Through the Looking Glass: Reflections on a Quality Improvement Study of a Year of Child Care Health Consultation

Donabedian's framework of structure, process, and outcomes has guided more than three decades of health care quality improvement. A child care health consultant is a public health nurse working in collaboration between nursing center and childcare quality improvement system in early care and education. The child care health consultant completed a year of pilot programming of no-cost consultation services with twenty early learning sites. The structure involved on-site, telephone, and email visits with urban, suburban and rural early learning centers targeting infant and toddler care. Interventions outlined by the Minnesota Department of Health, Office of Public Health Practice, described the processes used by the child care health consultant. The consultant reported the initial outcomes previously, however, outcomes were incomplete at that time. In this study, the child care health consultant will report on quality of services during the pilot year accomplished by a qualitative review of satisfaction surveys, and will reflect on additional outcomes from the year of intervention.