To uncover the capabilities underlying sustained Operational Excellence, we conducted a multi-year field study across four global banks and three healthcare firms that were similar in size, services, and Operational Excellence investments, but markedly differed in competitive outcomes. The banks werelarge(with total assets of $10 billion or more), multi-business financial institutions with global operations and customer bases ranging from 5.8 million to 22 million, while the healthcare firms were major hospital-based service providers included in Newsweek’sWorld’s Best Hospitals 2023list. This allowed us to compare organizations that looked similar in scale and operational investments but differed sharply in their ability to translate Operational Excellence into competitive advantage. Using customer satisfaction and financial performance metrics (such as J.D. Power ratings, return on assets, and efficiency ratios), we selected firms that ranged from industry laggards to leaders.