Purpose for the program: To enhance the utilization of "chain of command" principles in resolving every day issues.

Proposed change: At Baylor All Saints Medical Center, we re-invented the terminology for "chain of command" to be more appropriate and updated.  Our new term, "chain of resolution", more effectively describes what staff members and leaders are doing when activating a process to quickly resolve issues and concerns regarding patient care and safety, environmental needs, equipment issues, as well as a myriad of other possibilities.

Implementation, outcomes and evaluation: Leaders and frontline staff came together to rewrite policy, develop clinical vignetters for scenario-based teaching, and to roll out education to all employees of Baylor All Saints.  Managers, directors and vice presidents were trained on using the vignette teaching vehicle.

Implications for nursing practice: Staff and leaders have a better understanding and williingness to use the "chain of resolution" process after the implementaion of "chain of resolution".  The "chain of resolution" process is easily utilized by varying sizes of hospitals and other healthcare settings, such as surgery centers, and is an excellent fit for any geographic location.

Keywords: chain of resolution