Over half of patients at a rehabilitation hospital reported wanting greater involvement in their care decisions. To address this, the hospital conducted patient and family shadowing where observers followed patients to experience care from their perspective. This identified themes like explanations during rounds and involvement in discharge plans. A post-intervention survey found a statistically significant improvement in patients feeling involved in care decisions and clinically relevant improvements in understanding doctor explanations and recommending the hospital. Engaging medical leaders and balancing data with reflection time led doctors to change practices without formal rules.