As I mentioned last fall, we manage our continual service improvement program quarter by quarter: each quarter we select certain critical projects, and then as we have time we "pick up" other work and add it to our list.

Separate but related to this concept of quarterly improvement "releases," we have also created a "semi-annual governing document review." Twice a year we get several relevant staff members together to review our "governing documents"--our policies, standards, and procedures. We don't make major changes, but we make sure that everything makes sense together, uses the latest template, etc.