The Leadership Chapter has been revised for all accreditation programs as part of The Joint Commission’s regular standards renewal process, whose principal goal is to ensure that standards remain current. With respect to the Leadership standards, The Joint Commission has undertaken several parallel initiatives that have resulted in additional standards and a major reordering of the chapter. The chapter includes four sections: Leadership Structure, Leadership Relationships, Organization Culture and System Performance, and Operations. The revised Leadership Chapter will be effective January 1, 2009.