McLaren Oakland Hospital is a 278 bed hospital in the city of Pontiac Michigan. Our hospital joined the HMS collaborative in 2011. Our HMS team includes Dr F. Salloum as physician champion, Karen Krenke as our quality adminitrative lead and Paula Gazete as the clinical data abstractor. Drs Tong and Doyle are also involved with the HMS-related work. / We have implemented the following quality improvement intiatives related to HMS to improve the quality of care for hospitalized medical patient. Physician notification of patient refusal of VTE prophylaxis, and Physican completion of VTE risk form at patient first hospital encounter. We are presently working on care of the low risk patient.