Having a commitment to continuous improvement is an essential characteristic for effective department leadership (Lees et al. 2009). The process of making changes, both incremental and sweeping, that generate better outcomes, increased satisfaction, or enhanced efficiency is an expectation we have for our academic leaders. Promoting an agenda for improvement plays out differently based on a number of parameters, including whether the administrator is new or a veteran in the position, whether the individual was an internal or external hire, the current condition of the unit, and the resources available to the individual.