MSQC Shark Tank Application
This brief form has been designed to collect complete entries to the MSQC Surgical Shark Tank Competition. Submissions with the most innovative and impactful ideas to improve the quality of surgical care will be selected to present their proposal at the 2017 MSQC Conference, at Boyne Mountain Resort, for a chance to win $8,000 to support their project.

For more information visit: www.msqc.org/conference or contact us at MSQCCustomerSupport@med.umich.edu

Project Lead Information
The project lead will be considered the main point of contact for communications regarding this submission.
Hospital Name
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Name
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Phone
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Email
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Other Key Collaborators
Add all other team members to be included on submission updates. Please use the ENTER key to separate each member.
Names
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Affilliations
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Emails
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Project Details
Give an overview of your project to include goals/aims.
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Provide details of how you plan to accomplish the overall goals/aims.
Your answer
Estimated steps/milestones/timeline to reach patients.
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Anticipated total budget and outline of what a prize of $8,000 will allow you to accomplish.
Your answer
Explain what is unique about your project. If it is competitive to any existing product or service, please describe how your project compares.
Your answer
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