NICQ Next2 2016-2017


NICQ Next2: Transforming Newborn Care 2016 and 2017

MomandBabyFor 25 years Vermont Oxford Network has engaged interdisciplinary care teams and family advisors from the worldwide community of practice for multi-institutional improvement collaboratives. The NICQ Next collaborative offers action-oriented, interdisciplinary, team-based learning in a hybrid model of web-based, virtual, and in-person collaborative events throughout the year.

Building on the overarching goal of transformation, participating centers select a ‘Homeroom’ affinity group led by a skilled faculty team, including a Quality Leader, a Family Leader and Clinical Leaders. read more

All NICQ Next2 teams convene for expert-led webinars exampling theoretical and applied improvement science. Face to face collaboration with Homeroom colleagues will occur in person in the spring and fall of each year. In year one, all NICQ Next2 teams will gather in Jacksonville, Florida to advance their teamwork, to learn from other centers and expert faculty and to access tools and resources to maximize their quality improvement success. Building upon the success of Open NICUs Supporting Improvement Toward Excellence (ONSITE), centers will participate in an immersion learning experience at a designated center from within their Homeroom group. This will be in the spring of year two. Teams will also meet with their Homeroom colleagues during dedicated time provided in conjunction with the VON Annual Quality Congress and NICQ Symposium, which is held in the fall of each year.

NICQ Next2 Homerooms

Optimizing Outcomes of the Micro-Premature Infant - Three Homerooms

These Homerooms will focus on the population at the highest risk for morbidity and mortality which are micro-premature infants. Teams will examine antenatal and delivery room Potentially Better Practices (PBPs) for this population. Their work will include the golden hour, as well as the critical first 72 hours. Clinical issues will include DR care, fluid management, skin care, nutrition, respiratory support, and neurological care. Innovative approaches to the care of the micro-premature infant will include dedicated small baby care teams, 2 person cares and the development and utilization of developmentally appropriate care maps.

The POD Homeroom will be led by:
June Austin Quality Leader
Amy Nyberg Family Leader
Ginny Shaffer Family Leader
Mindy Morris Clinical Leader
Eileen Steffen Clinical Leader
Michael Dunn Clinical Leader

Group 2 Homeroom will be led by:
John Lester Quality Leader
Lelis Vernon Family Leader
Sharyn Gibbins Clinical Leader
Alan Picarillo Clinical Leader

Group 3 Homeroom will be led by:
Jan Schriefer Quality Leader
Janelle Bainter Family Leader
Chris Chambers Clinical Leader
Jim Gray Clinical Leader

Improving Lung, Brain and Nutrition: A Multi-System Approach

Three groups of teams will come together to create a Homeroom. Within the Homeroom, the groups will focus on Improving Lung Injury, Minimizing Brain Injury, or Improving Nutrition with the support of dedicated clinical experts for each group. The 3 groups will be supported by one Family Leader and one Quality Leader.
Hannah King Quality Leader
Alexa O’Dell Family Leader

Focus on Lung
This group will focus on the NICU population <30wks and/or ≤1500 grams who are at the highest risk for chronic lung disease (CLD) or death. Participating centers will form teams that will work collaboratively with the faculty and other teams to develop targeted treatment approaches geared towards reducing lung injury in the infants.
Wally Carlo Clinical Leader

Focus on Brain
This group will focus on implementing evidence-based practices and processes to minimize rates of IVH and explore modalities of brain monitoring. Additional improvement topics may focus on PVL, therapeutic hypothermia, and HIE. The group will look at care strategies aimed at optimizing development in the NICU.
Sonia Bonifacio Clinical Leader

Focus on Nutrition
This group will develop evidence-based nutritional support guidelines for extremely premature infants. Efforts will optimize nutritional management that reduces extrauterine growth restriction (EUGR) through the use of early, intense parenteral and enteral nutrition. The development of necrotizing enterocolitis (NEC) will be minimized through the use of (a) nutritional support strategies that reduce the risk of gastrointestinal atrophy, and (b) care practices that increase and improve the use of mother’s own milk. This group’s work will address processes and outcomes of nutritional care with a focus on NEC prevention, optimal nutrition, and avoidance of extra-uterine growth restriction.
Richard Ehrenkranz Clinical Leader

Improving Outcomes for Infants Requiring Surgery

Inter-disciplinary care teams will identify key care processes in the diagnostic phase (prenatal or postnatal), preoperative, perioperative and intraoperative care, as well as opportunities during the ongoing convalescent phases of care – that are amenable to process improvement and standardization. Although individual teams may elect to focus on specific or complex surgical populations (i.e. gastroschisis or tracheoesophageal fistula) the Homeroom’s work will apply to all common surgical care processes, with a focus on critical handoffs throughout the hospital stay. Further, each team will benefit from the inclusion of parent advisors, whose expertise and experience will assist in co-designing a family-centered approach to care.

Pat Heinrich Quality Leader
Teesha Miller Family Leader
Carolyn Lund Clinical Leader
Biren Modi Clinical Leader
Tom Jaksic Clinical Leader

Improving Teams and Teamwork

This group will address processes of care in the NICU that rely on teams and optimal teamwork, which might include: DR resuscitation, urgent response, transport, and teamwork embedded in our daily care (rounds and handoffs as examples). Key resources that will inform PBPs and change projects will include the AHRQ survey: Team STEPPS Teamwork Perceptions, and Dr. Eduardo Salas’s 9c’s: Understanding and Improving Teamwork in Organizations: A Scientifically Based Practical Guide (Salas et al).

Arvelle Balon-Lyon Quality Leader
Brenda Miller Family Leader
Eduardo Salas Clinical Leader
Sheri Carroll Clinical Leader