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When emergency department employees at Atlantic General Hospital in Berlin, MD, pledged to treat incoming patients in 30 minutes or less, they ran into an unexpected challenge: A success rate of higher than 90%. "We purchased a lot of gift certificates to be given to patients when we didn't meet the service guarantee," says Colleen Wareing, vice president of patient care services at the 62-bed acute care facility. "Since we were doing so well, we decided to give the gift certificates to the associates, because they're the ones that are making this happen. Every time we get 95% or above, we draw 50 names and give them the gift cards each month."