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USR
A diagnostic metric measuring the proportion of available feedback signals that fail to produce institutional update. USR = 1 - (Updates Implemented / Feedback Events Received). High USR indicates systematic suppression: the institution receives signals but doesn't change.
A hospital receives 500 incident reports annually and implements changes in response to 50. USR = 0.90 (90% of feedback is suppressed). The hospital is learning-active but update-suppressed.
ILA-ALR Section 3.1