This chapter presents two evidence-based practice (EBP) scenarios that depict how the success of a project can be impacted by external and internal organizational pressures. Understanding an organization's priorities and strategic goals is paramount in the success of projects, whether large or small. Applying evidence to a practice change focuses on improving processes that will lead to desired outcomes. Continuous improvement of the systems and processes is achieved through use of the plan-do-study-act (PDSA) cycle. These strategies are the foundation of modern-day quality improvement. A number of factors contribute to developing a high-reliability healthcare organization. These factors include leadership commitment, effective communication, interdisciplinary teamwork, standardized processes, and a structure for process improvement. EBP supports standardized practice, which leads to decreased cost and improved patient outcomes. EBP projects should align with organizational goals and be inclusive of all stakeholders in defining the problem as well as creating the solution.