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Ready for School, Ready for Life

The Duke Endowment

Continuous Quality Improvement for Kindergarten Readiness


Ready for School, Ready for Life

The Duke Endowment


Continuous Quality Improvement for Kindergarten Readiness


How can a community ensure that every child in their county has access to health and education resources and opportunities they need so they can enter kindergarten ready to learn?



The challenge at hand: In Guilford County, North Carolina, only 45% of children enter kindergarten literacy-ready.[1]

Despite a well-regarded county school system and notable state early childhood efforts, many of Guilford’s youngest residents are not prepared for kindergarten and later academic success. Once behind, it’s difficult and more expensive to help them catch up. Furthermore, kindergarten readiness is the number one indicator of whether a child will read at grade level in third grade. Reading at grade level, in turn, is the number one indicator of whether a child will later graduate from high school.[2]


To address these needs in Guilford County and move towards a connected, innovative early childhood system of care, Ready for School, Ready for Life and The Duke Endowment have partnered to form the Get Ready Guilford Initiative to achieve better childhood outcomes in the following areas:

  • Planned and Well-Timed Pregnancies
  • Healthy Births
  • On-Track Infant and Toddler Development
  • School Readiness at Kindergarten
  • Success in Third Grade

To advance this work, the Initiative partnered with Root Cause in forming the Continuous Quality Improvement (CQI) cohort and a county-wide effort to create a culture of continuous quality improvement among early childhood programs. Thirteen programs were selected to participate in the cohort – together, they serve more than 23,000 children and their families from prenatal health through pre-kindergarten education.

The 13 members of the first Continuous Quality Improvement (CQI) cohort are:

Root Cause, in partnership with Ready for School, Ready for Life and The Duke Endowment, developed a CQI assessment, taken by each cohort program, to use as a tool along with other information collected from each program to understand which areas to prioritize for continuous improvement coaching. Root Cause defined five distinct elements of high-quality service most important to driving improvement in services for families: accessibility, family engagement, referral processes, trauma-informed care, and use of evidence. Based on those responses, we worked with these organizations to create individualized capacity improvement plans. These plans identify and prioritize mutually agreed-upon areas for improvement that Root Cause coaches and programs will work on together over the two years of coaching. Programs will retake the CQI Assessment in the future to measure capacity gains.

From July 2018 – June 2020, each program is receiving individual coaching from the Root Cause team, and is participating in a Community of Practice, facilitated by Root Cause. Root Cause’s coaching and technical assistance is designed to strengthen each organization’s capacity to collect, analyze and use data to improve in at least two of the five quality areas outlined above.

[1] Guilford County Schools TSR Data 2017-2018

[2] The Campaign for Grade-Level Reading

“Guilford has built a vision for a stronger and more connected system of care to improve outcomes for families and our youngest children,” said Mary Herbenick, Executive Director of Ready Ready. “This continuous quality improvement effort helps programs invest in their own development, get focused on outcomes they will deliver individually and together, and to make data-driven decisions that will positively impact Guilford County’s infants, toddlers, preschoolers, their families, and our community.”
“Ultimately, we want to build a culture of continuous quality improvement across the entire early childhood program landscape,” said Susan Schwartz, Co-Chair of Ready Ready’s Board of Directors and Executive Director of the Cemala Foundation.

Goals & Results

Root Cause worked with Ready for School, Ready for Life and a volunteer CQI Task Force made of cross-organizational and cross-sector community leaders to select the 13 members of the first continuous quality improvement (CQI) cohort.

Root Cause coaches meet regularly with leadership from each program to make progress on their individualized plans. In addition, the 13 programs have formed a Community of Practice, a group that builds connections across programs, shares learnings and resources, and engages regularly with each other in collaborative activities and projects.

Through 2019, Root Cause will continue working with partners to generate population-level change across Guilford County.  In addition to directly coaching the CQI cohort programs, our team will facilitate coordination between services and contribute to building the culture of CQI within Guilford County as a whole.

Over the course of working with the first cohort, Ready Ready and Root Cause collected data to learn how cohort members strengthened their practice of continuous quality improvement.

Update:  Visit the Continuous Quality Improvement Resource Library to learn more about CQI for social service providers.


Blue Meridian Partners
Get Ready Guilford Initiative

Read More >
Greensboro News & Record
13 local early childhood programs to participate in two-year continuous quality improvement cohort

Read More >
Ready for School, Ready for Life
Ready Ready November/December Update

Read More >

About the Partner

Ready for School, Ready for Life Logo (Ready Ready Logo) for Get Ready Guilford Initiative in Guilford County

Ready for School, Ready for Life

Ready for School, Ready for Life (Ready Ready) is a collaborative effort to build a connected, innovative system of care for Guilford County’s youngest children and their families. Its vision is that every child born in Guilford County will enter Kindergarten developmentally on track in five key areas: Physical development, Language and communication, Social-emotional development, Cognitive development and Approaches to play and learning.

Ready Ready aims to improve and expand services for children and families from prenatal health through pre-Kindergarten education.  By enabling more children to achieve key developmental milestones, and by supporting parents in their efforts to raise healthy children, Ready Ready and its partners work to ensure children are ready and eager to learn when they enter Kindergarten and on track to succeed in school and life.

For more information about Ready Ready, please visit its website.

The Duke Endowment Logo

The Duke Endowment

Since 1924, The Duke Endowment has worked to help people and strengthen communities in North Carolina and South Carolina by nurturing children, promoting health, educating minds and enriching spirits.

Located in Charlotte, N.C., the Endowment seeks to fulfill the visionary genius and innovative legacy of James Buchanan Duke, one of the great industrialists and philanthropists of the 20th century. 

The Endowment has awarded more than $3.7 billion in grants since its inception, including over $1.5 billion to Duke University. With assets of $3.69 billion in 2017, the Endowment is one of the nation’s largest 501(c) (3) private foundations. Today, more than 80 percent of its total spending goes to grantmaking.

In addition to grantmaking work in four program areas, the Endowment shares its knowledge by publishing resources for grantees and other service organizations, including information about what the Endowment is learning from its work in various publications, reports and evaluations. The Endowment also operates a fellowship program to cultivate emerging leaders in philanthropy.

For more information about The Duke Endowment, please visit its website.

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