The above graphic displays the Early Childhood Program Quality Improvement and Indicator Systems Model (ECPQI2M) that has been described in a previous blog post. In this blog post, there is the need to cross-reference the model with the various monitoring approaches that have been used in the human services over the past 50 years in order to demonstrate how this model can tie the various approaches into a unified system as suggested in the previous post (also see the Licensing Measurement and Monitoring Systems eHandBook that is available on this blog as well as on the RIKI Introductory/Main Webpage).

Program monitoring has gone through many variations as has the ECPQI2M. Program monitoring has had an anecdotal phase, instrument-based phase, coordinated phase, differential/inferential phase, and integrative phases. The ECPQI2M has also gone through five phases/editions as well mirroring the program monitoring developmental stages.

In the above model, the anecdotal phase is depicted essentially by the first two blocks to the left: Licensing Systems and QRIS blocks. These were independent of each other during the anecdotal phase because these systems came online at different points in time. Licensing was first with QRIS coming on later in time to build upon and expand the quality component of licensing. The other problem with the anecdotal phase was the emphasis on case notes within licensing for doing inspections and reviews and the inability of using these data to communicate with any other system in a large scale way.

The instrument-based program monitoring phase basically started to replace the anecdotal phase beginning in the 1970’s with the introduction of checklists and tools to gather more and more data from programs that were increasing in number and size. There was a tremendous expansion taking place in the human services, especially in early care and education programs, that necessitated a new program monitoring system to track all these new programs. Once this system change occurred, it was possible to make the systems more efficient and effective based upon the new level of quantitative data measurement and analysis. This ushered in the inferential/differential monitoring phase. This is depicted in the above graphic in the same two boxes to the left but now they have the ability to communicate with each other.

The inferential/differential monitoring phase was a change made possible because of the regulatory compliance theory of diminishing returns/ceiling effect which was reported in the licensing research literature in the late 1970’s, early 1980’s. With this theory, it became possible to approach regulatory compliance in a new and innovative way that relied on risk assessment and key indicator methodologies and introduced the idea of abbreviated reviews or inspections. This is depicted in the above graphic in the middle three boxes: Risk Assessment, Key Indicators, and Differential Monitoring. It was a major paradigm shift for the human services field and was mostly felt in the early care and education domain. Two publications of standards by ACF/HHS Stepping Stones to Caring for Our Children and Caring for Our Children Basics came out of this phase which relied upon risk assessment and key indicators respectively for their development.

The next phase of program monitoring started in the 2000’s, the coordinated monitoring phase came into being because of the proliferation of early care and education programs in many areas: Head Start, child care, preschool, public and private center based and home based care (this phase of monitoring was heavily encouraged by ACF and OPRE). Based upon this growth and the differing standards, rules, and regulations, there was a need to coordinate monitoring reviews across the governmental/funding silos and domains in order to be more effective and efficient. In the above graphic, again the first two boxes are pertinent but now think about reviewing all the various standards, rules, and regulations in a coordinated fashion rather than separately when viewing these two blocks.

The last phase to be addressed in the above model is to take the full model into focus and to really begin to think in terms of an integrative monitoring approach (see the Freer & Fiene, 2023 blog post earlier this year related to their Journal of Regulatory Science article on this topic) which combines regulatory compliance and program quality into one effective and efficient program monitoring system. In this phase, the silos come down totally and all systems are talking with each other from licensing to QRIS to accreditation to professional development/technical assistance. Data are freely shared from one system to another and scoring takes into account health and safety but program quality as well. There is the development and implementation of program quality indicators as well as licensing indicators and risk assessment rules. When this is done, the beneficiary is in child outcomes in which true developmentally appropriate individualized targeted education and care can be provided for each child in a family friendly delivery system; assessments are tied to curriculum; encouraging communication and reasoning skills in children; and caregivers who are warm and attentive to children.