This document discusses the importance of leadership buy-in and support for process improvement initiatives. It emphasizes communicating with leadership to engage them from day one of implementation through various reporting methods. Quick wins should be leveraged to generate momentum and sustain gains. Leaders are encouraged to participate, provide resources, remove barriers, and celebrate successes, while avoiding compromising integrity or creating "pet" projects. Practitioners should challenge norms, be data-driven, use appropriate metrics, communicate, and be patient.