Creating organizations with a high IQ or creating organizations without the necessary intelligence guarantees success or failure of the organization. Without structures such as shared leadership and other forms of participative management, the organization or unit cannot access and use the available information and wisdom in the organization. When nurses and other health care professionals do not feel like they have a shared stake and do not feel like citizens of the organization, they lack passion for the organization's work. When nurses feel a sense of share ownnership and autonomy for the clinical practice, terrific outcomes are achieved. Leaders must accept the challenge to build the infrastructure that leads to excellence in organizational IQ.