 Good morning everyone and thank you Joe and Ariana for this opportunity to give a commitment announcement. My name is Bill Wilson. I'm the Chief Medical Officer at the University of California Irvine Medical Center. We're the only academic medical center in Orange County. You're in the middle of Orange County and we have 3.4 million people here. We have the only level one trauma center, the only NIH designated cancer center, the only comprehensive digestive disease center. We were Orange County's first comprehensive stroke and cerebral vascular center. We have received American Heart Association Gold Plus achievement and Honor Roll Elite Plus designation for the last three consecutive years because of a lot of hard work. We have achieved nine consecutive straight A's from LeapFrog and are designated for meritorious achievement from NISQIP, the National Surgery Quality Improvement Program, along with Stanford only one of two academic medical centers so distinguished. We have many patient safety and quality achievements to be proud of but I'm here today and most proud of our commitment to the Patient Safety Movement Foundation and our mutual goal of zero preventable deaths by 2020. I'm also humbly here to acknowledge the great work of our team. We have done a lot of work together in order to become the first academic medical center to achieve the five star hospital ranking within the Patient Safety Movement Foundation of Committed Hospitals and there are more than 4,700 hospitals globally in this group. So we achieve this distinction through teamwork commitment from the leadership to frontline caregivers and the stated goal from our CEO Rick Junada who will be here with us later today had another commitment earlier this morning but he'll be with us later today. In his words we would like to be the safest hospital to give care and the safest hospital to get care. That resonated with us and that's been our commitment and this has been evidenced by our specific commitment to achieve zero preventable deaths by 2020. We're on a journey to become a high reliable organization really in all segments of patient care. Part of the safety architecture that UCI Health has used and that has helped propel us to this five star status has been our mission to fully engage the staff in the culture of safety and we chose four major pillars of work to improve the safety culture. The first pillar is team steps. This is the and you've heard about it in this meeting and many of you are using this but it's as you know an evidence-based set of teamwork communication tools developed by the Agency for Healthcare Research and Quality, ARC. It's aimed at optimizing patient outcomes by improving communication and teamwork within hospitals. The second pillar for engaging our team has been the development and now implementation of a just and accountable culture algorithm. This algorithm is a transparent system for evaluating every breach in patient safety that occurs so when we correct a patient safety event we ensure that the staff is feeling free to report issues without any fear of retribution. The third pillar is our patient safety and quality crosswalk. This crosswalk provides a visual illustration of the alignment between the CMS conditions of participation, the other publicly reported safety and quality ranking systems. It's essentially a large spreadsheet that I think as was said in the last segment we talked about being data rich but maybe insight poor still so what we've done is we put all of this together in a way that makes it simpler for all of our rank and file doctors, physicians, and nurses to understand where we are and where we need to be moving from what was a lot of red to yellow to now a lot of green. So finally the fourth and really most important pillar is the patient safety movement foundation itself and our commitment to zero preventable deaths by 2020. So beyond these foundational principles we have implemented robust patient safety solutions apps in our hospital for each of the patient safety movement foundation challenges. We are proud that in 2018 we saved 16 lives with these processes but this is just the beginning. Furthermore we continuously searched for ways to improve patient safety and clinical outcomes. One recent initiative was launched just six weeks ago on December 3rd 2018 when we began reporting out at our daily patient safety and quality huddles how many days since the last breach in hand hygiene as well as how many days since the last event that was a preventable harm and we're looking at six harms looking at CLABSI, CAUTI, CYTH difficile, falls, hospital-associated pressure injuries, and venothrombolic events. So we have how many days since the last event some of our wards have had more than a thousand days since they've had one of these events and then we also call out how many how many days since a breach in hand hygiene and as soon as there is one of these events there's a small huddle on the ward where it occurred do a mini RCA and then the next day at the patient safety and quality huddle they report it out and then these lessons that were learned are now brought to the other team members. So whenever there is a breach in one of these processes a patient is at risk of becoming harmed and we are committed to avoiding these events. So this is really just one example of the many patient safety initiatives that we have focused on in order to reach zero preventable deaths in our hospital. So I'd really like once again to thank Joe and Ariana for their leadership and insights and the opportunity to share this with you today.