In the face of complex change, IH commissioned Intelligent Futures in 2022 to commence work on their first ever Climate Change and Sustainability Roadmap. Co-created with staff, physicians and external partners, including representatives from Aboriginal communities, local government, and municipalities in the Interior region, Intelligent Futures guided the project team towards creating a cohesive overarching strategy to population-based climate action and internal corporate sustainability. The roadmap builds on direction from the provincial government, action already taking place within IH, and the increasing impacts of climate change on the region. Through a suite of guiding principles, goals, and 20 comprehensive actions, a practical, effective strategy has been developed to strengthen Aboriginal partnerships, build a healthy and resilient health-care system, and support climate adaptation in BC’s Interior communities amongst a team of committed individuals. This positions IH at the forefront of how health authorities can evolve to meet the new realities of the climate crisis.