When planning for a new facility, expansion or major renovation, many of the expected benefits depend on various operational, organizational and technological improvements. Implementation of an electronic health record (EHR) provides the clearest example. While it’s possible to successfully implement a decentralized nursing model in a new building while still using a paper chart, preceding transition to an EHR makes success far more likely. Delays in these initiatives place the new facility at risk of failing to meet its operational, financial or competitive objectives. Transition planning—a detailed operational assessment and redevelopment completed shortly before a new facility opens—eases the transition, reduces risks associated with changing complex processes and identifies and mitigates any assumptions that the new building may have been based upon but that no longer match the institution’s operational reality. Change is difficult. Change in health care, with its multiple stakeholders and their divergent interests, brings even greater challenges.