Over the last 10 years, the incidence of NAS has increased 5-fold, concomitantly rising with an increased use of opiates during pregnancy. Caring for patients with NAS differs from hospital to hospital, and with that difference in care comes a difference in outcomes. This quality improvement study aimed to implement standards of care for NAS at 199 different U.S. hospitals in hopes of improved quality care and better outcomes. Results demonstrated significantly reduced LOT, LOS, and number of infants discharged on medications over the 2-year study period. This study was limited by the availability of prenatal maternal drug use, the possible presence of an unmeasured cofounder, and limited generalizability due to the enrollment of state collaboratives. These findings could encourage hospitals to standardize NAS care in order to participate in the shift towards improved outcomes called by the American Association of Pediatrics (AAP).