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In 2007, the Martin Luther King, Jr.-Harbor Hospital (MLK-Harbor), which served a large safety-net population in South Los Angeles, closed due to quality challenges. Shortly therea er, an agreement was made to establish a new hospital, Martin Luther King, Jr. Community Hospital (MLKCH), to serve the unmet needs of the community. To assist the newly appointed MLKCH Board of Directors in building a culture of quality, we conducted a series of interviews with ve high-performing hospital systems. In this report,

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faculty should have opportunities to retrain for uncommon procedures (98%, 95% CI: AE2%); that skills attrition is a concerning problem (91%, 95% CI: AE 4.1%); that skills attrition is a patient safety issue (89%, 95% CI: AE 4.5%); that attrition was more likely in academic settings (93%, 95% CI: AE 3.7%); that faculty should be required to demonstrate procedural competence (83%, 95% CI: AE 5.4%). The majority of respondents (73%, 95% CI: AE 6.4%) personally experienced procedural skill attrition and a similar number (68%, 95% CI: AE 6.7%) observed it in peers. The most preferred method for skills maintenance was simulation (83%, 95% CI: AE 5.4%). The most preferred learning environment was in groups with peers (89%, 95% CI: AE 4.5%).Conclusion: A majority of faculty reported skills attrition, both personally and observed in peers. Respondents also overwhelmingly agreed they should be competent to perform procedures for which they are credentialed. These findings raise questions about the need for technical skill competency assessments for continued clinical practice. Faculty preferred simulation-based learning and peer environments for skills maintenance. Further study is needed to determine the attitudes, beliefs, and experiences of non-academic emergency physicians with procedural skills attrition.