The American College of Surgeons Minimum Hospital Standardization (MHS) Programme was central to its foundation and subsequent growth. Its significance was second only to the election of Fellows. At its centre was the monthly staff meeting. In the 1920’s it formed the basis of several Clinical Quality Registries (CQR). It evolved into the Joint Commission on Accreditation of Hospitals, now the Joint Commission. The development of MHS overlapped the years before the foundation of the College of Australasian Surgeons. It was well known to both surgeons and governments. Between 1920 and 1927 the Medical Journal of Australia included over 20 related articles arguing that if ‘possible in America, it must be possible in Australia’. The four month visit of its Director, Malcolm MacEachern, in 1925 commenced only three weeks after the letter was sent to potential College Founders. His visit has been overlooked. In 1928 the College Council wrote state premiers suggesting MHS be adopted across Australasia. The letter reflected that the MHS was part of the then College constitution. There is no record of a reply. Devine spent a month at the Mayo in late 1924 and the monthly staff meeting, led by William Mayo a long term member of the MHS committee, had a profound effect. Devine was there at the same time as James Learmonth who introduced the same staff meetings on his return to the Edinburgh Royal Infirmary. These meetings evolved into the Australian and New Zealand Audit of Surgical Mortality, which thus has a direct linage to the MHS. Given the current interest in Australian CQRs, the College’s upcoming Centenary is an appropriate time to reappraise a missed opportunity and so fulfill the aims of its Founders.