The Ins & Outs of Neonatal Care: an iNICQ for Critical Transitions

The Ins & Outs of Neonatal Care

Improving Critical Transitions and Clinical Outcomes for Every Newborn

Registration is open to participate in 2019.


Our Internet-based Newborn Improvement Collaborative for Quality (iNICQ) is a multi-center collaborative focused on improving critical transitions of care for every infant under your care.

In 2019, teams will focus on critical transitions of “ins” (inborn admission/stabilization or transport) or on critical transitions of “outs” (transition home and follow-up). Every team will also work on improving the fidelity and safety of patient handoffs.


We expect participating teams will:

  • Improve clinical outcomes related to critical transitions (BPD, ROP, IVH, NEC, extrauterine growth restriction)
  • Identify and decrease potentially preventable NICU admissions
  • Decrease excess length of stay (and length of separation from families)
  • Avoid hospital readmissions
  • Improve patient and family engagement and satisfaction
  • Avoid patient injury/error related to poor care coordination or communication
  • Improve follow-up and follow-through rates

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Admission, Discharge, and How to Focus Improvement

Participating teams will choose to focus on either admissions or discharge in addition to improving handoffs that occur within the hospital care setting.

Teams can further focus their QI work on specific populations such as late preterm infants, micro-premature infants, infants transferred home with complex care needs, or  infants and families affected by neonatal abstinence syndrome (NAS).

As teams sign on to participate, we will guide them through a discernment exercise to identify the critical transitions most ripe for their local improvement.

Hundreds of Opportunities to Get It Right (or Wrong) Every Day

Handoffs affect length of stay, patient and family satisfaction, efficiency of resources, and quality of care. Two handoffs per infant each day communicated at (at least) five levels (nurse, charge nurse, respiratory therapist, NNP/resident, and attending physician each communicating to a corresponding peer) in an average 30-bed NICU adds up to 240 opportunities for communication – or miscommunication – each day. Factoring in the important conversations with families increases the stakes even more.

Participating teams will work on communication, teamwork, family integration, and standardizing processes to improve the effectiveness, efficiency, safety and quality of care during these vulnerable times.

Integrate Families into Improvement

In addition to the 7 webinars and key clinical concepts in the Core Curriculum, teams enrolled in the Intensive Curriculum will have the opportunity to learn a new quality improvement methodology, experience-based co-design, provided in cooperation with The Point of Care Foundation. By applying experience-based co-design, care teams and families come together to prioritize areas for improvement, define key actions, and demonstrate results. Learn more about experience-based co-design here.

Informational Webinar

Learn about the background and structure of this collaborative with the recorded webinar below.

Benefits to Participating Teams

VON’s faculty of world experts in neonatal care, quality improvement, and implementation science will guide and motivate teams as they work through a structured curriculum designed to guide them through improvement of critical transitions.

Tools and Resources

  • VON Day Audit – a new data module focused on critical transitions of care performed every 6 months
  • Gap Analysis –  performed directly after the VON Day Audit to identify key opportunities for improvement and progress over time
  • Critical Transitions Toolkit, including a complete review of the evidence, measures and metrics, and required tools to complete a structured QI project
  • Interactive expert-led webinars relevant both for the improvement team and the clinical interdisciplinary team
  • Online access to all recorded webinars, particularly useful for international teams who can view sessions at their convenience
  • Opportunity to ask questions, test ideas, and interact with content experts and other improvement teams via the discussion board/listserv
  • Continuing education credits (CME/CNE/CPE) awarded for each webinar and activity
  • Individual physicians or entire physician team receive Maintenance of Certification (MOC) Part 4 credit by submitting a group-authored abstract
  • Real-world examples of improvement from leading teams demonstrating results
  • Opportunity to share your local  improvement data at VON’s Annual Quality Congress and coaching to develop compelling, data-driven abstracts
  • Additional face-to-face learning, networking and collaboration at VON’s Annual Quality Congress with an entire day-long by invitation-only NICQ / iNICQ Improvement Symposium*^
  • Access to the VON / IHI online course, Foundations in Improvement Science, an important tool to build QI capacity for your entire team*
  • Deep dive webinars focused on accelerated experience-based co-design in partnership with families*

*Included in Intensive-level
^Optional for Core-level

How to Join

  • Decide if your center wants to participate at the Core or Intensive level
  • Register by filling out this form by December 1, 2018 (invoices will be sent separately)


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