Strategic change principles are widely cited in business and healthcare management literature, but not in the surgical quality improvement literature despite the need for effective change management skills to successfully enable quality improvement projects. The Ottawa Hospital (TOH) Comprehensive Unit-Based Safety Program (CUSP) model within the Division of General Surgery applied strategic change management principles to support the development and implementation of surgical quality improvement initiatives. Using the TOH CUSP experience, we aim to provide insight and a practical example for surgeons seeking to drive quality improvement within their practice environment.