In JAMA Surgery, Mila Jiu and colleagues, including Charles Bosk, compare surgical site infection (SSI) monitoring systems, discrepancies in their implementation, and their relationship to infection rates. The researchers compared the National Health and Safety Network (NHSN), which is required by most states, and the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), which is not. The study looks at how the NHSN or ACS NSQIP was implemented in 16 hospitals. It also observes rates of colon SSIs at these same hospitals. The data were collected by surgical clinical reviewers, who tracked the rates of SSI by using hospital-reported data and on-site monitoring. The authors find that the two monitoring systems have important differences and are implemented differently. The rates of SSI are higher when using ACS NSQIP as a monitoring system. Additionally, NSHN has marked variation in implementation between hospitals. The authors conclude that in order to increase efficiency and avoid duplicate data, one reliable method of SSI monitoring should be established.