physical health (i.e., pre- and postnatal care, pediatric or family care), oral health, mental and behavioral health, child welfare, and employment training and education.

Change Package 1: Early Childhood Partnerships With Maternal-Child Health Delivery Systems, Including Medicaid  provides ideas to increase the number of effective partnerships and improve meaningful collaboration and engagement. Primary drivers include relationships, equity-driven design, shared vision and SMART/IE goals, and shared accountability. This resource helps awardees identify, invite, and convene community partners as well as explore existing initiatives that could be leveraged to advance shared goals and strategies.

Change Package 2: Infrastructure to Support Integration Between Early Childhood and Maternal-Child Health Systems of Care provides ideas to increase the capacity, strength, and sustainability of state-level infrastructure that supports integration of P-3 systems. Primary drivers include partnerships, communication, governance, data, financing, and standards. This resource helps awardees assess and improve current alignment and coordination between systems.

Change Package 3: Family Leadership to Inform Maternal and Early Childhood Systems provides ideas to improve authentic engagement with parents as partners and to embed family leadership as a standard practice in P-3 systems. Primary drivers include commitment to diversity, inclusion, equity, and antiracism; prepared awardees and partners; trusting relationships; family voices; and family supports. This resource helps awardees advance family leadership as a key equity strategy that enables diverse caregivers with lived experience to play an influential role in redesigning the P-3 system to be more responsive to the needs of families and children.

Change Package 4: Strengthening Maternal and Early Childhood Leadership Capacity for System-Level Transformation provides ideas to build the capacity of maternal and early childhood system leaders to foster transformation that promotes equitable health, early development, and family well-being across culturally and linguistically diverse populations. Primary drivers include organizational investment, individual development, interpersonal relationships, and interagency connections. This resource helps awardees activate vision and shared goals using adaptive leadership and implementation science.

Change Package 5: Increasing Equitable Access to Early Childhood and Maternal-Child Health Services provides ideas for early childhood and maternal-child health system partners, including families, to increase access to services and advance equitable outcomes for populations that have been systemically marginalized and oppressed. Primary drivers include engagement with underserved communities, authentic family leadership, equity and community-centered change, representative and responsive workforce, and whole-family services.

Change Package 6: Building the Organizational Culture and Capacity for Systems Change Among Early Childhood and Maternal-Child Health Partners provides ideas for awardees to build their organizational capacity to lead systems change efforts and foster a collective culture, within and among partners, that embraces change through continuous innovation, learning, resilience, and improvement. Primary drivers include interorganizational function and climate, individual leaders of systems change, equity-centered values, and systems approach to change management.