Developing a consistent, whole-school approach to numeracy is often built on predictable curriculum pathways and sustained student engagement. In hospital education, however, these conditions rarely exist. Students arrive with diverse educational experiences and complex health needs, enrolments can be brief and unpredictable, and a child's capacity to engage in learning may change from day to day. At the previous HELP conference, we introduced the Numeracy GIFT (Gap Identification Formative Toolkit), an instructional game-based diagnostic assessment designed to quickly identify mathematical gaps when students enter our program. The next challenge was supporting teachers to respond effectively, translating assessment data into meaningful learning experiences that could be delivered immediately, regardless of the circumstances. In response, we developed the Teacher GIFT Playbook, a whole-school framework designed to help teachers move confidently from identifying need to delivering targeted instruction. Organised around the Big Ideas in Number, the Playbook provides a shared language for teaching while recognising that every student's learning journey is unique. It offers teachers immediate access to evidence-informed learning sequences, engaging activities, and practical teaching strategies aligned to specific points of need. Designed for the realities of hospital education, the framework reduces planning time while enabling teachers to provide responsive, high-impact learning experiences that can be adapted to each student's health, engagement, and length of stay. This presentation will explore the development and implementation of the Teacher GIFT Playbook and reflects on what it means to build consistency in a setting defined by change. While utilised at YYRCHS for Numeracy, this framework could easily be adapted to any curriculum area. We will discuss how a shared instructional framework can support both teacher confidence and student success, creating continuity of learning while remaining flexible enough to respond to the medical, emotional, and educational needs of every child.