This chapter aims to combine traditional approaches to analyzing narratives with strategies for using them to change organizational culture; introduce the concepts of emergent design and appreciative inquiry as a framework for uncovering and disseminating an organization’s core narrative; and describe several innovative organization-level activities that used emergent design and appreciative inquiry narratives to change the culture of a large medical school. Indiana University School of Medicine (IUSM) is currently the largest medical school in North America. In January of 2003, the Relationship-Centered Care Initiative (RCCI) was launched, with an audacious goal: to change the culture of the school and reverse some of the negative trends it had been experiencing over the past decade. Relationship-Centered Care is an expanded form of patient-centered care, which focuses on including the values, attitudes, and preferences of patients as they seek and receive care.