Healthcare organizations today need change to improve healthcare quality and safety and reduce costs. In creating and promoting a change vision that is exciting and organizing a strong leadership team, leaders must contend with a number of work settings and workforce factors that make change challenging. This chapter discusses the importance of an exciting team vision for successful organizational change, describes three organizational change conceptual models, and identifies key steps in leading and sustaining organizational change initiatives. It describes barriers and facilitators of systemwide change in an organization and discusses strategies in building a wellness culture, including return on investment (ROI) and value of investment (VOI). Many self-care and self-healing tools are low cost and can significantly and positively affect the work environment.