iNICQ Past Collaboratives

Choosing Antibiotics Wisely (2016)
Overuse and misuse of antibiotics is common in NICUs. In fact, studies show a 40-fold variation in prescribing practices across NICUs (as described by Schulman et al. in Pediatrics, May 2015 with 127 California NICUs). Alert to the growing danger, the CDC has identified antibiotic overuse as one of the “top five” targets for improvement, and has proposed core elements for hospital-based antibiotic stewardship programs designed to promote appropriate use of antibiotics. To help support this needed change, the CDC worked collaboratively with VON in the development of iNICQ 2016. A total of 166 centers participated in this collaborative. This collaborative work continues in 2017.

Alarm Safety! Driving Outcomes with Evidence-based Oxygen Therapy and Safe Monitoring Practices (2015)
The iNICQ Alarm Safety collaborative assisted centers and newborn care units to improve the quality, safety, and value of clinical care by ensuring safe use and monitoring of oxygen therapy to minimize key morbidities such as BPD and ROP. This collaborative will also assisted centers in meeting The Joint Commission-mandated National Patient Safety Goals (NPSG.06.01.01) focused on alarm safety. At total of 108 centers from 33 states, United Arab Emirates and United Kingdom participated in the team-based curriculum in an effort to make measurable improvements in quality and safety, learn about the evidence and about improvement, and engage families as partners in improvement.

A Universal Training Solution: Improving Outcomes for Infants and Families Affected by Neonatal Abstinence Syndrome (2015)
During iNICQ 2013 and 2014, teams made major strides in standardizing practice by adopting evidence-based policies. They developed innovative service models for mothers and infants across the trajectory of care. However, given the complex nature of this epidemic, more work was needed.

In 2015, iNICQ centers and statewide collaboratives focused on adopting a standardized universal interdisciplinary curriculum in an effort to deliver highly reliable care to every patient, every time. The VON designed and tested universal training curriculum included content from 35 of the leading experts in NAS care, including the author of the AAP Guidelines, Dr. Mark Hudak.

Beginning in May 2015, the iNICQ Collaborative used online technology to enhance their work on NAS. Over 8,000 enrolled learners were supported by the Learning Management System as they completed 17 NAS micro-lessons. Once 85% of the enrolled team members completed this critical training, their center was designated as a “Vermont Oxford Network Center of Excellence in Education and Training For Infants and Families Impacted by Neonatal Abstinence Syndrome”.

Structuring Success in the Care of Infants and Families Affected by Neonatal Abstinence Syndrome (2014)
This collaborative built upon the success of iNICQ 2013, which enrolled 205 centers from 42 states, Ireland and the United Kingdom. A total of 143 centers joined us in 2014 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). A series of four VON Day quality audits have been performed and represent the largest audit of NAS to date.

Controversies in the Care of Infants and Families Affected by Neonatal Abstinence Syndrome (2013)
This iNICQ Collaborative was designed to assist teams of neonatal and obstetric professionals with improving the quality, safety, and efficiency of care for substance-exposed newborns and their families. Although there is still considerable scientific uncertainty regarding the optimal approaches to identification, treatment, and monitoring of infants with NAS, we believe that making measureable improvement is not only possible, but is also our responsibility.

iNICQ Collaborative on Controversies in Respiratory Care (2012)
In this iNICQ Collaborative, 141 centers explored opportunities for improvement in respiratory care. Topics included oxygen management, delivery room care, intubation and extubation, reducing the risk for CLD, and ventilator-associated complications. Each web conference was preceded by a VON Day focusing on assessing local practices.

iNICQ Collaborative on More Controversies in Neonatal Intensive Care (2011)
This was a continuation of the popular “Controversies” collaborative. The subjects chosen for this series were controversial; the evidence in many cases did not provide a clear answer. The case presentation, review of the evidence addressing implications for practice and research, and debriefing of the case assisted teams in identifying opportunities for improvement and translating evidence into daily practice in the NICU.

iNICQ Collaborative on Controversies in Neonatal Intensive Care (2010)
This collaborative was designed to help interdisciplinary NICU teams assess their practices and identify opportunities for improvement through case presentations, review of evidence, and translating evidence into daily practice. The subjects chosen for this series were controversial, although they all arise routinely in daily NICU care.

iNICQ Collaborative on Improving Care for Neonatal Encephalopathy (2009)
This series explored new information in the rapidly evolving field of neonatal encephalopathy, including reliably identifying infants with neonatal encephalopathy, using brain monitoring and neuroimaging, and understanding if and how to use hypothermia.

iNICQ Collaborative on Creating Standard Processes (2008)
This collaborative helped teams improve and standardize key NICU processes by creating and using new tools to support standard work. Participants learned to make NICU processes family centered, safe, equitable, effective, efficient, timely, and socially and environmentally responsible.

iNICQ Collaborative on Potentially Better Practices (2007)
This collaborative provided an introduction to the potentially better practices identified and tested by teams that participated in the Network’s NICQ 2005 Collaborative. In that collaborative, 42 interdisciplinary teams from NICUs in North America worked with experts to identify and test potentially better practices in a variety of NICU domains.

iNICQ Collaborative on the Value Compass (2006)

In May 2006, Vermont Oxford Network hosted an iNICQ collaborative on the Value Compass. Under the direction of William Edwards MD and Gene Nelson DSc, interdisciplinary teams learned to assess their unit’s performance across important domains to evaluate and improve quality and value of care. Teams applied Value Compass thinking to their unit, using tools and methods tested by teams participating in VON’s intensive Newborn Intensive Collaborative for Quality (NICQ).

iNICQ Collaborative on Encephalopathy (2006)
In January 2006, Vermont Oxford Network hosted an iNICQ collaborative on neonatal encephalopathy, the fifth in a series of Internet collaboratives addressing a variety of topics aimed at improving the quality and safety of medical care for newborn infants and their families. This collaborative was coordinated with the Network’s Registry for Neonatal Encephalopathy.

iNICQ Collaborative on Infection (2005)
This series continued the work begun in the previous iNICQ collaborative. The goal of this collaborative was to achieve and sustain reductions in nosocomial infection; the collaborative launched with the motto “Making It Work, Making It Stick . . . Transforming Ideas into Action!”

iNICQ Collaborative on Infection (2004)
This collaborative focused on reducing infection while improving quality and safety in the NICU environment. Topics included nosocomial infection in the NICU, antibiotic use and resistant organisms, outbreaks and special pathogens.

iNICQ Collaborative on Safety (2003)
The second iNICQ collaborative focused on critical topics in patient safety directly tailored to the NICU environment, presented by nationally recognized experts in health care improvement and building on the learning and materials from VON’s successful NIC/Q quality improvement collaboratives.

iNICQ Collaborative on Infection, Nutrition, Change, and Family-Centered Care (2002)
Interdisciplinary teams comprised of nearly 1000 practitioners from 63 neonatal intensive care units around the world participated in the first Internet-based improvement collaborative. The collaborative included a series of four interactive web conferences presented by nationally recognized experts in health care improvement, each focused on a critical topic in quality improvement and safety directly tailored to the NICU environment.