As a community gaining considerable attention for approaching the goal of ending homelessness, Medicine Hat provides an important case study through which to examine the evolution of system planning approaches following Housing First. This case study relies on qualitative data from 18 key stakeholder interviews to elicit information about key learnings highlighting Medicine Hat’s evolution as a community working to end homelessness using a system planning approach. Five key learnings were identified:

1. Shared community ownership;
2. The right people, at the right time;
3. A focus on data, performance and continuous improvement;
4. An intentional community-wide system planning approach; and
5. A nimble coordinating body.

Rather than proving whether or not Medicine Hat has indeed ended homelessness, this chapter discusses the dynamics involved in on-the-ground processes of implementation involved in social change.