Leaders at Niagara Falls Memorial Medical Center (Memorial) recognized there was room for improvement in meeting the healthcare needs of the Greater Niagara community, especially when considering new federal health care policies that are taking effect. Excessive readmission rates of heart failure patients will result in financial penalties beginning in late 2012 and customer satisfaction scores have the potential to impact the government reimbursement levels that individual hospitals receive. Memorial reached into the continuous improvement toolbox in 2010 with the aim of improving its ability to heal patients.