Why now? Why are we focusing on transformational leadership? Healthcare costs continue to rise. Some of the critical issues and active debates prevalent in many hospital organizations include rapidly increasing healthcare costs, cuts in funding and reimbursement, and concern about the overall quality and safety of healthcare. “Health systems are under pressure to improve performance and manage productivity” (Botting, 2011). To be successful in the 21st century, health systems need to have vision and executive and clinical leadership that can inspire the change process and make the difference between success and failure in change. In this time of transition and uncertainty, research suggests that transformational leadership is highly effective (Straight, 2006). Leadership research has shifted from emphasizing leaders' competence in “managing change” to the ability to “transform” organizations. Transformational leaders have attributes and behaviors necessary to successfully motivate and empower employees. According to Bernard Bass (1990), transformational leadership occurs when a leader transforms, or changes, his followers in three important ways that together cause followers to trust the leader, perform behaviors that contribute to the achievement of organizational goals, and be motivated. to perform at a high level. Transformational leaders can achieve better performance by stimulating innovative ways of thinking and transforming followers' beliefs and aspirations. Maxwell (Maxwell, 2007) states that, in most cases, influence is more important than power or formal authority. I agree with him. Influence is very important at the organizational level and co...... halfway through the document to share the vision. Organizational Dynamics, 19-31.Botting, L. (2011). Transformative change in action. Nursing Management, 17 (9), 14-19.Chapman, A. (2012). Situational leadership. Retrieved January 22, 2012, from Businessballs.com: http://www.businessballs.com/slanalysis.htmCole, M. B., & Tufano, R. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, New Jersey, USA: Slack Inc. Maxwell, J. C. (2007). The 21 irrefutable laws of leadership. Nashville: Thomas Nelson.Straight, B.J. (2006). Uncertainty: a fruitful place to be. International Journal of Leadership Studies, 2 (1), 88-93. Taylor, R. R., Wook Lee, S., Kielhofner, G., & Ketkar, M. (2009). Therapeutic use of self: A nationwide survey of professionals' attitudes and experiences. American Journal of Occupational Therapy , 63 (2), 198-207.