The health system should maintain a program to evaluate and fund QI ideas from front line care givers. These would be detailed proposals directed to either process or quality. For example, a physician might propose an evaluation of the use of dexmedetomidine for delirium in the ICU, evaluating cost savings and morbidity. An RRT might suggest a different staffing model to deal with transports of ventilated patients to improve efficiency. An RN might suggest the approach that stops UTIs. The health system would provide resources to conduct the study and provide ethical oversight, which is especially needed for cost containment protocols.