Geographical distribution of American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) participating sites. Geographical distribution of American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) participating sites. Number of sites by state, region and country included in the January 2013 NSQIP semi-annual report. Reprinted by permission of ACS NSQIP. Melinda Maggard-Gibbons BMJ Qual Saf 2014;23:589-599 Copyright © BMJ Publishing Group Ltd and the Health Foundation. All rights reserved.