Traditional reference service at the Creighton University Health Sciences Library/Learning Resources Center has been transformed into a vibrant, information dissemination system. Maintaining routine reference skills and developing new ones is standard practice. The furious pace of demand for information, and the growing "technicalness" of information retrieval, have been met by a diversified approach: plenty of hands-on-teaching, proactive outreach, and customized assistance to individual customers as well as to entire departments. Constant review, evaluation and adjustment keep this system from crashing. On-going training, and support from the entire staff keep the library's approach invigorated and its outlook fresh. The paper describes the development and improvement of the library's reference services since the founding of the library in 1977; bibliographic instruction; lunchtime learning sessions and guest speakers; reference requests by e-mail; reference department use data; and staff cross-training. Photographs of library facilities and staff are provided. (Author/SWC)