Book excerpt: The quest for cost savings in hospitals and health systems too often prompts leaders to rush to make major cuts in the largest budget line item: staffing and labor costs. Evidence shows, though, that cutting labor expenses, especially in nursing, negatively impacts both quality of care and overall profitability. Faced with cutting costs while continuing to provide extraordinary patient care, nurses at Children’s Hospital of Philadelphia (CHOP) decided to pave a different path. In the process, they created a new model of bedside-driven fiscal responsibility. Nursing-Led Savings shows organizational leaders at all levels how to develop and implement a robust, sustainable plan that eliminates waste and streamlines processes in everyday clinical work. This strategy involves: · Educating frontline staff on the importance of financial stewardship · Using a structured improvement approach to execute cost savings at the bedside · Engaging Nursing Shared Governance councils in implementation and oversight · Prioritizing non-labor expense reduction