iNICQ: Internet-Based Newborn Improvement Collaborative for Quality

About the QI Collaborative

VON’s Internet-based Newborn Improvement Collaborative for Quality (iNICQ) brings teams together to use local and collective data to guide improvement on a designated topic. Participating centers are supported with access to expert faculty, VON measurement and reporting, and an interactive online toolkit of evidence-based practices.

  • Improving Critical Transitions (2018-2022): Teams aim to improve processes and practices to affect outcomes and experiences for infants and families.
  • All Care is Brain Care (2023-2026): Teams aim to improve care and outcomes for infants by addressing clinical care through a neuroprotective lens. Curious if this project is a fit for your center? We have discernment tools and reports you can use to determine an appropriate improvement focus.

Preparing for 2023

Please use the resources below to learn more about All Care is Brain Care and how the project can improve care at your center.

Improving Critical Transitions

Key Drivers

What is a Critical Transition?

A critical transition is any change to the site of care, status or plan of care, or care team.

In newborn care, these changes happen multiple times from birth to home, and frequently through each phase of care. Each transition can affect the outcome of the infant and experience of the family.

Teams participating in this collaborative will utilize the drivers of high-quality transitions to improve critical transitions within and between phases of care. The focus for 2022 will be on improving handoffs within these transitions.

The focus in 2022 on improving handoffs is a vital aspect of improving critical transitions across all phases of care.
Phases of Care

Critical Transitions in Phases of Care

Critical Transitions occur within and between phases of newborn care. Handoffs are a vulnerable aspect of all of these transitions, occurring frequently throughout each day and across the entire NICU stay.

This collaborative presents the opportunity to impact the care of all infants and families entering a hospital, and the opportunity to include multidisciplinary colleagues from all departments involved in transitions in newborn care.

Achieving High Quality Transitions

Participating teams:

  • Review their VON data;
  • Identify opportunities to enhance processes and practices during critical transitions;
  • Apply structured quality improvement in partnership with families and colleagues at other centers;
  • Achieve measurable improvement in health outcomes, family experience, and local organizational priorities.

Two twice-per-year VON Day Audits support center-level benchmarking and provide metrics to measure the improvement of the collaborative as a whole. One audit is focused specifically on handoffs and can be used as a tool to evaluate handoffs throughout the year, and the other audit is a brief form to measure critical transitions in general.

Additional Quality Circle benefits support QI education and training for all staff at participating centers, including a QI Foundations course and other resources specific to clinical topics in newborn care.



Evidence-Based Toolkits Support Improvement

A custom interactive toolkit presents resources aligned with the phases of the care experience as defined by NICU families. The toolkits include evidence-based potentially better practices and change ideas (we consider practices potentially better because they must be tested and adapted to each center’s unique context).

The practices address processes related to the primary drivers of improving critical transitions and provide potentially better practices for clinical processes that can be potentiated by improving critical transitions.

Teams can also reference the handoffs-specific toolkit, which includes a driver diagram, potentially better practices and change ideas intended for teams to adopt and adapt to meet their project-specific needs and reflect their current system.

Supplemental toolkits include: Improving outcomes for micropremature infants, Minimizing brain injury, Optimizing nutrition and minimizing NEC, Infants requiring surgery, and Minimizing lung injury.

health equity

Health Equity Innovation Grant

“Follow through” is a comprehensive approach to address health equity that begins before birth and continues into childhood. It involves health professionals, families, and communities as partners to meet the social as well as medical needs of infants and families.

The Improving Critical Transitions collaborative includes a competitive grant program to help teams develop tactics that will spread throughout our community of practice to “follow through” and address health equity.

Take Action to Follow Through Grant Information
CLD outcomes

Improving Outcomes and ROI

More than 700 teams participating in VON QI for over 25 years have demonstrated remarkable improvements in clinical outcomes and substantial cost savings.

Teams apply structured and disciplined QI methodology to address processes and practices that cumulatively impact big dot outcome measures.

Teams implement evidence-based practices, establish QI fundamentals to improve practices and processes, and set the foundation for data-driven sustainability of improvement for the measures that matter to care teams, hospitals, and families.

About the Experience and Outcomes of VON QI

How can we affect health outcomes at your center?

Handoffs are critical because they happen so often – each day and throughout the course of care – and yet they are also extremely vulnerable times that can lead to error, delays, duplications, dissatisfaction, and longer hospital stays. On the other hand, each handoff also provides an opportunity to re-evaluate and improve care.

iNICQ Improving Critical Transitions Features

The iNICQ improvement collaborative is a benefit of Quality Circle membership. Specific features of iNICQ include:

  • Interactive Handoffs Toolkit
  • Additional toolkit outlining key evidence, potentially better practices, and change ideas for critical transitions across phases of care
  • Community Forum and dedicated listserv to communicate with expert faculty and peers
  • Live webinar series
  • Support to implement Experience-Based Co-Design with families
  • Online classroom, including recorded webinars accessible any time for CE credit
  • VON Day Audits focused on handoffs to provide baseline gap analysis and track progress over time
  • Funding opportunities through VON’s Take Action to Follow Through grant
  • Education for QI fundamentals for entire interdisciplinary team
  • Improvement stories from teams applying QI and EBCD methodologies to critical transitions
  • Dedicated event at VON’s Annual Quality Congress with peer-to-peer learning
  • Faculty review of improvement posters
  • Discounted registration for Annual Quality Congress
  • Maintenance of Certification (MOC) Part 4 credits for entire physician team
  • CME/CNE, for an unlimited number of team members

2022 Schedule

January 19
Introductory Webinar for VON Champions and Team Representatives

February 9
Measuring for Local Improvement

April 6
Standardizing Handoffs

June 15
Engaging Families

September 8 – September 11
Annual Quality Congress

October 19
Exploring Communication and Teamwork Practices

December 14
Considering Human Factors

*Two VON Day Audit periods will occur during the year.


We will be happy to address any questions you have about Quality Circle membership or the iNICQ Improving Critical Transitions collaborative. Please contact Pam Ford, iNICQ Program Coordinator:

iNICQ participation is included in Quality Circle membership

Cost and Enrollment

iNICQ participation is a benefit of Quality Circle Membership.

Quality Circle Annual Fee: Core membership + $7,500

Group and health system pricing is available.

Please contact Pam Ford, iNICQ Program Coordinator, with questions or for more information:

Interested in committing further for collaborative improvement in critical transitions? Enroll in the NICQ program and engage a team in iNICQ for no extra cost.