Design and Implementation

Throughout the PDCA cycle, data—both quantitative and qualitative—are used to identify where changes might be needed to drive decisionmaking and for feedback loops and communication across all levels. In other words, data are used to monitor the program. Starting with design and planning, and continuously throughout the life of the program, data should be continuously gathered, reported, and used at every level. Monitoring takes results, processes, and experiences (data) and uses them.[31]

Data and monitoring are essential parts of the continuous learning cycle. Damschroder and colleagues’ review notes that “quantitative and qualitative feedback about the progress and quality of implementation accompanied with regular personnel and team debriefing before, during, and after implementation is one way to promote shared learning and improvements along the way.”[32]

Monitoring has four main purposes, including[33]

  • learning and improving,
  • providing accountability for resources used and results obtained,
  • making informed decisions on the future of the program, and
  • promoting empowerment of those who benefit from the program.

Monitoring should be iterative and integrated into the program from the start. It can generate early warnings when things are not going as planned. It informs both continuous improvement and adaptations made to activities. Monitoring can provide information needed to revisit decisions and change course.


[32] Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(50). Retrieved from

[33] Mathias, D. (2015). Impact of the Early Learning Challenge on State Quality Rating and Improvement Systems. In Dichter, H. (Ed.), Rising to the Challenge: Building Effective Systems for Young Children and Families. Washington, DC: The BUILD Initiative. Retrieved from .