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SOQIC Core Programs

SOQIC is focused on surgical outcomes research and quality improvement, with interests in comparative effectiveness, implementation science, and health policy. The team has been incredibly successful in generating hundreds of publications in top-tier journals and acquiring many grants, including project grants, career development awards, and training grants.

Core Topics

 Illinois Quality Collaboratives


  • The Illinois Surgical Quality Improvement Collaborative (ISQIC) is comprised of over 50 hospitals in Illinois.  ISQIC provides participating hospitals with a formal quality and process improvement training curriculum, surgeon mentors, and process improvement coaches as well as financial support for the implementation of QI initiatives.  ISQIC existing state collaboratives that work together to improve surgical quality and safety by sharing their experiences, best practices, successes, and failures. In addition, ISQIC hospitals report and receive comparative feedback on key process measures with the ability to view and compare empirical data about hospital performance and participate in the ISQIC initiatives. Hospitals will be equipped to use their data to successfully implement quality improvement (QI) initiatives and improve care.
  • The Illinois Cancer Collaborative (ILCC), in partnership with the Cancer Programs of the American College of Surgeons, is a first-of-its kind statewide cancer collaborative. Its mission is to convene a multidisciplinary learning collaborative of Illinois hospitals improving the safety and quality of care for cancer patients. The ILCC is an opportunity for Illinois hospitals to partner together to rapidly and efficiently address the unique challenges that we all face in providing safe and optimal cancer care to patients during and after the COVID-19 pandemic. The ILCC offers novel strategies to support effective QI in oncology: (1) guided implementation and mentoring of QI projects, (2) high-quality, Illinois-specific comparative data augmenting the NCDB, (3) cancer-specific QI resources and education, (4) statewide sharing of best practices.

Research Team

  • Lead faculty: Karl Bilimoria, MD, MS; Michael McGee, MD; Anthony Yang, MD, MS
  • Collaborating Faculty: Greg Auffenberg, MD, MS; Jeanette Chung, PhD; Julie Johnson, MSPH, PhD; Yue-Yung Hu, MD, MPH; Nisha Mohindra, MD; Ryan Merkow, MD, MS; David Odell, MD, MMSc; Mehul Raval, MD, MS; Sean Sachdev, MD; Jonah Stulberg, MD, PhD, MPH
  • Fellows: Brian Brajcich, MD; Matt Chia, MD; Chelsea Fischer, MD; Hae Soo (Rachel) Joung, MD
  • Staff: Brianna D’Orazio, MPH; Remi Love, MMPA; John Slocum, MPH; Jenny Slota, BS

Funding Sources

  • Statewide collaboratives are supported by Blue Cross Blue Shield of Illinois and the Agency for Healthcare Research and Quality (R01HS024516) and reflect a partnership with the American College of Surgeons. Additional funding for the ILCC comes from the Robert H. Lurie Comprehensive Cancer Center at Northwestern.

Selected High-Impact Publications

Yuce TK, Yang AD, Johnson JK, Odell DD, Love R, Kreutzer L, Schlick CJR, Zambrano MI, Shan Y, O'Leary KJ, Halverson A, Bilimoria KY. Association Between Implementing Comprehensive Learning Collaborative Strategies in a Statewide Collaborative and Changes in Hospital Safety Culture. JAMA Surg. 2020 Aug 12:e202842.

Berger ER, Kreutzer L, Halverson A, Yang AD, Reinhart S, Leary KJO, Williams MV, Bilimoria KY, Johnson JK; ISQIC Advisory Committee. Evaluation of Changes in Quality Improvement Knowledge Following a Formal Educational Curriculum Within a Statewide Learning Collaborative. J Surg Educ. 2020 Jun 15:S1931-7204(20)30133-1.

Yang AD, Hewitt DB, Blay E Jr, Kreutzer LJ, Quinn CM, Cradock KA, Prachand V, Bilimoria KY; Illinois Surgical Quality Improvement Collaborative (ISQIC). Multi-institution Evaluation of Adherence to Comprehensive Postoperative VTE Chemoprophylaxis. Ann Surg. 2020 Jun;271(6):1072-1079.

