HCA has a strong desire to improve efficiency, reduce waste and generally improve our capitol productivity, get more for our dollars. We along with our Partners are developing methods that serve to support our desires to improve capital productivity. Realizing doing things differently requires significant emphasis from the economic buyers we began issuing change directives titled “Innovation Memo’s”, directing changes in common practices. These directives are distributed to all our partners and they execute on them, bringing about the change. This practice has proven successful.