We examine how organizations select some routines to be changed, but not others, during organizational search. Selection is a critical step that links an exogenous trigger for change, change in individual routines, and larger processes of organizational adaptation. Drawing on participant observation of an initiative to improve perioperative efficiency in seven Ontario hospitals, we find that organizational roles shape selection by influencing both politics and frames in organizational search. Roles shape politics by defining the role-specific goals of the people who have authority to change a routine. Organizations will not select a routine for change unless at least some elites—people with role-based authority—frame the existing routine as negatively affecting their role-specific goals. Roles also shape individuals’ frames. Because people are only partially exposed to interdependencies between routines in their day-to-day work, they may not be fully aware of the diverse impact that an existing routine can have on their goals. Proponents for change can use strategic framing to focus attention on interdependencies between routines to get elites to better see how an existing routine negatively affects their goals. They can also change elites’ goals by using strategic framing to focus attention on new and broader goals that the change in routine would promote.