Get Ready Guilford: New partnership with The Duke Endowment launches in 2018

The opportunity. Guilford County, in partnership with The Duke Endowment, has an exciting opportunity to build a stronger and more connected system of care for our community’s youngest children and their families.

Today, no such robust system exists. During the most critical years of brain development — prenatally through age three — families spend significant time and resources navigating a disconnected system of care. Some families are able to get needed resources for their children, while others are unable to do so for a variety of reasons.

Guilford is charting a new vision. It’s one in which each pregnant woman will receive high-quality, timely prenatal care. Families will be connected to additional supports tailored to their unique needs within medical homes. The goal is that families of infants, toddlers and preschoolers will get what they need, when they need it, so every child enters school developmentally on-track and ready to succeed.

Why is building an early system of care important? Experiences during the infant, toddler and preschool years build the foundation for a child’s future learning; decades of research find those who have enriched experiences are more likely to succeed in school and in life.

Data shows that almost 50% of Guilford County children enter Kindergarten behind expected developmental standards. Once behind, it’s difficult and more expensive to help them catch up. Recognizing the short-and long-term economic consequences, local business and foundation leaders joined together to explore what it would take to build a system that produces better outcomes for young children and their families.

Why Guilford? In 2014, in partnership with 60+ agencies and organizations, Guilford County leaders launched Ready for School, Ready for Life. The initiative’s charge is to build a more responsive, innovative, and connected early childhood system. The goal is population level change so that children enter Kindergarten ready for what’s ahead.

For 18 months, hundreds of Guilford County residents contributed to an early childhood community vision grounded in local data and focused on engaging families with young children. Teams explored problems within the current system, identified root causes, and developed strategies to address them.

The Duke Endowment, which has long-standing partnerships with key early childhood programs delivered within Guilford, took an even stronger interest in Ready/Ready’s system-building approach in 2016. The Endowment’s staff participated in the vision building work from the beginning, and started making strategic investments in this work in mid-2017.

The goal. There are five outcome areas for the work: (1) Planned and well-timed pregnancies; (2) Healthy births; (3) On-track development at 18 and 36 months; (4) School readiness by kindergarten; and (5) School success by third grade. Child well-being will be measured using sixteen indicators that are described in the Get Ready Guilford Theory of Change (PDF).

Ready/Ready and The Duke Endowment have co-developed a shared theory of change to guide this work. We believe that we can measurably improve outcomes for both individual families and across Guilford’s population when the following five conditions exist:

  • All families are offered assessments to identify their needs
  • The right resources are available in the community
  • Families get connected to those resources at the right time, based on their needs and with the right information shared
  • Our community is informed about healthy development
  • We sustain the new system.

Pilot activities to launch in early 2018. Several pilot activities will launch in early 2018 to support this theory of change. The pilots leverage existing programs and expand the reach and integration of some key programs to reach more families. The new system will:

  • Identify and screen every pregnant woman in Guilford County as early as possible in pregnancy so she can be offered the resources and services she needs, including intensive home visiting programs (Outcome area: Healthy births)
  • Ensure that all families receive a home visit within three weeks of birth by a nurse who will provide needed support to the new mother, baby and family, as well as connection to resources. (Outcome area: On-track development at 18 and 36 months)
  • Additional child development experts work with all families at well-child visits in pediatric practices that serve a large proportion of Medicaid-eligible families (Outcome area: On-track development at 18 and 36 months)
  • Home visits offered to all families of toddlers (15-18 months old) and preschoolers (36 months) by parent educators to connect with needed resources (Outcome area: On-track development at 18 and 36 months)
  • Help Guilford County programs and services use data to continuously improve their effectiveness, make decisions, and coordinate their care for families (Intended outcomes: ALL)

The system will be supported by continued engagement with families to evaluate success and change course as needed. A rigorous evaluation process has been developed with an external evaluator to be hired in early 2018. A feasibility study for a new data infrastructure designed to help measure progress, manage referrals, and coordinate care for families will be completed by Duke University by February 2018. Our public will-building efforts to drive demand for better early childhood outcomes will intensify, and sustainability planning to maximize private investments is underway. Selected programs and supports will also be scaled to meet community need.

What’s next? Work groups of local and national experts are hard at work to develop the pilots, learn what’s effective and what needs to shift, and to begin pilot implementation. Stay tuned for updates and send any questions you have to our team at