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Based on the success of the EPIQ method in EPIQ I, a national prospective QI cohort trial was undertaken – EPIQ II – in which 25 of 27 NICUs across Canada participated. The objective of EPIQ II was to assess the generalizability and impact of EPIQ on the outcomes of extremely preterm infants. EPIQ II took place between April 2008 and September 2012, with one year of baseline data collection, six months of study preparation, and 3 years of an intervention phase. Through a collaborative process, sites continually identified, appraised, and implemented evidence-informed quality improvement initiatives. The five major morbidities in the neonatal population were targeted – ROP, NI, BPD, NEC and IVH.