This article uses two dominant traditions in the organizational study of schools--the neoinstitutional and faculty workplace approaches--to explain an urban elementary school's response to the Texas Accountability System. The findings indicate that teachers, guided by an institutional logic, sought to create the appearance of test score improvement by using a constellation of "educational triage" practices. Educational triage was manifest in the diversion of resources to students believed to be on the threshold of passing the Texas Assessment of Knowledge and Skills ("bubble kids") and to "accountable" students (those affecting the school's accountability rating). Teachers also attempted to remove any liabilities to the school's rating by referring these students for special education. To explain why teachers participated in educational triage, the author shows how the equation of good teaching with high test scores by the institutional environment and the district reconstituted both teacher professional identities and teacher-teacher relationships. (Contains 1 figure and 24 notes.)