NICQ: Newborn Improvement Collaborative for Quality
Small groups, custom measurement, and enhanced collaboration support improvement of focused projects in this two-year program.

Trust and Transparency in Small Groups
The most important element of NICQ is the environment of honesty and humility that makes collaborative improvement possible.
Homerooms of 8-10 teams from across North America (and possibly the world) focused on similar areas of improvement foster a culture of collaboration and openness.
In frequent meetings and conversations with faculty, peers, family partners, and the homeroom as a whole, multidisciplinary teams share effective practices, policies, and change ideas.
By committing to data-transparency, a data-driven and evidence-based approach, and rigorous quality improvement methodology, NICQ teams aspire to establish sustainable improvements that contribute to the evolution of newborn care for all.

The Role of Families
Infants and families are at the center of everything we do. Every decision we make and every improvement to practices and policies that NICQ teams implement can affect a family for their entire lifetime.
The VON NICQ collaborative and the teams within it partner with families to ensure the family experience is represented, valued, and enhanced during each improvement cycle.
Family partners are fully empowered members of each NICQ team. These contributing members bring their lived experience to the team and inform the trajectory of a team’s improvement.

Supporting Rigorous Improvement
Structured improvement processes and QI fundamentals support NICQ teams’ rigorous pursuit of better outcomes and experiences for infants and families.
Centers enrolled in NICQ will access the VON QI Foundations course for staff in every department of the hospital. Teams may partner with colleagues in Labor and Delivery, Obstetrics, Follow Up, and other departments or referring hospitals. Building a foundation of QI fundamentals for all staff spurs improvement across all phases of care.
Expert faculty guide teams in QI methodology, partnering with families, and clinical application of evidence.
Teams work toward measurable improvement through incremental changes using a structured “sequence to achieve change.”

NICQ 2021-2022: Improving Critical Transitions

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.
Improvement in critical transitions is driven by:
- Teamwork
- Communication
- Families as partners
- Health Equity
- QI Fundamentals (including standardization)

Critical Transitions in Phases of Care
Critical Transitions occur within and between phases of newborn care.
NICQ teams and homerooms can choose to focus on improving transitions in a single phase or related phases, or work across all phases by focusing on a specific clinical issue or key driver.
Homerooms of up to 10 teams focus their improvement in similar ways. Homerooms can be organized by:
- a distinct phase or collection of phases of care
- a single key driver such as Communication, Teamwork, Families as Partners, or Health Equity across all phases, or
- a specific clinical topic or outcome measure across all phases of care and key drivers for transitions.
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.

NICQ 2023-2024: All Care is Brain Care
Why Focus on Brain Care?
While we continue to improve neonatal survival rates, we cannot do so at the expense of or without a clear focus on our ability to safeguard the full potential of each infant.
All care we provide must consider an especially vulnerable and important organ: the developing brain.
By exploring evidence and implementing better practices, we can ensure that all care we provide benefits the brain.
All Care is Brain Care Program Structure
With the aim to prevent injury, protect normal maturation and development, and promote positive experiences and relationships, we support teams with:
- potentially better practices/change ideas and clinical examples
- measurement plans and reporting
- foundational QI resources
- consultation and collaboration with care experts and other teams
VON Collaboratives: iNICQ and NICQ
Teams participating in iNICQ and/or NICQ are part of the VON Quality Circle.
iNICQ: QI Collaborative bringing teams together to use local and collective data to guide improvement on a topic designated on a year-to-year basis.
NICQ: QI Collaborative in designated homerooms (8-10 centers) working on similar projects and collaborating on a focused area of improvement in two-year cycles.
Why Approach Brain Care with VON?
More than 700 teams participating in VON QI for over 25 years have demonstrated remarkable improvements in clinical outcomes, substantial cost savings, and progress in addressing disparities and promoting family-centered care.
Improvement in VON collaboratives is data-driven (with audits conducted by VON), and based in evidence. Our approach to quality improvement encompasses the entire care team, including parents, and is based on foundational principles that teams have found effective in sustaining improvement.
Features, Cost and Enrollment
NICQ enrollment includes access to all Quality Circle programs and benefits. Centers can enroll in NICQ and form an additional team to participate in iNICQ for Critical Transitions for no extra fee. See all VON QI collaboratives features and benefits (pdf).
To enroll your center in NICQ or for more information, please contact Sonia Darrow, VON QI & Education Program Assistant, at sdarrow@vtoxford.org.