In 2001, executives at Banner Health (a large hospital system with corporate offices based in Phoenix, AZ) proactively responded to external forces, emphasizing improvement in the quality and safety of patient care in hospitals. Organized under the umbrella of care management, 11 functional teams, ranging from process improvement and patient safety to clinical innovation and population health management, were created to achieve this goal. Initially focused on improvement with core measure metrics, these teams and their related work groups (focused on more task-specific work) initiated their plan in 20 facilities in seven states and supported local implementation of recommended changes that were grounded in evidence-based medicine. With 2 years of experience with this process, Banner Health began a 3-year journey from 2004 to 2006 to reach upper-quartile performance in select clinical quality metrics. A retrospective account of the experience follows.