The authors' proposition to use "common work environment metrics to improve performance in healthcare organizations" is a concept that has merit and whose time has come. Like all good ideas, however, it remains only a good idea until it is acted on and implemented successfully. Healthcare organizations are complex. That complexity must be accounted for in efforts to implement common metrics as a tool to incent fundamental change. The change management challenge is all about the quality of leadership in health organizations: the vision and visible commitment of senior leaders; the determination to support the transformation with effective accountability mechanisms; and the will to solve the limitations of front-line leadership capacity.

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