Al Duke brings over 20 years of emergency department experience from staff nurse to department director. He has served in all capacities in the ED at both urban academic settings to smaller community hospitals. In addition, Al has faculty appointments at Loma Linda University School of Medicine and School of Nursing, providing interdisciplinary education in Leadership and Statistics. Dedicated to patient safety and quality care, Al contributed to the development of core competencies in emergency nursing in partnership with the Emergency Nurse Association and published on this work. He has also presented both locally, nationally, and internationally on TeamSTEPPS, simulation, the use of Lean/Six Sigma strategies, patient safety, clinical decision-making, human factors, and emergency care. Al currently works for BETA Healthcare Group, in his role, he provides risk management and patient safety expertise to member organizations.  Al is very active in the Emergency Nurses Association, where he sits on the ENA national Advocacy Advisory Council and is the President-elect for the California State Council of ENA.    Al received his Bachelor of Science in Nursing at Loma Linda University and Masters in Business Administration from the University of Phoenix. He is currently working on a doctorate in leadership and system design at Loma Linda University. Additional certifications include Certified Emergency Nurse, Certified Professional in Healthcare Risk Management, Certified Professional in Patient Safety, Lean Six Sigma Black Belt, Master TeamSTEPPS Trainer, and continues to evolve in Just Culture and Human Factors concepts.