Told from the perspective of ninety administrative and staff nurses, it serves as a model for change in similar institutions everywhere. Key Features: Provides 'real world' system-level description of hospital-wide change initiated and implemented by nurses committed to safe quality patient care; Serves as a roadmap for institution-wide change for aspiring nurse leaders, including values to support, tools to develop or use, resources to be managed, key personnel to employ, and more; Offers nurse executives an array of catalytic ideas they can adapt to their own settings; Acts as a model for administrators and students who are interested in seeing how change occurs in complex systems through personal engagement at all levels