But simply changing leadership’s view of front-line staff or changing hospital culture to embrace a culture of improvement will be insufficient. One of the lessons we draw from the TCAB experience is that improvement must be institutionalized in the day-to-day work of the front-line staff, with adequate time and resources provided and with front-line staff participating in decision making. The experience of Magnet hospitals and of units engaged in TCAB provide concrete models of hospital- and unit-level organizations and processes to accomplish this. Increasingly, there are organized vehicles for promoting these models, including the Magnet accreditation program, IHI and AONE plans to promote TCAB models in their ongoing work, and the RWJF’s ongoing support of this program at the state and national levels.