iNICQ 2014

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iNICQ 2014: Structuring Success in the Care of Infants and Families Affected by Neonatal Abstinence Syndrome


The Vermont Oxford Network is pleased to announce our 14th Internet-based quality improvement collaborative. A total of 143 centers are joining us in the quest to measure, learn, improve, and share potentially better practices in the care of infants and families affected by maternal substance abuse disorder (SAD) and neonatal abstinence syndrome (NAS). Currently participating centers, as well as new centers and state regional perinatal collaborative networks, are building upon the success of iNICQ 2013, which enrolled 205 centers from 42 states, Ireland, and the United Kingdom. A series of three VON Day quality audits have been performed and represent the largest audit of NAS to date.


Care by ParentThe over-prescription, diversion, and/or illegal use of street drugs or prescription medications is reaching epidemic proportions in key areas of the United States. In the adult population, deaths from prescription drug overdoses totaled 36,450 in 2008, closely rivaling the 39,973 deaths from motor vehicle crashes as a leading cause of death and injury (CDC 2011). Substance abuse in pregnancy is a growing problem. The rapid cycle vertical transmission of drug dependence, from mothers to infants, has created a major public health burden for maternal and child health care systems across the US.

A lack of understanding of addiction as a disease has led to a punitive culture of blame and shame. Fear of stigmatization, discrimination, child removal, poor treatment, and criminal prosecution has deterred women from seeking care. However, the research suggests that providing substance-dependent women with comprehensive health care, drug- and alcohol-abuse treatment, and social support improves pregnancy, birth, and child-development outcomes. There is an urgent need for development of a coordinated public health approach and innovative, collaborative solutions for providing care.

Infants exposed in utero to opiate medications may exhibit signs of withdrawal after birth, a syndrome characterized as neonatal abstinence syndrome (NAS). There is wide variation in the approach to the care of these infants, leading to tremendous variation in both resource utilization and outcomes.

Scope of the Problem

Recently Patrick and colleagues have documented a dramatic increase in NAS during the past decade (JAMA. 2012;307(18):1934-1940) PubMed:22546608. Infants with NAS have higher rates of neonatal complications and prolonged lengths of stay, consuming substantial NICU and hospital resources. Further, they impose a growing burden on already strained health care resources because state Medicaid expenditures are disproportionately impacted. At the state level, state health departments are reporting dramatic increases in rates of NAS as well.

Structure for the iNICQ 2014 NAS Collaborative Improvement Project (core curriculum)

  • Baseline local assessments, VON Day quality audit, team building, and session pre-readings and work
  • Five 90-minute Internet-based webinars, conducted from January to September 2014, comprised of expert evidence reviews, program highlights from centers of excellence, and improvement knowledge and tools, and followed by 30- minute post-session work sessions designed to assist local teams in structuring success
  • Access to world-class faculty experts who participate in every web session and are accessible for questions and answers throughout the year via the robust listserv
  • A Virtual Video Visit to a Center of Excellence, and a companion Facilitator’s Field Guide focused on action-oriented team learning
  • Access to a host of quality improvement tools and resources on NICQpedia, the QI collaboratives “members only” online learning platform

Download pdf of the detailed core curriculum.

Structure for the iNICQ 2014 NAS Collaborative Intensive Track (elective)

Participants in the iNICQ 2014 Intensive Track have the opportunity to participate in an accelerated quality improvement series that is designed to help organizations execute and sustain their QI efforts. The Intensive Track includes all elements of the core curriculum plus:

  • Four additional 60-minute Internet-based learning sessions led by experienced QI faculty
  • Collaboration with the existing NICQ Next centers to identify effective QI strategies
  • A face-to-face 1-day NICQ Symposium, designed to foster learning and cross pollination with the NICQ Next: Innovations in Newborn Care teams, held in Chicago IL, in conjunction with the 2014 Vermont Oxford Network Annual Quality Congress

Download pdf of the detailed intensive curriculum.

Continuing Education Credits / Maintenance of Certification Part 4

The educational activities associated with iNICQ 2014 have been approved for Continuing Medical Education and Nursing Contact Hours credit.

The iNICQ 2014 Collaborative has been approved by the American Board of Pediatrics (ABP) as a source of Maintenance of Certification (MOC) Part 4 credit for those participating physicians who meet the criteria established by the ABP. Individual physicians as well as teams of physicians may submit this work for credit.

For more detailed information regarding continuing education credits or MOC please see the CE/MOC page.

How to Register

Vermont Oxford Network will provide ongoing curricular offerings and serial measurement of each center’s progress. Rolling admissions will be accepted and new teams will have access to all of the 2013 and 2014 collaborative materials.

iNICQ 2014 Core $3500 per VON member hospital
$6000 per non-VON members
iNICQ 2014 Intensive $6000 per VON member hospital
$8500 per non-VON members

Note: Intensive includes all Core benefits listed above

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