This case reveals the importance of business analytics and process data to nurture organizational excellence and continuous operational improvement. The organization in focus is a paradigmatic example of a data-driven health care organization with outstanding worldwide levels of excellence. In 2005, the organization faced various challenges: it was increasingly difficult to improve donation rates (due to fewer traffic accidents and aging population) and the system exhibited large variations in observed performance (some hospitals could not replicate other’s ability to find donors). In contrast to manufacturing contexts or simpler service deliveries in the case of organ donation and transplant, the appraisal of performance is complex and subjective as (1) some factors are not controllable (e.g., patient’s age, medical background, relative’s propensity to consent) and (2) some processes are not fully observable (e.g., surgeon deciding not to accept an organ, judge not allowing a donation to take place). As a result, performance metrics are hard to define and realize in practice. The case can be used as part of an operations management core or courses related to business analytics, service delivery or data science.