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Deb Mathias, Director of the QRIS National Learning Network of the BUILD Initiative, discusses the relationship between Quality Rating Improvement Systems and Continuous Quality Improvement. She discusses what's needed to focus on creating cultures of quality in early childhood programs. She also shares her perspective on the importance about focusing coaching on sustainable quality - really improving programmatic quality care and being in it for the long haul - continuous quality improvement and avoiding using a “quality for a day” and “get those scores up” approach.