Strengthening Continuous Quality Improvement Practices in Early Care and Education through a Breakthrough Series Collaborative

Young children benefit from high-quality early care and education (ECE) programs.[1] One way to ensure quality is to promote early educators’ use of evidence-based practices. To that end, the Breakthrough Series Collaborative (BSC) is an innovative, flexible continuous quality improvement (CQI) methodology that uses organizational-level coaching to help program administrators and educators apply evidence-based practices to support children’s well-being and adapt these practices to meet children and families’ needs in their unique ECE contexts.[2]

For the BSC in early childhood contexts, teams from ECE centers—including leaders, educators, support staff, and parents—are brought together to implement improvements through rapid cycle testing, peer learning, and data-driven decision-making. These BSC teams choose from a set of evidence-based goals and practices to test in their ECE context through iterative cycles that help determine whether each small change in practice resulted in improvement.[3] A broad collection of activities—including day-long learning sessions, monthly all-team calls, and monthly affinity group calls—helps teams within a BSC build connections among themselves and learn from each other. Each BSC also has coaches who provide ongoing quality improvement support, including coaching on using tools to support data-based decisions about whether a change in practice leads to an improved outcome. Although the BSC methodology has been effective in improving practice and outcomes in sectors such as health care, education, and child welfare, evidence in ECE contexts is still emerging.[4]

The goal of the Culture of Continuous Learning (CCL) project is to explore the implementation and outcomes of a BSC in ECE centers and systems. This report summarizes findings from Phase II of the CCL project, which examined the BSC as a methodology to support the use of evidence-based practices in ECE and sought to add to the evidence base for the CCL Theory of Change.[5]

Findings are drawn from a longitudinal mixed-methods case study that examined the implementation and outcomes of three BSCs supporting social and emotional learning (SEL) practices in a total of 19 Head Start and child care centers across three states. Each participating center formed a BSC team. Data sources included administrative data (e.g., BSC applications and attendance records), focus groups and key informant interviews with BSC team members and BSC staff, and surveys with BSC team members and with other staff and parents at the ECE centers. Data were collected at four timepoints: T1 (baseline, before the BSC started, March–April 2024), Time 2 (mid-point, during BSC implementation, October–December 2024), T3 (post-BSC, April–June 2025), and T4 (follow-up, six months after the conclusion of the BSC, October–December 2025).

Key findings

BSC participation varied across centers, but centers with lower turnover and stronger organizational climate at baseline participated in more BSC activities.

• Six of the centers in the case study were characterized by “robust” participation in BSC activities, whereas 13 centers were “less robust.”
• Centers with lower turnover and stronger organizational climate at baseline participated more in BSC activities than centers with higher turnover or weaker organizational climate scores at baseline. Other facilitators of BSC participation included strong leadership support and encouragement; organizational culture of continuous learning; peer accountability; a collaborative team culture; unrestricted stipends; flexibility in BSC design and delivery; and financial, credentialing, and workforce supports.
• Barriers to BSC participation included lack of time, insufficient staffing and organizational capacity, unclear goals and expectations of the BSC, lack of participation from other teams, and technology platforms that were difficult to use.

Increases in CQI practices were both sustained and spread throughout ECE centers, especially among centers that robustly participated in BSC activities.

• Some indicators of CQI practices significantly increased within centers from baseline to post-BSC, and these gains were sustained six months later.
• Centers with more robust BSC participation showed even greater increases in quality improvement practices over time than centers with less robust participation.
• Although only BSC team members showed significant increases in CQI practices at post-BSC (T3), both BSC team members and center staff who did not participate directly in the BSC showed increases in CQI practices by follow-up (T4), suggesting spread in intra-organizational learning of CQI.
• In qualitative data, BSC team members described the BSC as building stronger communication and collaboration, both within their centers and across BSC teams.
• Although survey reports of overall data use did not significantly increase across all survey respondents, administrators showed significantly greater increases in data use compared to teachers and other staff. Additionally, in interviews and focus groups, BSC team members across roles described meaningful shifts toward becoming more comfortable using data to guide decisions and having a more inquiry-based mindset.

Some outcomes of interest improved over time, but findings were mixed overall.

Evidence of both increased positive outcomes over time and spread of these outcomes beyond BSC team members varied across quantitative and qualitative data sources. For example:

• Survey measures of short-term outcomes such as organizational climate and shared leadership significantly decreased from baseline (T1) to post-BSC (T3). There were also no significant changes over time in survey measures of self-efficacy or attitudes and beliefs toward SEL and CQI. In contrast, qualitative data described improved workplace relationships and organizational climate, increased levels of distributed leadership across staff and parent roles, and increased confidence and intentionality in approaching both SEL and CQI among staff.
• For long-term outcomes, survey measures of family engagement reported by both staff and parents decreased from baseline (T1) to post-BSC (T3), and there were no significant changes in survey measures of SEL-promoting classroom practices, perceptions of children’s challenging behaviors, and employee retention. Furthermore, decreases in measures of organizational climate, SEL culture, and family engagement from baseline to post-BSC in the full sample did not vary by BSC participation level. In contrast, the qualitative data described increases in some of the same longer-term outcomes: improved family engagement strategies and improved SEL classroom practices and environments.
• Facilitators of the spread of BSC practices to center staff who did not participate directly in the BSC included individuals who acted as champions within centers. Barriers to spread included siloing between classrooms and centers and the tendency for nonparticipating staff to not see themselves as part of the process.

BSC team members reported high levels of satisfaction with the BSC methodology and suggested that some BSC strategies were likely to be sustained beyond the end of the BSC.

• The majority (90%) of feedback survey respondents reported that they would recommend participating in a BSC to staff in other child care/Head Start centers. Likewise, the majority (88%) of final feedback survey respondents were “very satisfied” or “moderately satisfied” with their BSC experience. In-person learning sessions were a highlight that BSC team members wanted to see more frequently.
• BSC team members identified four key areas in which BSC strategies were likely to be sustained beyond the end of the BSC: SEL strategies, family engagement, a CQI mindset, and organizational climate. BSC team members identified three facilitators that supported sustainability: practices with low implementation burden, the integration of practices into existing operations, and alignment of practices with broader systems, such as state quality improvement systems. BSC team members identified two barriers to sustainability: time and competing priorities, and staff turnover. BSC team members also identified the need for further support to help them sustain CQI practices, particularly when onboarding new staff and continuing to make sense of data.