Performance data elements of concern, incidents/sentinel events, new regulatory requirements, new technology, medical advances, low volume/high risk procedures, etc. are systematically reviewed, staff competency training is regularly planned and delivered to 100% of staff (ideally in actual patient situations) considering the special attributes of patient populations served (if applicable), and the impact of the training is tracked. A comprehensive team member communication and engagement plan is developed and followed, incorporating at minimum rounding on all shifts, monthly staff meetings, staff involvement in planning and quality improvement activities, recognition events, performance and career coaching, and cascade learning from hospital leadership meetings, and bulletin boards.