Although the identification of problems might be helpful, merely understanding what causes organizational stasis does little to resolve matters. Instead, an organization’s participants need a sense of how to overcome barriers to reform. In what follows I offer five strategies for enabling change to occur that I observed at the institutions I visited. Again, the solutions proffered here are not to be thought of as mechanistic solutions to structural dilemmas. Organizational life is not an equation in search of a proof. Instead, decision-makers need to think about the dynamics of an institution and how particular responses might be developed that enable action within the organization’s culture.