Building an online quality improvement information exchange for home visiting programs in Missouri

Early childhood home visiting programs date back to the 1880s and deliver a vital public service of providing and connecting families with health, educational, and economic resources to support optimal development. Continuous quality improvement (CQI) consists of systematic and continuous actions that lead to measurable improvement in services for targeted groups. CQI initiatives (CQII) in home visiting programs have traditionally occurred within a local implementing agency (LIA), parent organization, or funding provision. LIA CQII are often lost to the benefit of external agencies facing similar challenges. We developed a web-based environment, the Gateway, to virtually connect and engage users within an environment aimed to balance CQII training and practice. The environment supports CQII activities which promote and support LIAs quality improvement initiatives while aligning stakeholders from seven Missouri home visiting LIAs. Gateway standardizes quality improvement training, collates overlapping resources, and supports knowledge translation, thus improving capacity for measurable change in organizational initiatives.Gateway allows LIA personnel to identify program activities in need of quality improvement, and guide the planning, implementation, and evaluation of CQII. Prior to site launch, pilot and usability testing was conducted to three defined groups with positive results and a combined System Usability Scale score of 71.63. After full launch, we examined performance relative to targets through the integration of data, dashboards, and reports. To our knowledge, a virtual environment aimed to create a culture of quality improvement and foster CQII for home visiting program LIAs has not been previously reported. Given broad focus on CQI priorities across disciplines, the Gateway offers endless potential with expansion of this site and deployment to programs and agencies beyond the build population.