HMS held its November Collaborative Wide meeting on November 13, 2018 at Eagle Eye Golf and Conference Center in Lansing. We reviewed data of our current HMS initiatives (VTE-retired, PICC/Midline, Antimicrobial), as well as our new 2019 Performance Index. Dr. Jonathan Segal, a Nephrologist from Michigan Medicine joined us to give a presentation titled, "Hemodialysis Vascular Access". We also had a 1.5 hour interactive session that was broken out into three sessions - VTE, PICC, and Antimicrobial. Each session had presenters from some of our participating hospitals sharing whats working for them: VTE-Ann Ruffulo, St. Joseph Ann Arbor Abstractor, Dr. David Paje, Michigan Medicine Hospitalist; PICC-Dr. Gary Salem, McLaren-Lapeer Region, Alicia Cummings, McLaren-Lapeer Region Abstractor; Antimicrobial-Jason Pogue, PharmD, DMC Sinai Grace, Matthew Bondi, PharmD, Sparrow, and Lisa Dumkow, PharmD, Mercy Health Saint Mary's. The VTE session focused on how to leverage the EMR within the hospital, the PICC session focused on PICC eGFR and nephrology, and the antimicrobial session focused on antimicrobial stewardship. We also had a very successful poster session with 14 posters from our hospitals being presented with their work using HMS data.