Barnes-Jewish Hospital, St. Louis, wanted to transform its organization and in turn, transformed its culture into a continuous improvement culture. While the organization had embraced Lean methodology for years, it found that its project improvements were isolated and not always sustained. A multidisciplinary team that included the chief medical officer strategized to figure out how to make continuous improvement part of everyday work for all 9,300 employees. The project included training 500 employees in Lean tools such as 5S, Standard Work, Problem Solving and Managing for Daily Improvement. The intangible results included an increase in trust and teambuilding throughout the hospital and clarified expectations for both frontline staff and leadership. The hospital saw other results too, such as a 26 percent improvement rate in the operating margin and a 23 percent improvement in the turnover rate. Additionally, patient satisfaction and length of stay rates improved. For more information, contact Laurie Wolf, performance improvement/human factors engineer at firstname.lastname@example.org.