Leadership is cited as a critical success factor in virtually every publication on complex change. What is not as frequently described are the perspectives, strategies and behaviours that are required to effectively lead initiatives involving multiple independent entities in complex systems. A recent study by Starfield Consulting was designed to determine exactly that. The goal was to pinpoint common characteristics and behaviours of leaders who had successfully implemented complex change in public service and healthcare systems. Research interviews were conducted with 40 leaders who each had successfully led a change initiative involving multiple organizations, jurisdictions or highly siloed functions within an organization.