Funding for health care in Ontario is moving from global funding to equity funding. In the future, hospitals will be reimbursed for how efficiently they care for their various patient populations. The Ontario Case Costing Project (OCCP) was a joint venture by the Ontario Hospital Association and the Ministry of Health. Incentive for participation in this project was based on the need to assess efficiencies in caring for patient populations in surgical suites and to obtain Canadian data. Case Costing has the potential to forecast budgets, identify variances and highlight areas for cost savings. Case Costing can also determine cost per surgeon, cost per service, cost per procedure. The nurses at Markham Stouffville Hospital are empowered to enhance the focus of their practice to include managing human resources, processes and materials. This enhanced focus in the Operating Room maximizes efficiency and effectiveness of processes, and allows the organization to provide better service. This article documents the journey and growth of perioperative nurses toward the destination of case costing. Key to this journey is not only the destination, but the growth and change that occurred and enabled perioperative nurses to effectively champion initiatives such as case costing. Opportunities and Threats, a One Page Plan and our recommended learnings will be shared.