This chapter addresses many requisite elements of the doctor of nursing practice (DNP) essentials and answers a variety of practice questions. In the world of always-competing priorities, ever-increasing complexity, and persistent uncertainty, how do organizations manage to stay on track, move forward, evolve, and even succeed? The chapter explores the answers to these and other questions that arise when observing organizations, both large and small. It discusses a sample organizational framework that allows nurse executives and managers to lead and stay on course. The chapter introduces the concepts of strategy, alignment, organizational planning, executing, and monitoring as well as provides sample tools for accomplishing these important leadership functions. It then looks at capital budgeting, projects feasibility, evaluation, and selection and provides a sample model for financial decision making. Although the concepts and tools contained herein are widely applicable to many industries, the chapter concentrates on nursing services and nursing education.