Abstract
Healthcare has been transformed over the past few years: the economic crisis, demographic change, increased expectations of users, significant progress in the treatment of patients, continuous increase of scientific knowledge and skills, etc., factors that provide great opportunities and major challenges for the healthcare system as a whole. The article present provides interesting insights on how one may be an agent of change, and not just a spectator, thanks to the theoretical analysis of concepts such as leadership and clinical governance, and their practical application in the context of Sardinia.