 This article discusses the implications of the study by Ten Bensil et al, which examined how different healthcare organizations responded to a new metric design to measure performance in the emergency department. The authors identified seven principles from complexity science that can help guide the design and implementation of metrics. These include acknowledging unpredictability, promoting sense-making, coping with self-organized gaming behaviors, facilitating interdependence, attending to relationships between senior management and front-line staff, using an adaptive research approach, and harnessing conflict productively. The authors suggest that these principles can be used to reduce gaming behavior and instead promote a more positive outcome. This article was authored by Jun Chao Chen.