Getting nurses and other front-line staff actively involved in efforts to simultaneously improve hospital quality and increase efficiency will require action both within institutions and by those who measure their quality and pay for their services. The models for accomplishing this are still evolving, but the broad outlines for achieving such engagement are clear. The lessons from Magnet accreditation and TCAB should be used as hospitals take full advantage of nurses’ knowledge and commitment to their patients and institutions—to increase the safety and reliability, patient-centeredness, and efficiency of care.