Hospital accreditation is a new concept for Hong Kong Hospital Authority hospitals. Queen Mary Hospital has been engaged as one of the hospitals in a territory-wide Pilot Scheme of Hospital Accreditation. In preparation for accreditation, Queen Mary Hospital has undergone the process of self-assessment, staff engagement, and service improvements which all require well-planned strategies to achieve successful outcomes. In this article, we highlight the journey of preparation and the staff engagement exercise we conducted to attain full accreditation. We also highlight the obstacles, conundrums, and pitfalls we encountered, along with successful overcoming strategies and countermeasures we adopted, and quandaries to be avoided. Throughout the preparation, the hospital’s senior executives insisted that achieving hospital accreditation was not the main focus, but rather an emphasis on how the Pilot Scheme would bring about organisational transformations in our culture, and thus foster quality, safety, effectiveness, and reliability of services. We hope our experience can provide a reference and be of value to other hospitals that will go through the journey in the future.