In the original study NICU sites were assigned to either the NI or BPD group. Members received training in evidence-based practice changes and team building. These new skills were soon applied while assembling interdisciplinary teams, gathering evidence from the literature, targeting specific practices, and implementing the changes. EPIQ teams consisted of Neonatologists, Nurses, Respiratory Therapists, Research Assistants, Dieticians, and members of other disciplines. Practice Changes were implemented using the Plan-Do-Study-Act (PDSA) method. The Coordinating Centre promoted communication within and amongst groups, a critical component of the EPIQ process, via organizing teleconferences, meetings, e-mail discussion groups, and so on.

Through these combined efforts the incidences of both NI and BPD were significantly reduced in both the NI and BPD groups (Lee et al 2008 submitted). Efforts to reduce BPD also significantly reduced NI. Though still being evaluated, we project that the EPIQ process will deliver financial savings to hospitals, for example by reducing the length of infant stay and use of supplemental oxygen.

Significance

The successes from EPIQ demonstrate how a national network of clinicians, front-line workers, and researchers can engage in a collaborative system that utilizes their cumulative experience and expertise, to encourage evidence-based practice for improving quality. EPIQ is innovative because it establishes a national system for on-going evidence-based quality improvement. In addition to using available published evidence and generating new reviews, EPIQ utilizes objective local and national benchmarked data to identify practices associated with outcome differences for targeted change. This maximizes impact and is more meaningful for individual NICUs. EPIQ may be a model for other areas of health care.