This article discusses management and organizational development lessons learned as the result of an innovative primary health care project (Sitra Project), sponsored by the Ministry of Health, Bahrain. The improvement models commonly referred to as continuous quality improvement (CQI) and human performance technology (HPT) were applied to effect significant improvement in a number of control variables while maintaining or reducing operational costs. The most important lessons are that improvement can be made through CQI and HPT; that participation, empowerment, and accountability are the foundation of success; organizational decisions must be based on relevant data; strategic commitment of top management must underpin improvement must underpin improvement efforts; turfism and threats to power and status can derail change efforts; and the future will always remain uncertain.