One measure of the degree of engagement of staff is the volume of testing of improvement ideas that was conducted. The thirteen pilot units tested 533 innovations over four years—an average of 41 per unit. Testing was done across all four TCAB domains. At the end of the pilot period, unit managers at the hospitals reported that 71 percent had been sustained and were still in place. Many of the innovations focused on improving efficiency or increasing the value of care. Examples include adoption of new end-of-shift reporting methods and work to speed and better coordinate the discharge process among physicians, nurses, housekeeping, and other departments.