There are also a number of other programs and collaborations measuring surgical quality using clinical data. These include but are not limited to the Society of Thoracic Surgeons (STS), the Michigan Surgical Quality Collaborative (MSQC), the Surgical Clinical Outcomes Assessment Program (SCOAP) from Washington State, and the New York State Adult Cardiac Surgery program. Like ACS NSQIP, each program has unique strengths and weaknesses. The STS and the New York State Adult Cardiac Surgery program focus on cardiac and thoracic surgery and therefore collect risk-adjustment variables and outcomes specific to those operations. MSQC and SCOAP are regional programs that offer hospitals within a state an opportunity to work together on quality improvement initiatives.