Healthcare providers world-wide are discovering how simulation modalities in clinical care settings change practice behaviors. Not only must new behaviors result in improved and safer patient care, but the investment of limited resources must prove worth the tangible and intangible outcomes. This paper presents an Organizational Change Management (OCM) framework used by two healthcare provider systems (one government and the other private) to satisfy this dual imperative—to improve healthcare quality through physical simulation; then prove its value. The first example involves the US Department of Veterans Affairs (DVA) hospital in Durham, NC. To meet current American Heart Association (AHA) guidelines for resuscitation, the DVA used an OCM framework to guide physical simulation efforts during the rollout and implementation of three, necessary changes: 1) a stroke code emergency policy; 2) use of new emergency code carts; and 3) intraosseous needle (IO) use for cardiac arrest patients. The OCM framework positioned grassroots stakeholders to increase adoption and sustained commitment by role-playing emergency response situations requiring decision-making. The second example involves a healthcare system in Birmingham, AL with an objective to reduce central line blood infections in intensive care units at local hospitals. This healthcare system also implemented a comprehensive value stream measurement methodology which generated six types of quantitative and qualitative metrics to prove the value (including Return on Investment (ROI)) of quality care and patient safety culture change initiative. Both the OCM framework and the ROI value stream evaluation methodology assisted with planning and proving the value of simulation to support organizational and behavioral change initiatives as well as address organizational education and training requirements.