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In December 2004, Donald Berwick, Managing Director, President and CEO of the Institute for Healthcare Improvement (IHI), challenged US hospitals to reduce unnecessary deaths by 100,000 within the following 18 months. By the end of this 18 month period, over 3,100 hospitals enrolled in the ''100,000 Lives Campaign'', representing more than 70 percent of US hospital beds. Calculations estimated that approximately 123,000 preventable deaths were avoided in participating hospitals. The case describes the state of quality in the healthcare industry, the history of the IHI, and the IHI''s efforts to bring modern quality practices to health care. After seeing pockets of improvement, the IHI launched the 100,000 Lives Campaign in an effort to stimulate large scale change. The campaign approach incorporated lessons from political campaigns and social activism. The operation of the campaign is described. The impact of the campaign on hospitals is also discussed, with particular emphasis on one hospital that used the campaign as the basis for fundamental transformation.