The introduction of a treasury management system (TMS) is a strategic milestone—especially for organizations in the healthcare and non-profit sectors, where processes are often particularly complex and regulated. In this roundtable, we join Katja Steinkühler, Head of Treasury at Alexianer, to provide insights into the reality of a TMS project: What challenges arose? What factors were crucial to its success? And what lessons can be applied to other organizations? Look forward to an open exchange with concrete experiences, practical tips, and honest lessons learned.