disch? >> i'd like to add or civil procedures assume that we should be able to say wash your hands. and yet when you get down to even that simple of a basic which we all know is the number one preventive action you can take, it will becomes complex. you need to leaders that will say we are concerned about the finance but you also need the resources in place but even something as simple as washing your hands, the right equipment, new sinks that are accessible, the soap that is there, housekeeping making sure the soap dispensers are filled, that the position comes with a bunch of equipment, where do they put that down? on the floor? i don't think so. it's such a ripple effect that you need equipment, unique people to understand what's going on. i was going to mention about transparency. staff have to understand what's going on with the metrics. so we can do national promoting. we can do information among hospitals but staff need the feedback that here's our infection rate compares what we're d

disch? >> web minnesota is doing is networks to bring together the sea of to look at what we're doing to have a conversation across institutions that how come your sister doing better than ours and talk among themselves. i said to them how many ceos do you think are changing natalie concerned about finance but also the bottom line? she said it is changing the dial when they sit down and talk to share stories. it is the senior team like medical leadership and that comparison is happening at the state level. >> senator warren we have reduced these dramatically the several hundred hospitals have 10 times the national average with no accountability outside the public reporting their fully accredited and we know they can get at zero. of above to see them start with the infection rates but we have a good measure if he were not download there is no excuses. if your hospital is five there should be a greater sanction. >> let me pick up on a point you know, that there are some hospitals and had the i