The Michigan SIREN Collaborative (MI-SIREN) is organized around a strong network of research universities and hospitals with long-term successful collaborations. MI-SIREN includes 2 previous NETT hubs (Wayne State University (WSU) and Henry Ford Health Systems). MI-SIREN encompasses a hub and 8 primary spokes situated within 7 sizeable health care systems. MI-SIREN is affiliated with five major research universities, Wayne State University, Michigan State University, University of Michigan, University of Virginia and Oakland University. MI-SIREN accounted for over 940,000 ED annual visits in 2019 and 2020. MI-SIREN incorporates eight designated ST elevation myocardial infarction (STEM) centers, seven level 1 trauma centers, four Children’s hospitals, three certified burn centers, and three level 1 pediatric trauma centers. MI-SIREN has the capacity to provide the diverse population of critical patients required for SIREN. MI-SIREN incorporates innovative enrollment and retention practices like a three-tiered enrollment, designated duties, and shared employees which reduces errors and increases enrollment. MI-SIREN has tight collaboration with EMS divisions in metropolitan Detroit, Ann Arbor, Grand Rapids, and Charlottesville, Virginia and has performed multiple Exception From Informed Consent (EFIC) studies. MI-SIREN is the third highest enroller in the current SIREN Network with exceptional quality metrics. MI-SIREN provides access to nearly the entire population of Detroit, MI, approximately 680,000 with 82% African American, and 49.8% living below the poverty level. MI-SIREN will build upon our exemplary subject recruitment by leveraging shared resources, making strategic investment into spokes, and expanding capacity. MI-SIREN will support, engage, and train the next generation of diverse clinical scientists. MI-SIREN will encourage faculty to enrich SIREN leadership and actively pursue grant proposals utilizing the SIREN network. MI-SIREN offers a pipeline for SIREN grant submissions through our expert faculty. MI-SIREN has a proven record of engaged high quality performance of clinical trials.