Quality Improvement Process

A New Model – A New Way of Thinking

Quality Improvement is a process; a journey that is continuous. The current focus on ratings for Great Start to Quality leaves providers “checking the box” in order to achieve a higher rating, rather than focusing as much as they could on true quality improvements.

Over the years providers have shared how the connection between Star ratings and other rating systems (Yelp, Google, etc.) gives families an inaccurate context for measuring program quality. With provider and stakeholder feedback, the Great Start to Quality Advisory Committee has developed a new model to better support program reflection and quality improvement. In this new model, there will also be indicators for self-reflection that will not be scored, but instead is used to inform quality improvement.

Child painting

Levels of Quality

There will no longer be Star ratings but instead four Levels of Quality:

Maintaining Health and Safety

Maintains a licensing status of Original, Regular, or 1st Provisional

Reflecting on Quality

Conducts a Self-Reflection of the Quality Indicators

Enhancing Quality

Creates one goal in the Quality Improvement Plan and assigns a due date
May choose to receive free coaching from a Great Start to Quality Resource Center or specific program coaching

Enhancing Quality – Validated

Completes at least one goal in the Quality Improvement Plan then completes Validation and prepares for On-Site Observation

Demonstrating Quality

Meets threshold scores for all ages served through On-Site Observation

The Process

Quality Improvement Process Graphic

The process of quality improvement never ends. There is always new research and learnings in the field of Early Care and Education and in the new process, programs are encouraged and supported to continue to reflect on their practices, in line with the program’s philosophy. This can assist programs in creating goals for improvement to ensure the best quality care for the children and families they serve.

What Happens to My Rating?

Programs that have a current, valid rating will convert to a quality level on February 1, 2023. Programs that receive increase subsidy reimbursement will continue to receive the same rate of payment.

Some Things Change – Some Things Stay the Same

While many improvements to Great Start to Quality are taking place, there are also many parts of the process that will stay the same. Check out what is changing and what will stay the same.

Quality Indicators

As part of the revisions to Great Start to Quality, the Quality Indicators have been thoroughly revised, based on provider and stakeholder feedback to provide simple and clear language. The revised Indicators are supportive of all program types, give opportunity to reflect and improve high-quality practices, and promote equity and inclusion in all programs.

Transition Timeline for Programs

If you are a currently Star rated program, or are interested in becoming Star rated before the transition to the Quality Improvement Process in February 2023, it is important to understand the timeline for submitting the Self-Assessment Survey to allow time for the rating to take place. If you have questions about the timeline, contact your local Great Start to Quality Resource Center at 1-877-614-7328 or greatstarttoquality@ecic4kids.org

Maintaining Quality Levels

Programs can apply to access the Self-Reflection before the current quality level expires in order to maintain that level and the related increased subsidy rate. From the time the program applies for Reflecting on Quality, they have six months to move through the process to their current level. If the program does not take all the steps to get back to the same quality level, they will publish at the level they achieved at the 6-month mark from the date of application for Reflecting on Quality.


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