McGee MF, Kreutzer L, Quinn CM, Yang A, Shan Y, Halverson AL, Love R, Johnson JK, Prachand V, Bilimoria KY; Illinois Surgical Quality Improvement Collaborative (ISQIC). Leveraging a Comprehensive Program to Implement a Colorectal Surgical Site Infection Reduction Bundle in a Statewide Quality Improvement Collaborative. Ann Surg. 2019 Oct;270(4):701-711.

Berian JR, Thomas JM, Minami CA, Farrell PR, O'Leary KJ, Williams MV, Prachand VN, Halverson AL, Bilimoria KY, Johnson JK. Evaluation of a novel mentor program to improve surgical care for US hospitals. Int J Qual Health Care. 2017 Apr 1;29(2):234-242.

 Surgical Education & Culture


Continuing on the success of the Flexibility in Duty Hour Requirement for Surgical Trainees (FIRST) trial, 2019 saw the launch of The Surgical Education Culture Optimization through targeted interventions based on National comparative Data (SECOND) trial.

This effort, a collaboration between Northwestern Medicine, the Accreditation Council for Graduate Medical Education (ACGME), the American College of Surgeons (ACS), the American Board of Surgery (ABS) and the Association of Program Directors in Surgery (APDS) is a prospective, pragmatic cluster randomized trial examining whether giving general surgery residency programs access to their performance data and an interactive toolkit of wellness interventions can improve residency program culture and resident wellness.

The SECOND Trial has enrolled 212 residency programs. For more information, please see

Research Team

  • Lead faculty: Karl Bilimoria, MD, MS and Yue-Yung Hu, MD, MPH
  • Collaborating Faculty: Elaine Cheung, PhD; Caryn Etkin, PhD, MPH; Julie Johnson, MSPH, PhD; Gaurava Agarwal, MD
  • Fellows: Brian Brajcich, MD; Matt Chia, MD; Chelsea Fischer, MD; Rachel Joung, MD; Andrew Hu, MD; Debbie Li, MD; Meixi Ma, MD; Brian Nasca, MD; Arielle Thomas, MD
  • Staff: Daniela Amórtegui, MA; Josh Eng, PhD; Nate Monson, MS; Sarah Plummer, BA; Tia Zhan, MS

Funding Sources

  • The SECOND Trial is a partnership among the following:

    • Accreditation Council for Graduate Medical Education (ACGME)
    • American College of Surgeons (ACS)
    • American Board of Surgery (ABS)
    • Association of Program Directors in Surgery (APDS)
    • Society of Surgical Chairs (SSC)
    • Association of American Medical Colleges (AAMC)

Selected High-Impact Publications

Bilimoria KY, Chung JW, Hedges LV, Dahlke AR, Love R, Cohen ME, Hoyt DB, Yang AD, Tarpley JL, Mellinger JD, Mahvi DM, Kelz RR, Ko CY, Odell DD, Stulberg JJ, Lewis FR. National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training. N Engl J Med. 2016;374(8):713-27.

Hu Y-Y, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, Potts JR, Buyske J, Hoyt DB, Nasca TJ, Bilimoria KY. Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training. N Engl J Med. 2019 Oct 31;381(18):1741-1752.

Hewitt DB, Ellis RJ, Chung JW, Cheung EO, Moskowitz JT, Huang R, Merkow RP, Yang AD, Hu YY, Cohen ME, Ko CY, Hoyt DB, Bilimoria KY. Association of Surgical Resident Wellness With Medical Errors and Patient Outcomes. Ann Surg. 2020. In press.

Khorfan R, Yuce TK, Love R, Yang AD, Chung J, Hoyt DB, Lewis FR, Bilimoria KY. Cumulative Effect of Flexible Duty-hour Policies on Resident Outcomes: Long-term Follow-up Results From the FIRST Trial. Ann Surg. 2020;271(5):791-798.

Yuce TK, Turner PL, Glass C, Hoyt DB, Nasca T, Bilimoria KY, Hu YY. National Evaluation of Racial/Ethnic Discrimination in US Surgical Residency Programs. JAMA Surg. 2020.

Zhang LM, Ellis RJ, Ma M, Cheung EO, Buyske J, Hoyt DB, Bilimoria KY, Hu YY. Prevalence, Types, and Sources of Bullying Reported by US General Surgery Residents in 2019. JAMA. 2020; 323(20): 2093-2095.

