Change is all around. Healthcare professionals are constantly being urged to do more with less. Nurses are being asked to exert transformational leadership and assume responsibility for the design of caregiving processes and environmental structures [1]. Improving quality isn’t just a preoccupation of nurses working in acute care, but also of those concerned with public health [2]. If you accept the challenge of trying to exert transformational leadership, the question remains: How do you go about doing this? One strategy, I would recommend, is to consider clustering excellence.

The business sector was the first to talk about cluster-based development. Porter [3] noted that innovation thrived in a culture of collaboration which featured shared leadership and organizational flexibility. If you have a critical mass of expertise, you can build on existing strengths, create new combinations, play off of each other’s ideas, and seize opportunities not available to lone agents. Silicon Valley computing and Vermont cheese making were put forward as areas that thrived because there was such cross-pollination of efforts. It wasn’t a matter of one high-tech company or one dairy doing well, but of similar or related businesses using their collective advantage to accomplish more than any one of them could on its own.