NeoQIC Mission Statement
REDUCING INFECTIONS IN THE NICU (2007-2014)
The first NeoQIC improvement initiative sought to eliminate hospital-acquired infections in the neonatal intensive care unit (NICU). All ten level III NICUs in Massachusetts participated. Through sharing of local practices and improvement efforts, site visits, use of standardized checklists and bundles, and twice-yearly comparative progress reports, infection rates decreased by over 60% across all Massachusetts NICUs. Any late infection rates in very low birth weight (VLBW) infants decreased from over 16% to approximately 6%, and NICU central-line associated bloodstream infection (CLABSI) rates decreased from over 3 per 1000 line days to just over 1 (see figure).
IMPROVING SAFE SLEEP PRACTICES IN HIGH-RISK INFANTS (2015-2017)
This project launched in July 2015 with nine level III NICUs, with all ten in MA now participating. The project expanded to include level II centers in 2016, with six level II units now involved. The project, a key component of a statewide DPH initiative focused on infant mortality, aims to increase the use of appropriate safe sleep positioning in high risk infants in Massachusetts NICUs and special care nurseries (SCN), with the ultimate goal of increasing compliance with safe sleep at home and reducing sudden unexpected infant deaths. Through weekly audits, real-time progress reports, webinars, and twice-yearly statewide summits, hospital teams increased compliance with safe sleep practices for high risk infants in Massachusetts from 48% to 76% (see figure).
IMPROVING THE CARE OF INFANTS WITH NEONATAL ABSTINENCE SYNDROME (NAS) AND THEIR FAMILIES (2012-2015)
This was the first NeoQIC project to extend to level I and level II centers in addition to level III NICUs, with nearly 40
Massachusetts hospitals participating (see figure). Through webinars, statewide summits, data audits, and regular performance reports, multidisciplinary hospital teams learned best practices in
NAS care, shared practices and data, and improved their care. Many state agencies and organizations were key partners, including the Department of Public Health, the Bureau of Substance Abuse
Services, Early Intervention, the Department of Children and Families, the Attorney General’s Office, and the March of Dimes. Numerous improvements in outcomes were seen, including
increased standardization of practices, increased use of breast milk, reduction in pharmacologic therapy for NAS, and reduction in hospital length of stay for infants with NAS.
Average length of stay decreased 13%, from 23 to 20 days (see figure).
Note: this project has been relaunched in 2017 as a PNQIN initiative on perinatal opioid use and substance exposed newborns.