Why It Matters
Can quality improvement work in settings other than health care? A project in Chile shows the power of improvement science in early childhood education — a key determinant of health.
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New Frontiers for QI Methods: Improving Early Education in Chile

By Sara Alvarez | Wednesday, April 27, 2016

Quality improvement in early education Fundacion Oportunidad

A large-scale quality improvement initiative in Chile has improved educational outcomes for more than 2,000 children, including these two boys who live outside Santiago. Photo credit: Fundación Oportunidad.

Evidence shows that early childhood education is crucial to good health over the course of a person’s life.

That’s how the program Un Buen Comienzo (UBC) — “A Good Start” in English — came to life. UBC is a project implemented in Chile by the Fundación Oportunidad (Opportunity Foundation), which uses IHI’s improvement methodology to improve the quality of early education in vulnerable communities. This work has introduced improvement methods in Chile’s education sector and has improved education outcomes of more than 2,200 children.

I spoke with Francis Durán, the Improvement Advisor for the project, about the movement to incorporate quality improvement in Chile’s education system.

How did you start your journey applying quality improvement in education?

It all started about five years ago, when the Foundation decided to use QI methods in the UBC project. UBC started as a Harvard study in Chile that didn’t yield the expected results. In that process, the Foundation became familiar with IHI’s work and started working in collaboration with IHI to improve early education in 28 schools in an area just outside of Santiago. It was through this collaboration that I had the chance to participate in IHI’s Improvement Advisor Program, which deepened my knowledge of quality improvement.

With this experience, I’ve obtained a deeper confidence in the methodology and gained extensive experience in this innovative approach, managing groups and improvement tools, and working in the field, especially. Today, I feel more confident about foreseeing obstacles and designing projects in the appropriate scale.

What do you think the UBC project has shown about the value of innovation and continuous improvement in education? Was there much of a history of this work in Chile before?

I think the biggest impact this work has been to catch the attention of the National Agency for Education. Last year, UBC had the best results so far, and the government noticed. The Agency saw the extraordinary results of the initiative, and is now going to implement this methodology at a national scale. This wouldn’t have been possible without the Foundation’s work.

Introducing these concepts and methods in Chile was a huge innovation in general, not only in education. The first year was one of learning, especially around adapting the tools’ language from health to education. We had to generate and cultivate skills and trainings on data usage, since it was not common in our educational context.

READ MORE: Learn about IHI’s work in Latin America

Initially, there was a natural resistance both from the schools and the Foundation, because we were all learning at the same time. It was a big challenge to be learning and leading the changes at the same time.

What results did you achieve?

Last year, we were able to achieve exemplary improvements. We created a positive environment around improvement and a cultural change inside the schools with the improvement tools, which gave us and the schools the drive to keep improving.

The most relevant achievement from an educational perspective was improving the teachers’ practices in the classroom, which drew national and international interest to our project. 

Another crucial achievement was to improve children’s attendance to class, through a strategy within schools themselves. The schools created Attendance Committees with faculty members and family representatives to look for shared solutions. With the use of improvement strategies, the committees themselves proposed innovative approaches and solved problems that weren’t even visible to the schools before.

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For example, one little boy had a very poor pattern of attendance, but it wasn’t clear why. After some examination, the committee realized that he was missing school because he has to cross a bridge that broke down, so he didn’t have a reliable means of transportation. The committee was able to understand the reason for the problem, and they motivated the community to find collaborative solutions to concrete difficulties the children were facing.

What lessons could you share with others trying to tackle similar challenges?

Personally, I think that we started the work using the improvement tools with extreme rigor and forgot about the human side of improvement. The use of the methodology was too rigid from our part, and it made it difficult to collaborate with the people doing the field work. With time, we were able to be more flexible: we didn’t compromise the methodology, but we were able to connect with teachers, children, and the community.

I’d just advise to always take into account the human side of improvement, to find a balance between the data and the children, and to connect with people and their will to improve. We can’t forget people, and that we all work best when we are motivated.

What surprises people most when you describe the success of UBC?

People tend to think that the improvement methodology is just too much work, so they get very surprised when they realize that the methodology is really more about efficiency and redistribution of work.

MaryCatherine Arbour, faculty for the UBC project, presented our work at the 2016 Carnegie Foundation for the Advancement of Teaching Summit, where the public was surprised to see that the improvement tools were successfully used in Chile and that the teachers could fully understand and incorporate PDSA cycles.

This feedback motivates us to find ways to publish our learning and results with other organizations in Chile and around the world. 

What was your proudest moment as part of the UBC work?

After about two years of work, one of the teachers approached me and expressed how happy she felt because she was finally doing her job the way she was supposed to, the way it should be done. She felt that she was finally the teacher she had always wanted to be. The schools and teachers started to disseminate the work within other grade schools and among the communities.

Last year we were able to get the teachers to take a leading role in the process, with great enthusiasm. Seeing the teachers’ self-confidence grow was one of the most rewarding outcomes of the project. In Chile, teachers aren’t often valued like they should be and they get paid very poorly. It’s a demanding and exhausting job, which can be demoralizing.

The teachers were participating, using the methodology, and they felt more valued. This really improved their self-esteem and their own expectations of what they could achieve. We really saw how this formed a virtuous cycle, where they kept wanting to tackle more challenges, improving, and getting more motivated to do more.

Learn More about IHI’s work in Latin America

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