The document discusses the healthcare outcomes improvement engine as the best way to ensure sustainable and scalable change. It describes the engine as having four key components: 1) engaging executives, 2) prioritizing opportunities, 3) adequately staffing initiatives, and 4) communicating success early and often. Effective engagement of executives is needed to launch improvement work through strategic vision and prioritization of goals. Standardized processes for prioritizing opportunities based on data ensure resources are focused on initiatives with the highest return. Teams dedicated to improvement initiatives and communication of successes helps drive engagement and scale outcomes improvement efforts across the organization.