At Kaiser Permanente, design thinking found its way into a relatively risk-averse, data- and evidence-driven healthcare nonprofit. Nevertheless, this is the story of a very pragmatic approach driven by a small enthusiastic team. The initiative's objective was to prove the value of a human-centered approah and build capability using storytelling and training. Accordingly, the projects and the people involved were critical and deliberate. Kaiser Permanente chose projects that featured diversity in locations and business units, a direct impact on customers and front-line staff, and a possibility to share results within and outside the organization. The small team in charge of design thinking considered the sscale-up of the initiative as a design challenge. It was open to adopting other methodologies, including behavior design and behavioral economics, Agile and Lean Six Sigma. The importance of using external communication to fuel an internal fire and gain legitimacy helped to grow the "movement" and the central role of leadership for design-thinking implementations helped to build it into a legitimate trail-blazing practice.