Ellis RJ, Hu YY, Jones AT, Kopp JP, Soper NJ, Hoyt DB, Buyske J. Association between Resident Training Experience and Program Performance on Board Examinations. JAMA Surgery 2020; 155(2):163-5.

Engelhardt KE, Bilimoria KY, Johnson JK, Hewitt DB, Ellis RJ, Hu YY, Chung JW, Kreutzer L, Love R, Blay E, Odell DO. A National Mixed-Methods Evaluation of Preparedness for General Surgery Residency and the Association with Resident Burnout. JAMA Surg. 2020;155(9):851-859.

Hewitt DB, Ellis RJ, Hu YY, Cheung EOY, Moskowitz JT, BilimoriaKY. Evaluating the Impact of Multiple Burnout Definitions and Thresholds on Prevalence and Outcomes. JAMA Surgery 2020; in press.

Yuce TK, Turner PL, Glass C, Hoyt DB, Nasca T, Bilimoria KY, Hu YY. National Evaluation of Racial/Ethnic Discrimination in US Surgical Residency Programs. JAMA Surg.2020; 155(6):526-528.

Ellis RJ, Holmstrom AL, Hewitt DB, Engelhardt KE, Yang AD, Merkow RP, Bilimoria KY. A Comprehensive National Survey on Thoughts of Leaving Residency, Alternative Career Paths, and Reasons for Staying in General Surgery Residency. American Journal of Surgery 2020;219(2):227-32.

Ellis RJ, Hewitt DB, Hu YY, Johnson JK, Merkow RP, Yang AD, Potts JR, Hoyt DB, Buyske J, Bilimoria KY. An Empirical National Assessment of the Learning Environment and Factors Associated With Program Culture. Annals of Surgery. 2019;270(4):585-592.

Hewitt DB, Ellis RJ, Chung JW, Cheung EOY, Moskowitz JT, Huang R, Merkow RP, Yang AD, Hu YY, Cohen ME, Clifford Y, Hoyt DB, Billimoria KY. Association of Surgical Residents Wellness with Medical Errors and Patient Outcomes. Annals of Surgery 2020. In press.

Schlick CR, Hewitt DB, Quinn CM, Ellis RJ, Shapiro KE, Bilimoria KY, Yang AD. A National Evaluation of Motor Vehicle Crashes Among General Surgery Residents. Annals of Surgery 2020; in press.

 Health Policy


Evaluating the impact of policy initiatives on healthcare quality measurement, improvement and delivery has been a focus area of SOQIC, and this work has resulted in numerous changes in national quality measurement, pay-for-performance programs, and public quality rating systems.

Research Team

  • Lead faculty: Karl Bilimoria, MD, MS
  • Collaborating Faculty: Jeanette Chung, PhD; Cynthia Barnard, MBA, PhD; Ryan Merkow, MD, MS

Funding Sources

  • SOQIC’s Health Policy efforts have been supported by the NIH, AHRQ, the American College of Surgeons, and Northwestern Medicine. 

Selected High-Impact Publications

Yuce TK, Chung JW, Barnard C, Bilimoria KY. Association of State Certificate of Need Regulation With Procedural Volume, Market Share, and Outcomes Among Medicare Beneficiaries. JAMA. 2020;324(20):2058–2068. doi:10.1001/jama.2020.21115

Chung JW, Dahlke AR, Barnard C, DeLancey JO, Merkow RP, Bilimoria KY. The Centers For Medicare And Medicaid Services Hospital Ratings: Pitfalls Of Grading On A Single Curve. Health Affairs. 2019; 38(9): 1523-1529. doi: 10.1377/hlthaff.2018.05345

DeLancey JO, Softcheck J, Chung JW, Barnard C, Dahlke AR, Bilimoria KY. Associations Between Hospital Characteristics, Measure Reporting, and the Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings. JAMA. 2017 May 16;317(19):2015-2017. doi: 10.1001/jama.2017.3148. PMID: 28510670; PMCID: PMC5815009.

