In the United States and many countries around the world we are encountering the limits of our change strategies. Linear thinking and hierarchical structures have led to what has been termed by Don Berwick, in a recent talk at Harvard University that I attended, as “the bankruptcy of change.” We cannot intensify our linear thinking and hierarchical structures and expect to achieve innovative and creative change. Using such an approach leads to the trap of efficiency and improvement by inspection. These approaches result in ever increasing micromanagement, leading to a fear based climate fostering widespread disengagement. What does it mean to move away from a linear thinking model within a hierarchy? For starters, it is imperative to take the time to set up an infrastructure that allows for multilevel and cross-functional teams at every level that are built on trust and collaboration. Taking time to establish this infrastructure upfront allows the benchmarks to be achieved at a much faster pace than teams who set up a proforma infrastructure in order to be efficient and rush to full implementation. Over and over again, I have seen the former far outpace the latter, although initially the proforma organizations appear more productive. On another level, trust and collaboration allow for leadership to be widely distributed throughout the organization and decisions to be made at the point of execution. This style of organization could be called leading together with the result being innovation, a positive experience of change, and successfully achieving benchmarks. The good news is that once this type of change has begun, small changes can, and often do, have a big impact.