The purpose of this article is to review the problems and processes impacting the deviation in first-case actual start times when compared to first-case scheduled start times. This article will also discuss the Continuous Outcomes Measurement and Improvement Technique (COMIT) model for problem resolution and share the experiences encountered by a group of collaborative nurse manager leaders in their outcome improvement efforts. The overall process improvements are discussed using the eight-step COMIT model, which showed the overall success of the project.