Practice Brief ReportAdvancing Quality Improvement in Public Health by Exploring CQI in Alabama's Home Visiting ProgramFifolt, Matthew PhD; Arbour, MaryCatherine MD, MPH; Johnson, Heather H. MPH; Johns, Elisabeth OTR/L, MPH; Preskitt, Julie PhD, MSOT, MPH Author Information Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama (Drs Fifolt and Preskitt and Mss Johnson and Johns); and Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (Dr Arbour). Correspondence: Matthew Fifolt, PhD, Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 330M Ryals School of Public Health, 1665 University Blvd, Birmingham, AL 35294 ([email protected]). The CQI Practicum was part of the Design Options for Home Visiting Evaluation (DOHVE) Contract HHSP233201500133I, which is led by the US Department of Health and Human Services' Administration for Children and Families in collaboration with the Health Resources and Services Administration (“HRSA”). DOHVE was awarded to James Bell Associates in partnership with Educational Development Center, Inc. HV CoIIN is led by the HRSA Division of Home Visiting and Early Childhood Systems in partnership with Educational Development Center, Inc, under cooperative agreement UF4MC26525. The authors have no conflicts of interest to report. All of the authors have made substantial contributions in designing, drafting, and approving the final manuscript. Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (http://www.JPHMP.com). Journal of Public Health Management and Practice: January/February 2022 - Volume 28 - Issue 1 - p E33-E36 doi: 10.1097/PHH.0000000000001080 Buy SDC Metrics Abstract Continuous Quality Improvement (CQI) is the use of a deliberate and defined improvement process to advance organizational systems. Quality improvement in public health is increasingly widespread, but there are still limited examples of success or descriptions of developmental trajectories for building CQI capacity. The goal of this article is to add to the extant knowledge on the topic by describing one state's implementation of evidence-based CQI in the Maternal, Infant, and Early Childhood Home Visiting program between 2014 and 2019. On the basis of a systematic review of Annual Yearly Progress reports and semistructured key informant interviews, analysis yielded 3 themes that facilitated successful implementation of CQI in Alabama: starting small and building capacity; engaging in continuous and supported learning; and establishing and maintaining a culture of quality. This project demonstrates that CQI can help public health practitioners refine processes and grow capacity to best serve clients' diverse needs. © 2021 Wolters Kluwer Health, Inc. All rights reserved.