(Not) the Same Old Story

Make innovation a group activity. Thomas doesn't claim to have all the answers for improving nursing homes. The Eden program gives a framework and some ideas, but individual facilities decide which changes are best to make. Administrators share ideas through Eden's Web site and at get-togethers. Thomas has the same "open source" philosophy about the Greenhouse Project, which involves building homes for small groups of elders. He's sharing his ideas online and letting others build on them. "You can't do it alone," he says.

Expect setbacks. Failure is an inevitable part of the change process. So you'd better be prepared for it, or you won't be able to bounce back. Understand that people are going to get scared and revert back to doing things the old way. Forgive them and move forward -- and expect it to happen again. "Frost always comes," says Thomas. "We've never been wrong on that one."