Developing alternative health care delivery systems that successfully meet the needs of multiple consumers in a cost-efficient manner is essential. Minor revisions of long-standing programs are frequently inadequate in the face of escalating demands for a more efficient health care system. The SSU Observation Area has met the primary objectives by providing a quality, cost-efficient alternative to the use of existing inpatient and emergency department services. Alternatives, such as the SSU, require three major components to succeed: A risk-taking environment. Innovative nursing leaders, especially at the department head level. Staff nurses who demonstrate flexibility, enthusiasm, and pride in expanding their professional roles. The SSU was not developed without difficulty or some conflict. As the program was developing, full-time night coverage was not warranted so an on-call system was used. Increased use of the SSU resulted in the on-call person frequently being called in rather than just occasionally being called. Staff discontent grew as this continued. Additional night staff were added and use continued to increase, which ensured financial viability. Nursing leaders are developing alternatives in every setting. As we learn from each other, the opportunities for change grows.