The pharmacy department of a large research hospital had recently completed a major accomplishment that changed the way they did business, and several more change initiatives on the horizon were all tied specifically to improving patient safety. Many of their nurses and pharmacists were resistant to the changes because it caused them extra steps on the front end.  By introducing a new way of dialoguing, with leadership actually listening to their concerns, they were able to inspire and motivate active involvement in ensuring success of current initiatives and more involvement in future initiatives.  Leadership provided a more coordinated approach to strategic planning and action planning.  For the first time in the history of the Department, people in line positions were brought in to engage in planning.  The impact was energizing to the workforce and resulted in new levels of consensus around the mission.  New insights arose, which had significant cost saving implications.  They discovered new ways of including the nurses going forward and addressing their concerns.  They found new ways of streamlining business processes, while also increasing job satisfaction and fulfillment by giving the lowest paid level of the workforce more responsibility and to eliminate assumptions about them being overwhelmed.  A social network map was created of a recent major accomplishment, showing the actual system involved in this initiative–several hundred people!  It was surprising for the leadership, and the workforce, to see the far-reaching scope of the system that organized itself to achieve this major change.  The map reflected who worked with whom, who the key players were, where the single points of failure were, and was a major point of learning and incorporating insights going forward.  Besides aligning the team, this consulting engagement created new ways of interacting, not just between leadership and the workforce, but across the Pharmacy, Nursing, and IT Departments, the hospital patients and other external stakeholders.