NICQ: Newborn Improvement Collaborative for Quality

In NICQ for Critical Transitions, VON teams commit to two years of focused improvement in dedicated small groups to achieve wide-ranging changes in care and improved outcomes.

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.

PDSA Cycle

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.”

Resources and Support for NICQ Teams

Improved outcomes and experiences depend on high quality processes and practices during critical transitions in newborn care.

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.

Improvement in critical transitions is driven by:

  • Teamwork
  • Communication
  • Families as partners
  • Health Equity
  • QI Fundamentals (including standardization)
Phases of Care

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 teams aim to sustainably improve the family experience and clinical outcomes.

CLD chart

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.

NICQ 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

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