Bilimoria KY, Birkmeyer JD, Burstin H, Dimick JB, Joynt Maddox KE, Dahlke AR, DeLancey JO, Pronovost PJ. Rating the Raters: An Evaluation of Publicly Reported Hospital Quality Rating Systems. New England Journal of Medicine Catalyst. 2019; 2642-0007.

Asch DA, Bilimoria KY, Desai SV. Resident Duty Hours and Medical Education Policy — Raising the Evidence Bar. New England Journal of Medicine. 2017;376(18):1704-6. PubMed PMID: 28402246.

Bilimoria KY. Facilitating Quality Improvement: Pushing the Pendulum Back Toward Process Measures. JAMA. 2015;314(13):1333-4. PubMed PMID: 26441175.

Merkow RP, Ju MH, Chung JW, Hall BL, Cohen ME, Williams MV, Tsai TC, Ko CY, Bilimoria KY. Underlying reasons associated with hospital readmission following surgery in the United States. JAMA. 2015;313(5):483-95. PubMed PMID: 25647204.

Rajaram R, Barnard C, Bilimoria KY. Concerns about using the patient safety indicator-90 composite in pay-for-performance programs. JAMA. 2015;313(9):897-8. PubMed PMID: 25654581.

Rajaram R, Chung JW, Kinnier CV, Barnard C, Mohanty S, Pavey ES, McHugh MC, Bilimoria KY. Hospital Characteristics Associated With Penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program. JAMA. 2015;314(4):375-83. PubMed PMID: 26219055

Bilimoria KY, Barnard C. The New CMS Hospital Quality Star Ratings: The Stars Are Not Aligned. JAMA. 2016;316(17):1761-2. PubMed PMID: 27802552.

Bilimoria KY, Chung J, Ju MH, Haut ER, Bentrem DJ, Ko CY, Baker DW. Evaluation of surveillance bias and the validity of the venous thromboembolism quality measure. JAMA. 2013;310(14):1482-9. PubMed PMID: 24100354.

 Peri-Operative Patient Safety & Surgical Safety


To identify opportunities to inform and improve the quality and delivery of surgical care, SOQIC researchers have conducted hundreds of outcomes research studies and developed tools to help clinicians provide better care.

Research Team

  • Lead faculty: Anthony Yang, MD, MS and Ryan Merkow, MD, MS
  • Collaborating Faculty: Karl Bilimoria, MD, MS; Greg Auffenberg, MD, MS; Jonah Stulberg, MD, PhD, MPH; Amy Halverson, MD; Yue-Yung Hu, MD, MPH; David Odell, MD, MMSc; Mehul Raval, MD, MS; Michael McGee, MD
  • Staff: Brianna D’Orazio, MPH; Remi Love, MMPA; Jenny Slota, BS

Funding Sources

  • SOQIC’s Perioperative Patient Safety and Surgical Safety efforts have been supported by the NIH, AHRQ, BCBS-IL, and numerous other organizations and societies.

Selected High-Impact Publications

Merkow RP, Ju MH, Chung JW, Hall BL, Cohen ME, Williams MV, Tsai TC, Ko CY, Bilimoria KY. Underlying reasons associated with hospital readmission following surgery in the United States. JAMA. 2015 Feb 3;313(5):483-95. doi: 10.1001/jama.2014.18614. PMID: 25647204.

Bilimoria KY, Bentrem DJ, Talamonti MS, Stewart AK, Winchester DP, Ko CY. Risk-based selective referral for cancer surgery: a potential strategy to improve perioperative outcomes. Ann Surg. 2010;251(4):708-16. PubMed PMID: 19898231.

Bilimoria KY, Cohen ME, Ingraham AM, Bentrem DJ, Richards K, Hall BL, Ko CY. Effect of postdischarge morbidity and mortality on comparisons of hospital surgical quality. Ann Surg. 2010;252(1):183-90. PubMed PMID: 20531000.

Bilimoria KY, Liu YM, Paruch JL, Zhou L, Kmiecik TE, Ko CY, Cohen ME. Development and Evaluation of the Universal ACS NSQIP Surgical Risk Calculator: A Decision Aid and Informed Consent Tool for Patients and Surgeons. J Am Coll Surgeons. 2013;217(5):833-+. PubMed PMID: WOS:000325759500011.

