When health service executives and professionals are asked to explain what outcomes are being achieved by the provincial and territorial health systems across Canada, the reply is usually rhetoric and platitudes, but with little evidence. The reality is we do not have the ability to define what we accomplish that costs approximately 44 per cent of the provincial and territorial budgets. This course explores the concepts of accountability and governance in detail. The collective goal is to better explain what the health systems are producing as tangible outcomes. Servant leaders are called to communicate with the communities and populations they serve with integrity and honesty and to serve their patient/client/resident needs as best they can, based on the organization's values and strategy, as well as the customer's expectations.