After over ten years of quality improvement and quality and safety software development at Hey Clinic, Dr. Hey discussed the idea of sharing what he and his team had been learning with a group of surgeons.  These conversations led to a series of conference calls and then a grant application to the Pediatric Orthopedic Society of North America (POSNA).  POSNA approved the grant to implement 3Greens to a group of 11 surgeons around the United States.  A feasibility and effectiveness study was designed by Prof Ivy at NCSU School of Industrial Systems Engineering and two graduate students.  The pilot showed a significant improvement in teamwork and team dynamics during the course of the six month study.  Additionally, based on their individual and group outcomes during the trial period, all of the surgeons and their teams desired to continue use of 3Greens.