FIRST Trial

We will re-contract each of the 117 programs, 151 hospitals to continue participating in the Extension Study. We will aim to add approximately 12 additional programs for a total of approximately 130 programs and 170 hospitals, as more programs are now eligible as they have joined ACS NSQIP. We may continue to recruit hospitals over the trial period as programs enroll in the ACS NSQIP or if New York law changes to allow participation. We will actively work with New York programs to propose legislation again to allow flexibility. All hospitals will be required to obtain signatures in order to participate including the Program Director, the Chair of Surgery, and the surgical quality director. We will also require hospitals to agree to data sharing regarding ACS NSQIP, ACGME, and ABS data for the purposes of this project. Each program will be required to complete an enrollment form and four contracts that will be managed by the Coordinating Center at Northwestern. 1. Northwestern and the program: To allow participation in the FIRST Extension Study a. Only for newly enrolling programs (already completed for original trial hospitals). 2. ACS NSQIP and each hospital: To allow data sharing of ACS NSQIP data with Northwestern a. Only for newly enrolling programs (already completed for original trial hospitals). 3. ACGME and each program: To allow sharing of ACGME data with Northwestern 4. ABS and each program: To allow data sharing of ABS data with Northwestern