School readiness is a topic of great interest to early childhood and maternal child health initiatives, such as the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) programme. However, there is a lack of information about best practices or strategies in home visiting and their relative effectiveness in improving school readiness, making this topic appropriate for improvement through Continuous Quality Improvement (CQI) methods. In 2022, Alabama developed a Key Driver Diagram (KDD) for improving school readiness efforts within the home visiting programme using synchronous online focus groups as a method of qualitative data collection with early childhood and home visiting experts. Findings from this study include development of a KDD that includes aims, key drivers, and secondary drivers. The KDD represents the first of many steps toward a unified theory of change. Future efforts will include development of a CQI change package and testing change ideas in the field.