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Cleveland Clinic nursing leadership  feedback from staff nurses to improve care escalation after a caregiver engagement survey revealed they did not always feel comfortable escalating care when they recognized patient deterioration. Leaders convened 241 nurses at 15 hospitals within the system and asked them four open-ended questions. Based on feedback, nursing leaders ensured a clear escalation pathway existed in every unit within the system. They prioritized timely escalation of care by ensuring they had the correct protocols, policies and procedures in place. Leaders stressed open communication and ensured front-line nurses knew leaders supported them. The following year, scores related to the ability to challenge the decisions and actions of those with more authority improved. (Cleveland Clinic , 7/25/25)