Yang AD, Bilimoria KY. Accurately Measuring Hospital Venous Thromboembolism Prevention Efforts. JAMA. 2016;315(19):2113-4. PubMed PMID: 27187304.

 Video-Based Coaching


  • Video based feedback for the Improvement of Surgical Technique (VISTA) video-based feedback initiatives are learner-driven, quality improvement projects focused on actionable recommendations for refining surgical technical skill.
  • We lead initiatives for Northwestern Medicine (NM) surgeons and collaborations across ISQIC. Our interactive and user-friendly website,, offers busy surgeons accessible, objective, and unbiased learning opportunities through community-based feedback. Surgeons give and receive feedback anonymously while gaining CME credits and building cross-organizational partnerships.
  • The VISTA project has further expanded to support the NM IQ Urology initiative led by Dr. Gregory Auffenbergand NM Technical Excellence Collaboratives. For more information, please contact or visit the VISTA website at

Research Team

  • Lead faculty: Jonah Stulberg, MD, PhD, MPH
  • Collaborating Faculty: Greg Auffenberg, MD, MS; Karl Bilimoria, MD, MS; Heather Himelhoch, PhD, MPH
  • Fellows: Bona Ko, MD, MPH; Andres Guerra, MD; Andrew Hu, MD; Brian Nasca, MD; Arielle Thomas, MD, MPH
  • Staff: Neha Negrete MBA, MPH; Daniela Amórtegui, MA

Funding Sources

  • Video coaching efforts are supported by NM system funds

Selected High-Impact Publications

Stulberg JJ, Huang R, Kreutzer L, Ban K, Champagne BJ, Steele SE, Johnson JK, Holl JL, Greenberg CC, Bilimoria KY. Association Between Surgeon Technical Skills and Patient Outcomes. JAMA Surg. 2020;155(10):960-968.

Schlick CJR, Bilimoria KY, Stulberg JJ. Video-Based Feedback for the Improvement of Surgical Technique: A Platform for Remote Review and Improvement of Surgical Technique. JAMA Surg. Published online September 9, 2020.

 Pediatric Surgical Outcomes


The research team is dedicated to projects seeking to improve outcomes in children’s surgical care. The scope of their research extends from quality improvement and implementation science to advancement of clinical practice and standards of care. Our research has played a key role in the establishment of the American College of Surgeons National Surgical Quality Improvement Program –Pediatric (ACS-NSQIP-P) which is now in place at more than 150 hospitals.

Research Team

  • Lead faculty: Mehul Raval, MD, MS
  • Collaborating Faculty: Jane Holl, MD, MPH; Karl Bilimoria, MD; Julie Johnson, MSPH, PhD; Willemijn Schäfer, PhD
  • Fellows: Martha Ingram, MD, MPH; Andrew Hu, MD; Salva Balbale, PhD
  • Statistician: Yao Tian, PhD, MPH
  • Staff: Erin Wymore, MS; Peter Graffy, MPH; Karen Miller, BS

Funding Sources

  • Efforts are supported by the following:

    • Eunice Kennedy Shriver National Institute Of Child Health & Human Development of the National Institutes of Health (R01HD099344)
    • Agency for Healthcare Research and Quality (R01HS024712)
    • Digestive Health Foundation
    • Crohn’s & Colitis Foundation

Selected High-Impact Publications

Tian Y, Ingram M-CE, RavalMV. A pitfall of using general equivalence mappings to estimate national trends of surgical utilization for pediatric patients. Journal of Pediatric Surgery. Available online24 March 2020.

VacekJ, Davis T, Many BT, Close S, Blake S, Hu Y-Y, HollJL, Johnson J, StropleJ, RavalMV. A baseline assessment of enhanced recovery protocol implementation at pediatric surgery practices performing inflammatory bowel disease operations. Journal of Pediatric Surgery. Available online 27 June 2020.

 Northwestern Medicine Quality Innovation Center


 Cancer Quality


The Northwestern Medicine Cancer Collaboratives are multidisciplinary groups of oncology care providers and quality leaders who seek to align and improve cancer care across the system. The collaboratives aim to equip hospitals and individual providers with skills to identify their local performance gaps in cancer care in a rigorous manner based on high-quality data, and then implement solutions to those problems using established process improvement methods. The collaboratives will ultimately measurably improve adherence to best practice guidelines, quality of care, and outcomes while reducing variation and costs arising from unsafe, inefficient, or inappropriate care.

