Tom Mosgaller from the Network for the Improvement of Addiction Treatment (NIATx) discusses the the role of a change leader as both an opportunity and an obligation. An opportunity because we get the change leader to make a positive difference in the lives of the people we serve; an obligation because we have to confront our own freedom and muster the courage to lead the transformation. Mr. Mosgaller's plenary presentation will focus on two critical aspects of being an effective change leader. First, the role of the change leader as torch bearer for the transformation, and second, making sure the gains are sustained. Mr. Mosgaller will draw from his experience as leader in the public, private, and associational world, and the research study just completed by the Center for Enhanced Healthcare Systems Studies (CHESS) at the University of Wisconsin School of Engineering focusing on the critical elements essential to effective improvement initiatives.