In the original 100,000 lives campaign, there were over 3,000 hospitals involved. Engaging with such a large community requires serious commitment to organizational change leadership. Berwick's innovation in this area was to introduce ideas from political campaigns into practice. This means carving up areas that need to be changed, just as a politician would tackle the challenge of changing the hearts and minds of voters- by engaging through trained precinct captains, who are given well-defined targets of opportunity, supporting materials, and a cascading series of messages to drive towards a particular outcome in a particular timeframe.

Engaging this network of passionate evangelists that were already embedded at each site (and respected for their thought leadership) become a key tactic in winning the community over. You can have the best ideas in the world, but they still have to effectively communicated, supported with a focussed support infrastructure, deployed with an organized and effective execution plan, and must confront constraints which may prevent their successful execution.