Research Team

  • Lead faculty
    • Breast Cancer: Anthony Yang, MD, MS
    • Colorectal Cancer: Ryan Merkow, MD, MS
    • Lung Cancer: David Odell, MD, MMSc
  • Collaborating Faculty: Karl Bilimoria, MD, MS
  • Staff: Brianna D’Orazio, MPH; Remi Love, MMPA; Jenny Slota, BS

Funding Sources

Selected High-Impact Publications


 Surgical Opioid Prescribing


Following surgery, surgeons frequently prescribe far more opioid pills than patients need to control their pain. These excess pills are too often consumed for non-medical indications or diverted to individuals other than the intended user. Furthermore, despite recent efforts to decrease the number of pills prescribed following surgery, patients continue to have a significant number of pills left over when their acute pain resolves.

Our portfolio of initiatives aims to reduce surgical overprescribing of opioids and develop appropriate tools for providers and families to address post-operative pain management. Using an implementation science approach, our efforts further seek to understand the effectiveness of these interventions to thus facilitate dissemination.

Research Team

  • Lead faculty: Jonah Stulberg, MD, PhD, MPH; Julie Johnson, MSPH, PhD
  • Collaborating Faculty: Salva Balbale, PhD; Karl Bilimoria, MD, MS; Willemijn Schäfer, PhD
  • Staff: Brianna D’Orazio, MPH; Reiping Huang, PhD; Kiana Jones, BA; John Slocum, MPH

Funding Sources

  • The following grants support our Opioid Reduction initiatives:

    1. System-Level Implementation to Reduce Excess Opioid Prescribing in Surgery – National Institute on Drug Abuse (R34DA044752)
    2. Preventing Opioid Misuse through Safe Opioid Use Agreements between Patients and Surgical Providers (PROMISE ME) – Agency for Healthcare Research and Quality (R18HS027331)
    3. Illinois Surgical Quality Improvement Collaborative (ISQIC) Opioid Reduction Initiative: Phase 2 – PaciraPharmaceuticals
    4. Understanding Opioid Use by Surgical Approach – Intuitive Foundation
    5. A Missing Piece of the Puzzle: Patient and Provider Perspectives on Opioid Use and Pain Management in Inflammatory Bowel Disease Care – Digestive Health Foundation

Selected High-Impact Publications

Coughlin JM, Shallcross ML, Schäfer WLA, Buckley BA, Stulberg JJ, Holl JL, Bilimoria KY, Johnson JK. Minimizing Opioid Prescribing in Surgery (MOPiS) Initiative: An Analysis of Implementation Barriers. Journal of Surgical Research, 2019 Jul;239:309-319. doi: 10.1016/j.jss.2019.03.006.

Stulberg JJ, Schäfer WLA, Shallcross ML, Lambert BL, Huang R, Holl JL, Bilimoria KY, Johnson JK. Evaluating the implementation and effectiveness of a multi-component intervention to reduce post-surgical opioid prescribing: study protocol of a mixed-methods design. BMJ Open, 2019 June;9:e030404. doi: 10.1136/bmjopen-2019-030404.

Khorfan R, Shallcross ML, Yu B, Sanchez N, Parilla S, Coughlin JM, Johnson JK, Bilimoria KY, Stulberg JJ. Preoperative patient education and patient preparedness are associated with less postoperative use of opioids. Surgery, 2020 May;167(5):852-858. doi: 10.1016/j.surg.2020.01.002.

Schäfer WLA, Stulberg JJ. Addressing (over)prescribing of opioids in surgery. Am J Surg, 2020 July. doi: 10.1016/j.amjsurg.2020.07.021

Shallcross ML, Stulberg JJ, Schäfer WLA, Buckley BA, Huang R, Bilimoria KY, Johnson JK. A mixed-methods evaluation of clinician education modules on reducing surgical opioid prescribing. Journal of Surgical Research, 2021 January. doi:

 Health Disparities


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