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An extraordinary number of young children are exposed to trauma that impacts their healthy development. Early care and education (ECE) programs play an important role in reducing the impact of traumatic stress in children’s lives. This study investigated a quality improvement initiative in urban ECE programs to promote the adoption of trauma-informed practices. The initiative took a novel approach through its use of the Breakthrough Series Collaborative (BSC) quality improvement methodology. This multiple case study examined how ECE programs improved trauma-informed practice as a result of the BSC. Results and discussion highlight 1) how programs implemented trauma-informed practices, 2) key facilitators and barriers encountered, and 3) implications for adapting the BSC model for the ECE context.