DIANE L. DIXON is managing principal of D. Dixon & Associates LLC, specializing in health care leadership and organizational development. She also has taught leadership and organizational behavior for the business of medicine program at Johns Hopkins University and holds a doctorate in human resource development from George Washington University, Washington. Does your long-term care organization need change? For instance, is your nursing home stuck in the old institutional model? Are you thinking about how you might lead that change? Are you pondering what it will take to do so? There is no quick prescription or handy tool kit for making yourself into a leader who can overcome an organization's inertia. But there are useful guidelines for developing the skills required for leading change. To start, the emphasis should be on looking to see if you're ready to be a change leader. Are you ready to lead change? A good place to begin is with introspection about your willingness to embrace new ways of thinking about yourself within the context of your long-term care organization. Before getting much further, it's important to make sense of change semantics. The use of words and phrases related to organizational change can cause confusion. “Leading change,” “change agent,” and “culture change” are not jargon, but they're sometimes misused or overused. Then, they become clichés that lose the power of their meaning. But these terms do have real significance in long-term care and health care delivery overall. Are you a medical director who, as part of the leadership team, feels responsible for improving your organization's care of residents overall? Are you a director of nursing who sees the need to improve care quality at several levels of the organization? Are you a nurse practitioner who wishes to facilitate dialogue among all the people working in your nursing home about how to improve teamwork? Are you an administrator who embraces change and understands that the organizational culture is influenced by your leadership? Are you a department manager or neighborhood coordinator who sees himself or herself continuously working with others to discover new ways to deliver quality care? Are you a consulting pharmacist who wants to be an active participant on an interdisciplinary team? Introspection and reflection are the foundation for leadership development. It's essential that you be willing to engage in these processes and accept that the first thing needing change could well be you. It is important to look through this individual lens to understand your potential leadership role in long-term care. This then can move you to develop your personal capacity to lead and forge the vital relationships required for a collective commitment to change within your organization. Leadership development requires assessments of both your inner capacities and your abilities to lead others. The two sets of self-assessment questions that I've developed are based on the work of David V. Day, PhD (Leadership Quarterly 2000;11:581–613). Your answers to the questions listed on this page may create a framework for getting started on the journey to leading long-term care change. Reflecting on the questions and taking time to answer them honestly is the groundwork for your leadership development plan. As you begin, consider your vision for your organization. The effort will lead you in the right direction for your personal development plan. Focus on your strengths and how you can further enhance them. The areas for growth you identify aren't weaknesses. They're opportunities for learning and development. Start by focusing on a few critical competency areas that will make a significant difference in your ability to lead change. Here are some suggested components of your plan: ▸ Goals: Make them specific, measurable, attainable, realistic, results oriented, and time focused. ▸ Strategies: Action plans, with time frames, used to achieve goals. ▸ Critical relationships: Interactions you'll need with mentors, coaches, partners, and others who can provide support. ▸ Accountability: Details of how you will hold yourself accountable for completing the plan. ▸ Indicators of Success: Methods of determining the impact of achieving the goals. Thinking about leading change in long-term care can be daunting in the midst of competing priorities. But don't let that hold you back at a time when the field needs leadership and change more than ever. Moving forward with your own development as a leader will help make the effort manageable and fulfilling. What's important is getting started.