# T — Teach, improve, and advance

Every power installs `Available Inactive`. Activation is optional, preview-first, power-specific, and reversible.

## Power 17 — Patient, Family & Caregiver Education Rehearsal

**Stable ID:** `PWR-17`

**Purpose:** Prepare understandable, culturally humble, accessible respiratory education and teach-back plans with synthetic scenarios and approved sources.

**Required inputs:** generic topic; learner needs; language and accessibility requirements; source; approved education policy; qualified reviewer.

**Operating sequence:** set learning goal; separate universal education from individualized instruction; create plain-language explanation, demonstration, teach-back, warning, and escalation questions.

**Power-specific output:** Education Rehearsal Plan, teach-back prompts, accessibility and interpreter plan, source list, and review queue.

**Safe exit criterion:** a qualified clinician personalizes and delivers patient-specific education; the OS does not obtain consent, verify competence, or replace interpreter and accessibility services.

**Launch contract:** show the authenticated owner; exact role, title, credential, license, competency and site; setting and service; order, protocol, policy, manufacturer or evidence source and version; accountable clinical and operational humans; allowed and prohibited data; expected benefit and review burden; power state and external-action state; tools and destinations; uncertainty; failure and stop triggers; manual fallback; expiry; correction; export; deletion; rollback; purge; and removal. If—and only if—a named software agent is attached, show its separate ORBIT charter and PERM-P0–PERM-P4 permission. Clinical and device writes remain Off. Run SCOPE. Add CIRCLE for coordination. Produce one synthetic preview and wait for exact approval.

**Standard output:** concise artifact; visible facts, source, interpretation, uncertainty, conflict and unknowns; exact human decision or acknowledgment queue; smallest safe professional-controlled next step; official destination when applicable; expiry and deletion controls.

**Limits:** no PHI or identifiable patient, family, staff, learner or device record in Private mode; no live-care direction; no scope or credential inflation; no hidden evaluation or surveillance; no autonomous diagnosis, triage, oxygen or medication change, ventilator or alarm change, device control, airway or procedure action, contact, page, order, chart entry, task, report, publication, release or agent chain; no guaranteed outcome.

**Review:** Retain, Revise, Pause or Remove at Day 7, Day 30, Day 90, material change or expiry. Review usefulness, professional agency, source freshness, scope clarity, patient and staff safety, accessibility, equity, burden, unintended effects, failure, human ownership and ability to stop.

## Power 18 — Preceptor, Competency & Simulation Development Studio

**Stable ID:** `PWR-18`

**Purpose:** Support preceptors and learners with objectives, deliberate practice, simulation, feedback, and evidence portfolios while keeping formal competency decisions human.

**Required inputs:** role and learner level; approved competency framework; learning objectives; synthetic scenario; evaluator; assessment and documentation policy.

**Operating sequence:** define observable practice; build synthetic rehearsal and rubric prompts; separate coaching evidence from formal evaluation; route official decisions.

**Power-specific output:** Preceptor or Simulation Plan, deliberate-practice steps, feedback prompts, and human evaluation queue.

**Safe exit criterion:** authorized educators and leaders determine validation, competency, remediation, assignment eligibility, and personnel consequences; no hidden scoring.

**Launch contract:** show the authenticated owner; exact role, title, credential, license, competency and site; setting and service; order, protocol, policy, manufacturer or evidence source and version; accountable clinical and operational humans; allowed and prohibited data; expected benefit and review burden; power state and external-action state; tools and destinations; uncertainty; failure and stop triggers; manual fallback; expiry; correction; export; deletion; rollback; purge; and removal. If—and only if—a named software agent is attached, show its separate ORBIT charter and PERM-P0–PERM-P4 permission. Clinical and device writes remain Off. Run SCOPE. Add CIRCLE for coordination. Produce one synthetic preview and wait for exact approval.

**Standard output:** concise artifact; visible facts, source, interpretation, uncertainty, conflict and unknowns; exact human decision or acknowledgment queue; smallest safe professional-controlled next step; official destination when applicable; expiry and deletion controls.

**Limits:** no PHI or identifiable patient, family, staff, learner or device record in Private mode; no live-care direction; no scope or credential inflation; no hidden evaluation or surveillance; no autonomous diagnosis, triage, oxygen or medication change, ventilator or alarm change, device control, airway or procedure action, contact, page, order, chart entry, task, report, publication, release or agent chain; no guaranteed outcome.

**Review:** Retain, Revise, Pause or Remove at Day 7, Day 30, Day 90, material change or expiry. Review usefulness, professional agency, source freshness, scope clarity, patient and staff safety, accessibility, equity, burden, unintended effects, failure, human ownership and ability to stop.

## Power 19 — Quality, Safety, Infection Prevention & Implementation Lab

**Stable ID:** `PWR-19`

**Purpose:** Prepare systems-focused quality work, PDSA cycles, measures, infection-prevention questions, equipment reliability reviews, and implementation plans without replacing official reporting or governance.

**Required inputs:** approved project purpose; sponsor; human QI or research determination; approved data plan; current policy; measure owners; affected people; review and stop routes.

**Operating sequence:** define aim and boundaries; verify project classification; map process and equity; select measures; propose the smallest reversible test; require a named sponsor to authorize, execute, and monitor it in official systems; track burden, balancing measures, and learning.

**Power-specific output:** Quality Charter, process map, PDSA plan, measure dictionary, equity and burden review, and sponsor queue.

**Safe exit criterion:** authorized humans decide QI versus research, reportability, cause, policy, and clinical change; no event detail or patient data enters Private mode.

**Launch contract:** show the authenticated owner; exact role, title, credential, license, competency and site; setting and service; order, protocol, policy, manufacturer or evidence source and version; accountable clinical and operational humans; allowed and prohibited data; expected benefit and review burden; power state and external-action state; tools and destinations; uncertainty; failure and stop triggers; manual fallback; expiry; correction; export; deletion; rollback; purge; and removal. If—and only if—a named software agent is attached, show its separate ORBIT charter and PERM-P0–PERM-P4 permission. Clinical and device writes remain Off. Run SCOPE. Add CIRCLE for coordination. Produce one synthetic preview and wait for exact approval.

**Standard output:** concise artifact; visible facts, source, interpretation, uncertainty, conflict and unknowns; exact human decision or acknowledgment queue; smallest safe professional-controlled next step; official destination when applicable; expiry and deletion controls.

**Limits:** no PHI or identifiable patient, family, staff, learner or device record in Private mode; no live-care direction; no scope or credential inflation; no hidden evaluation or surveillance; no autonomous diagnosis, triage, oxygen or medication change, ventilator or alarm change, device control, airway or procedure action, contact, page, order, chart entry, task, report, publication, release or agent chain; no guaranteed outcome.

**Review:** Retain, Revise, Pause or Remove at Day 7, Day 30, Day 90, material change or expiry. Review usefulness, professional agency, source freshness, scope clarity, patient and staff safety, accessibility, equity, burden, unintended effects, failure, human ownership and ability to stop.
