Objective <p>To Improve timely administration of the first antibiotic dose in the neonatal intensive care unit (NICU) through a quality improvement (QI) initiative.</p> Study design <p>Conducted in a 53- bed NICU over 3 years involving 1094 neonates who received antibiotics for suspected sepsis. Using the Institute for Healthcare Improvement (IHI) methods, three interventions were made: NICU staff education; developed order sets for stat antibiotic doses and implementation of a secure code medication delivery system. Outcomes included the infants receiving their first antibiotic dose within 60 min of ordering and average time from order to administration.</p> Results <p>Infants receiving antibiotics within 60 min improved from baseline 32.7% to 84.4% over a 3 year period and has been sustained over 2 years. The average time to administration decreased from 93.3 min to 44.7 min.</p> Conclusion <p>A systematic multidisciplinary approach decreased the time from antibiotic order to administration time in the NICU.</p>