In 2004, Donald Berwick, a doctor and the CEO of the Institute for Healthcare Improvement, had some ideas about how to save lives--massive numbers of lives. The institute he led had analyzed patient care applying the analytical tools used to assess the quality of cars coming off a production line. Berwick and colleagues discovered the "defect" rate in health care was as high as 1 in 10, meaning that only 90 percent of patients received their antibiotics in the right dose at the right time. This was a shockingly high defect rate. Other industries had managed to achieve performance at levels of one error in 1,000 (and often far better). Berwick knew the high medical defect rate meant that tens of thousands of patients were dying every year, unnecessarily. Berwick's insight was that hospitals could benefit from the same rigorous operational improvements that had worked in other industries. Berwick's ideas were so well-supported by research that they were essentially indisputable. Yet nothing was happening. And he certainly had no ability to force any changes on the industry. Often, big changes like those Berwick was contemplating seem paralyzingly distant. In public education, the behavior patterns of teachers, administration, parents, and students are sufficiently entrenched that any change proposal quickly encounters resistance. In this article, the authors outline a game plan for overcoming resistance to change in a school district.