title: The Michigan Surgical Quality Collaborative: a legacy of Shukri Khuri.
abstract: BACKGROUND
  From the legacy of Shukri Khuri, we have successfully implemented a regional quality collaborative in Michigan, the Michigan Surgical Quality Collaborative (MSQC).
  
  
  METHODS
  The MSQC represents a partnership between the American College of Surgeons (ACS), 34 Michigan hospitals, and a large private payer. It is based on a "pay for participation" rather than a "pay for performance" model. Although based on the ACS National Surgical Quality Improvement Program (NSQIP) platform, this collaborative has a unique infrastructure for information technology, collaboration, and ad hoc quality improvement (QI) initiatives.
  
  
  RESULTS
  Specific initiatives have been implemented with colectomy, myocardial ischemia, and surgical site infection (SSI). Based on these initiatives, best practices have been implemented. Adherence to these best practices is modest, but despite this, there has been significant QI.
  
  
  CONCLUSIONS
  The improved quality was likely the result of diverse process measures, many not yet recognized in the literature, which came together effectively in specific hospitals.
authors.affiliation: Department of Surgery, University of Michigan, MI, USA. darrellc@med.umich.edu
authors.forename: Darrell A
authors.initials: DA
authors.lastname: Campbell
authors.forename: James J
authors.initials: JJ
authors.lastname: Kubus
authors.forename: Peter K
authors.initials: PK
authors.lastname: Henke
authors.forename: Max
authors.initials: M
authors.lastname: Hutton
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Englesbe
mesh_terms: D003299:Cooperative Behavior; D006764:Hospitals, Community / Q000592:standards*; D006801:Humans; D008824:Michigan; D010043:Outcome and Process Assessment, Health Care; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D013514:Surgical Procedures, Operative / Q000592:standards*; D014481:United States