The demand for certified nursing assistant (CNA) staff used as 1:1 sitters for safety enhancement and fall prevention can be costly. Through Lean thinking and tools and brainstorming, leaders at Denver Health conceptualized the centralized video monitoring (CVM) program for patient safety. The CVM program reallocated the underutilized talents of CNA sitters as video monitoring technicians (VMT) to meet the challenge of delivering high-quality, cost-effective patient care. Implementing the CVM program required tight connections and collaboration with a multidisciplinary team of individuals. Actual program performance exceeded the initial projected benefits. The CVM program supports the high level of vigilance required by nursing staff to ensure patient safety and quality.